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Care for hospitalized patients is challenging due to the complexity of diseases and their respective treatments. In addition, oral changes can alter the evolution and response of systemic conditions and vice versa. So, the dentist's participation in the multiprofessional team is essential to promote comprehensive and more resolute care. Thus, the aim of this article is to report three cases of successful experiences in Dentistry at Hospital Unimed Recife 3. The cases show that the presence of the dentist in a hospital environment can significantly contribute to the integral care of the patient, and this professional is essential in the of oral infectious foci, in the diagnosis and treatment of oral lesions resulting from trauma and other etiologies and in the restoration and / or maintenance of oral health. Keywords: Patient Care Team; Oral Health; Hospital

The aim of this study was to evaluate the frequency of oral mucositis in patients with hematologic malignancies and relating to the cancer treatment and chemotherapy regimen. This was a cross-sectional study with 112 patients with hematologic malignancies treated by chemotherapy. The association between oral mucositis and the variables was performed by Pearson’s chi-square test, considering a 5% error probability. The frequency of oral mucositis was low (25%). Its occurrence was associated with hematopoietic stem cell transplantation (PR = 3.33, 95% CI = 1.60–6.91) and the use of melphalan or methotrexate (PR = 5.26, 95% CI = 2.31–11.95). Some chemotherapy drugs, such as melphalan and methotrexate, are more toxic to the oral mucosa, as well as the chemotherapy regimen prior to hematopoietic stem cell transplantation. Furthermore, the low frequency of oral mucositis may be related to preventive non-pharmacological protocols, like cryotherapy during drug infusion and laser therapy. This result suggests the importance of the oral care to patients with hematologic malignancies undergoing chemotherapy.

Objetivo: Relatar o caso de um paciente com diagnóstico de Síndromeda Imunodeficiência Adquirida (SIDA) e Sarcoma de Kaposi (SK)tendo como sítio primário a cavidade bucal. Descrição do caso: Pacientedo sexo masculino, previamente hígido, apresentou um quadrode astenia, tosse seca, perda ponderal, esplenomegalia e odinofagia.Paciente foi encaminhado para um Hospital Universitário, onde foi realizadoum teste rápido para Vírus da Imunodeficiência Humana (VIH),sendo positivo para o mesmo. O paciente não sabia sobre a infecçãodo vírus e devido ao quadro de imunossupressão severa com contagemde células CD4 de apenas 5 células/mm³e carga viral de 246.441cópias/mlapresentava infecções secundárias à SIDA.No exame odontológico,foi observadauma lesão em palato duro de coloração arroxeada,compatível com SK, tal lesão apresentouum curso rápido einvasivo, comconsequente disseminação da doença.Para determinaro diagnóstico foi realizada uma biopsia incisonal da lesão sob profilaxiaantibiótica, devido ao quadro de imunossupressão do paciente.O resultado do diagnóstico patológico foi de SK. Com isso, o pacientefoi encaminhado para tratamento especializado. Conclusão: O SK frequentementetem como sítio primário a boca, por isso, é importante oconhecimento do cirurgião-dentista sobre esse tipo de lesão para queseja possível a realização do diagnósticoprecoce, no intuito de realizarmedidas terapêuticas necessárias para atenuar os sintomas e melhorara qualidade de vida do paciente.ABSTRACTPurpose: To report the case of a patient diagnosed with Acquired ImmuneDeficiency Syndrome (AIDS) and Kaposi’s Sarcoma (KS) with thebuccal cavity as the primary site. Case description: A previously healthymale patient had asthenia, dry cough, weight loss, splenomegaly, andodynophagia. Patient was referred to a University Hospital, where arapid test for Human Immunodeficiency Virus (HIV) was performed,being positive for it. The patient did not know about virus infectionand due to severe immunosuppression with a CD4 cell count of only5 cells / mm³ and a viral load of 246,441 copies / ml had infectionssecondary to AIDS. In the dental examination, a lesion was found ona hard palate of purplish coloration, compatible with KS, such lesionpresented a rapid and invasive course, with consequent disseminationof the disease. In order to determine the diagnosis, an incisional biopsy of the lesion under antibiotic prophylaxis was performed, due tothe immunosuppression of the patient. The result of the pathologicaldiagnosis was SK. With this, the patient was referred for specializedtreatment. Conclusion: The KS often has a primary site of mouth, soit is important the knowledge of the dental surgeon about this typeof lesion, so that early diagnosis can be made in order to perform thenecessary therapeutic measures to reduce the symptoms and improvethe patient’s quality of life.

Primary manifestations of extraganglion non-Hodgkin lymphoma (NHL) from T-cells in the oral cavity are rare and often difficult to diagnose. Herein, we describe a case of T-cell NHL with a primary lesion on the lip diagnosed with a 25-year-old woman. The patient reported the appearance of the initial lesion on the upper lip, which advanced to the hard palate and oral mucosa. Histological examination and immunohistochemistry were compatible with peripheral T-cell NHL without further specifications. The proposed treatment consisted of six cycles of multiagent chemotherapy. The patient died from complications of the disease before the third cycle of chemotherapy. Understanding the clinical signs of lymphoma is important for the early diagnosis of this disease to avoid aggressive and potentially fatal behavior.

Aim To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers. Methods and results An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%). Conclusions The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed.

This study aims to report a one-session endodontic treatment of a patient with chronic Non-progressive encephalopathy (CNPE). A patient with CNPE attended our postgraduate clinic for patients with special needs. During the anamnesis, the patient's brother, who is his legal representative, reported discomfort with the esthetics of the patient's anterior tooth and that the patient felt discomfort when touching the same dental element. After detailed anamnesis and elaboration of the treatment plan, endodontic treatment of element 11 (upper right central incisor) and coronary reconstruction were performed. Taking care of patients with cerebral palsy is still a challenge in dentistry. This is because care has to be taken when carrying out necessary interventions in these patients. This treatment aims at the positive resolution of their pathological condition and well-being. The possibility of endodontic treatment in a single session makes treatment more humane and less mutilating. Este trabajo tiene como objetivo informar sobre un tratamiento endodóntico de una sesión de un paciente con encefalopatía crónica no progresiva (CNPE). Un paciente con CNPE acudió a nuestra clínica de posgrado para pacientes con necesidades especiales. Durante la anamnesis, el hermano del paciente, quien es su representante legal, refirió malestar con la estética del diente anterior del paciente y que el paciente sintió malestar al tocar el mismo elemento dental. Tras una anamnesis detallada y elaboración del plan de tratamiento, se realizó tratamiento endodóntico del elemento 11 (incisivo central superior derecho) y reconstrucción coronaria. La atención al paciente con parálisis cerebral aún es un desafío en la Odontología. Esto se debe a que hay que tener cuidado al realizar las intervenciones necesarias en estos pacientes. Este tratamiento tiene como objetivo la resolución positiva de su estado patológico y su bienestar. La posibilidad de un tratamiento de endodoncia en una sola sesión hace que el tratamiento sea más humano y menos mutilador. Esse estudo objetiva relatar o tratamento endodôntico de uma sessão em paciente com encefalopatia não progressiva crônica (CNPE). Um paciente com CNPE atendeu nossa clínica de pós-graduação para pacientes com necessidades especiais. Durante a anamnese, o irmão do paciente, que é seu representante legal, relatou desconforto com a estética do dente anterior do paciente e que o paciente sentia desconforto ao tocar o mesmo elemento dentário. Após detalhada anamnese e elaboração do plano de tratamento, foi realizado tratamento endodôntico do elemento 11 (incisivo central superior direito) e reconstrução coronariana. O atendimento ao paciente com paralisia cerebral ainda é um desafio na Odontologia. Isso ocorre porque é preciso ter cuidado ao realizar as intervenções necessárias nesses pacientes. Este tratamento visa a resolução positiva do seu estado patológico e bem-estar. A possibilidade de tratamento endodôntico em uma única sessão torna o tratamento mais humano e menos mutilador.

Introdução: Exercícios domiciliares são uma opção terapêutica acessível para pacientes com doença de Parkinson que apresentam dificuldade de locomoção. Serviços de fisioterapia utilizam palestras e manuais como forma de orientar a prática destes exercícios, mas carecem de avaliar o que está de fato sendo compreendido pelo paciente. Objetivo: Investigar conhecimentos, atitudes e práticas de pessoas com doença de Parkinson sobre um programa de exercícios terapêuticos domiciliares autossupervisionados com orientação em grupo. Métodos: Trata-se de um estudo transversal realizado com pessoas com doença de Parkinson idiopática leve e moderada, em um Programa de referência em um hospital universitário do nordeste do Brasil. Palestras e manual são disponibilizados pelo Programa desde 2012. Foram coletados: dados sociodemográficos, da doença, assistência e hábitos (ficha geral); conhecimentos, atitudes e práticas sobre exercícios fisioterapêuticos do manual (Inquérito Conhecimentos, Atitudes e Práticas) e barreiras associadas à prática (questionário estruturado). Utilizou-se o software BioEstat 5.0 para estatística descritiva e testes de associação, p ≤ 0,05. Resultados: Foram avaliados 28 pacientes (63 ± 7,4 anos) com tempo de diagnóstico médio de 4,5 (± 2,1) anos e maior prevalência do estágio HY 2 (71,4%). A maioria frequentava o Programa há pelo menos 1 ano (85,7%), era sedentária (60,7%) e relatava como principais entraves para a realização de sessões de fisioterapia a dificuldade financeira (92,8%) e de locomoção (53,6%). A adesão às palestras de fisioterapia foi de 60,7%. A maioria apresentou conhecimentos (60,7%) e atitudes (96,4%) adequados, entretanto, práticas inadequadas (53,6%) acerca dos exercícios terapêuticos domiciliares autossupervisionados orientados em grupo. Conclusão: Programa autossupervisionado requer maior disciplina dos pacientes e apenas orientar em grupo e distribuir manual podem não ser suficientes. Estratégias de acompanhamento semanal para motivação e suporte às dúvidas podem ser necessárias.

To evaluate the use of the network of oral health services by children and adolescents with leukemia, according to the phase of cancer treatment, type of dental treatment received, and access barriers.An exploratory cross-sectional study carried out in a referral hospital in cancer in northeast of Brazil, with all children and adolescents (3-16 years old) with leukemia who used dental services and who attended the medical consultation in the outpatient clinic between March and August 2016. The analysis of the medical records and a structured interview with caregivers were performed. The majority who used only the specialized network were in a single phase of cancer treatment (49.1%), had oral mucositis treatment (79.2%), and had a time of displacement for oral health services greater than 40 minutes (92.6%). In addition, dental care was centered in the specialized network (76.8%) and during hospitalization (37.7%).The findings suggest that the oral health care of these individuals is centered on tertiary care, reflecting a deficiency in communication between the network services, as well as the nonrecognition of the basic network as a caregiver source by its users. Despite this, more research is needed.

Crianças e adolescentes com leucemia podem apresentar manifestações bucais que interferem no tratamento antineoplásico. Desta forma, faz-se necessária a utilização regular da rede de serviços de saúde bucal para o restabelecimento e/ou manutenção da saúde bucal. Pesquisas que avaliem determinantes do uso desta rede são escassas neste público. Esta dissertação avaliou a utilização da rede de serviços de saúde bucal por crianças e adolescentes com leucemia, segundo características socioeconômicas e demográficas dos cuidadores, de organização dos serviços odontológicos, de condição de saúde e de percepção de saúde bucal e necessidade de tratamento odontológico. Trata-se de um estudo transversal exploratório abrangendo todas as crianças e adolescentes com leucemia entre 03 e 16 anos que compareceram à consulta médica no ambulatório do Centro de Onco-hematologia Pediátrica do Hospital Universitário Oswaldo Cruz da Universidade de Pernambuco no período entre março e agosto de 2016. Os dados foram coletados mediante análise do prontuário contendo informações sobre a doença e realização de entrevista estruturada dirigida aos cuidadores das 80 crianças e adolescentes, sendo registrados em um formulário de pesquisa. Em seguida, os dados foram analisados no programa SPSS versão 22.0. Dentre os achados, ser do sexo feminino, não trabalhar, não ter renda mensal e receber benefício social foram as principais características demográficas e socioeconômicas dos cuidadores das crianças e adolescentes com leucemia que utilizaram a rede. Também, renda familiar per capita < R$ 220,00 e > R$ 220,00 estava presente naquelas que usaram a rede pública e particular, respectivamente. Ademais, a maioria das crianças e adolescentes que utilizou algum SSB da rede tinha cuidadores que acharam necessário o tratamento odontológico. Além disso, a maioria que utilizou apenas a rede especializada estava em uma única fase do tratamento oncológico (durante o internamento), realizou tratamento de ferida e teve um tempo de deslocamento entre a residência da criança/adolescente e os serviços de saúde bucal maior que 40 minutos. Esta pesquisa se torna relevante por gerar informações que possam servir para o planejamento de políticas ou programas que estimulem a utilização da rede de maneira mais integral e resolutiva. Entretanto, são necessários estudos com a participação de mais centros de referência em oncologia pediátrica para confirmação dos nossos achados. Children and adolescents with leukemia may present oral manifestations that influence in the antineoplastic treatment. Thus, it is necessary to use the dental care network regularly for the restoration and / or maintenance of oral health. Research that evaluates factors associated with the use of this network is scarce in this public. The aim of this dissertation was to evaluate the use of the dental care network by children and adolescents with leukemia, according to the socioeconomic and demographic factors of caregivers, the organization of dental services, health condition and oral health perception and the need for dental treatment. It is an exploratory cross-sectional study, covering all children and adolescents with leukemia between the ages of 3 and 16 who attended the outpatient clinic of the Center for Pediatric Onco-hematology at the Oswaldo Cruz University Hospital of the University of Pernambuco between March and August 2016. Data were collected by analyzing the medical record containing information about the disease and a structured interview conducted for the caregivers of 80 children and adolescents, being recorded in a research form. After, they were analyzed in the SPSS program version 22.0. Among the findings, being female, not working, not having monthly income and receiving social benefit were the main demographic and socioeconomic characteristics of caregivers of children and adolescents with leukemia who used the network. Also, family income per capita R$ 220,00 was present in those that used the public and private network, respectively. In addition, most children and adolescents who used some SSB from the network had caregivers who found dental treatment necessary. Furthermore, the majority who used only the specialized network were in a single phase of oncological treatment (during hospitalization), performed wound treatment and had a time of displacement between the child's home / adolescent and the oral health services greater than 40 minutes. This research becomes relevant for generating information that can be used to plan policies or programs that stimulate the use of the network in a more integral and resolutive way. However, studies with the participation of more reference centers in pediatric oncology are necessary to confirm our findings.

The condylomata acuminata is a benign epithelial neoplasm induced by papillomavirus, and it is characterized by the proliferation of stratified squamous epithelial tissue that affects the anogenital and oral mucosa. It is considered to be a sexually transmitted disease and has a higher prevalence in individuals infected with human immunodeficiency virus. Various therapies have been used for the removal of lesions, such as cryotherapy, surgical laser and surgical excision, which are painful and scarring. These techniques, however, do not eliminate the virus and relapses are common shortly after treatment. The use of immunomodulators has been proposed to be an alternative treatment, as imidazolquinoline has been shown to be effective in the treatment of lesions in the anogenital region. However, its use in the oral cavity has been the subject of few reports in the literature. Thus, the objective of this study is to describe a case of warts in the labial mucosa of an HIV positive patient using imidazolquinoline 5%.

This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: (“dental care/utilization” OR “dental health services/utilization”) AND (child OR “child, preschool”) AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária.

Introduction: Individuals undergoing onco-hematologic treatment present higher risk for developing oral and/or systemic infections, due to the intense immunosuppression and compromise of the mucosal barriers during treatment. The aim of this study was to identify the fungal and viral oral infections that most frequently affected patients undergoing onco-hematologic treatment in a University Hospital, and relate them to the biopsychosocial data, underlying disease and treatment. Methods: This was a crosssectional study in which descriptive analysis of the data was performed, and the Exact Fisher test was applied to verify the association between the infections and the variables: sex, age group, educational level, underlying disease and treatment, considering a 5% probability of error. Results and Discussion: The clinical exam revealed that oral candidiasis was present in 8.92% of the individuals, and herpes simplex, in 4.5%. No significant associations were found between the variables and infections. The fungal and viral oral infections were little prevalente in individuals with hematologic neoplasms in the present study, suggesting that the action of dental surgeons in caring for the onco-hematologic patients at the Institution evaluated and the protocols use were efficient.

The induced colorectal carcinogenesis in rodents has a long history and currently uses the substances 1,2-dimethylhydrazine and azoxymethane. Objective: The aim of this study was to compare the inductive effect of the substances azoxymethane and 1,2-dimethylhydrazine in colorectal carcinogenesis. Method: 30 randomly chosen male Wistar rats were divided into four groups. G1 group was treated with 1,2-dimethylhydrazine and C1 was its control group; G2 group was treated azoxymethane and C2 was its control group. The animals were weekly weighed until euthanasia, when their intestines were removed, processed and analyzed by an experienced pathologist. Results: Among the control groups (C1 and C2) no histologic changes were observed; moderate dysplasia was detected in G2 group; hyperplasia, mild dysplasia, severe dysplasia and carcinoma were observed in G1 group. When this study compared the cost of the substances, 1,2-dimethylhydrazine was more than 50 times less expensive than azoxymethane. Conclusion: Azoxymethane is able to promote histological changes consistent with colorectal carcinogenesis. 1,2-Dimethylhydrazine produced neoplasia and dysplasia, and, compared to the azoxymethane, was more efficient in the induction of colorectal cancer. Resumo: A carcinogênese colorretal induzida em roedores tem longa história e utiliza, atualmente, as substâncias 1,2 dimetil-hidrazina (DMH) e azoximetano (AOM). Objetivo: Comparar o efeito indutivo das substâncias AOM e DMH para o câncer colorretal (CCR). Método: 30 ratos Wistar machos foram randomizados em quatro grupos. O grupo G1 foi inoculado com DMH, o grupo C1 foi seu controle; G2 recebeu o AOM e C2 foi seu controle. Os animais foram pesados semanalmente até a eutanásia, quando tiveram seus intestinos retirados, processados e analisados por um patologista experiente. Resultados: Os animais dos grupos de controle apresentaram tecido colorretal normal e os animais do grupo G2 apresentaram um padrão de displasia moderada. Nas lâminas do grupo G1, foram encontradas regiões de hiperplasia, displasia leve, displasia grave, e carcinoma. Comparado o custo das substâncias AOM e DMH, este último teve um preço mais de 50 vezes menor ao do AOM. Conclusão: AOM é capaz de promover alterações histológicas compatíveis com a carcinogênese colorretal. DMH produziu neoplasia e displasia grave e, comparada ao AOM, foi mais eficiente na indução do câncer colorretal. Keywords: Colorectal cancer, Experimental model, Carcinogenesis, Azoxymethane, 1,2-Dimethylhydrazine, Palavras-chave: Câncer colorretal, Modelo experimental, Carcinogênese, Azoximetano, 1,2-Dimetil-hidrazina

Resumo O objetivo desta revisão integrativa da literatura foi analisar estudos publicados entre 2006-2016, disponibilizados em português, inglês ou espanhol, sobre fatores associados à utilização dos serviços de saúde bucal pela população pediátrica entre 0 e 15 anos. Foi realizado um levantamento nas bases de dados Lilacs e Medline, utilizando a estratégia de busca: (“dental care/utilization” OR “dental health services/utilization”) AND (child OR “child, preschool”) AND NOT adult. Para análise da qualidade metodológica, utilizou-se o Critical Appraisal Skill Programme (CASP) adaptado e o Agency for Healthcare and Research and Quality (AHRQ). Destacam-se como preditores do uso: fatores da criança ou adolescente (idade, frequência de escovação, condições crônicas), do cuidador (escolaridade, percepção da saúde bucal do filho, necessidades bucais referidas), do dentista (disponibilidade à noite e nos finais de semana) e o acompanhamento da saúde bucal pela equipe de saúde da família. Estes fatores são inerentes ao planejamento de políticas ou programas em saúde bucal na população pediátrica, entretanto, variam de acordo com o contexto em que se inserem. Portanto, uma análise contextual é necessária. Abstract This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: (“dental care/utilization” OR “dental health services/utilization”) AND (“child” OR “child, preschool”) AND NOT adult. To analyze the methodological quality, the adapted Critical Appraisal Skill Programme (CASP) and the Agency for Healthcare and Research and Quality (AHRQ) were used. The following predictors of use of dental health services stood out: factors associated with children or adolescents (age, frequency of tooth brushing, chronic conditions), caregivers (schooling, perception of child's dental health, perceived oral health needs), dentists (availability at night and on the weekends) and follow up of oral health by the family health team. These are inherent factors for the planning of oral health policies or programs for the pediatric population. However, these factors vary according to the context, and therefore, a contextual analysis should be conducted.