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Objectives/hypothesis The accurate diagnostic assessment of clinically relevant human papillomavirus (HPV) infections in patients with head and neck squamous cell carcinoma represents an urgent unmet medical need. The aim of this study was to determine feasibility, accuracy, and clinical significance of HPV16/18 E6 oncoprotein detection on cytological specimens from oropharyngeal squamous cell carcinoma (OPSCC) and neck lymph node metastasis of SCC from unknown primary tumor (CUP) via a protein immunochromatographic assay. Study design Cross-sectional study. Methods Cytological specimens from primary tumor and neck metastases were collected from 34 patients with OPSCC or CUP and applied to a lateral flow format test that detects HPV16 and HPV18 E6 oncoproteins. E6 oncoprotein positivity or negativity in these specimens was compared to the specimens' "HPV-driven" reference status, defined by presence of HPV-DNA in combination with p16INK4a overexpression and/or HPV E6 seropositivity. Results Eighteen of 29 OPSCC (62%) and three of five CUP (60%) were HPV-driven according to our reference method. The E6 oncoprotein lateral flow test had a sensitivity of 94% (95% CI: 70%-100%) and a specificity of 100% (95% CI: 66%-100%) on primary tumor, and a sensitivity of 88% (95% CI: 64%-99%) and a specificity of 100% (95% CI: 74%-100%) on neck metastases. Test agreement between the E6 lateral flow test and the clinical reference method, HPV-DNA plus p16INK4a was excellent, both for primary lesion and neck metastases. Conclusions We found the detection of HPV16/18 E6 oncoproteins to be a feasible, highly reliable, and low-invasive method to assess "HPV-driven" status in OPSCC and CUP. Level of evidence II Laryngoscope, 131:1042-1048, 2021.

Immediately after a disaster, such as a flood, wildfire or earthquake, networks might be congested or disrupted and not suitable for supporting the traffic generated by rescuers. In these situations, the use of a traditional fixed-gateway approach would not be effective due to the mobility of the rescuers. In the present work, a double-layer network system named LoRaUAV has been designed and evaluated with the purpose of finding a solution to the aforementioned issues. LoRaUAV is based on a WiFi ad hoc network of Unmanned Aerial Vehicle (UAV) gateways acting as relays for the traffic generated between mobile LoRaWAN nodes and a remote Base Station (BS). The core of the system is a completely distributed mobility algorithm based on virtual spring forces that periodically updates the UAV topology to adapt to the movement of ground nodes. LoRaUAV has been successfully implemented in ns-3 and its performance has been comparatively evaluated in wild area firefighting scenarios, using Packet Reception Ratio (PRR) and end-to-end delay as the main performance metrics. It is observed that the Connection Recovery and Maintenance (CRM) and Movement Prediction (MP) mechanisms implemented in LoRaUAV effectively help improve the PRR, with the only disadvantage of a higher delay affecting a small percentage of packets caused by buffer delays and disconnections.

Made available in DSpace on 2015-08-06T16:14:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-04-01. Added 1 bitstream(s) on 2015-08-06T16:44:29Z : No. of bitstreams: 1 S1807-25772013000200002.pdf: 366511 bytes, checksum: ef8b1f1ad0a438b5691f20e438c0cfe3 (MD5) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) INTRODUÇÃO: A dor é definida como uma experiência desagradável, sendo o controle da dor pós-operatória um grande desafio na área da saúde. OBJETIVO: Comparar a eficácia da dipirona e do paracetamol no controle da dor pós-operatória após exodontia de terceiros molares inclusos. MATERIAL E MÉTODO: Foram selecionados 30 pacientes da Disciplina de Cirurgia da Faculdade de Odontologia de Araçatuba - UNESP, que necessitavam extrair os terceiros molares inclusos. Desses, 15 receberam dipirona (Grupo I) e outros 15 receberam paracetamol (Grupo II) no pós-operatório. Todos os pacientes foram tratados, no pré-operatório, uma hora antes do procedimento cirúrgico, com dexametasona 4 mg e amoxicilina 1 grama. A intensidade da dor foi avaliada pelos pacientes por meio de escala visual analógica, em um período pós-operatório de 48 horas, em intervalos de 6 horas. Os critérios de exclusão foram: presença de desordens sistêmicas, hipersensibilidade medicamentosa, gestação, lactação e contraindicações locais. Os escores obtidos foram submetidos ao teste de Mann-Whitney (α = 0,05) para comparação das intensidades de dor em intervalos de 6 horas, nas 24 horas iniciais, nas 24 horas finais e no período total de 48 horas. RESULTADO: Não houve diferença estatística entre os analgésicos estudados nos intervalos de 6 horas; entretanto, nas 24 horas finais e nas 48 horas totais de observação, o Grupo I apresentou valores médios menores, estatisticamente significantes, quando comparado ao Grupo II. CONCLUSÃO: A eficácia analgésica da dipirona foi superior à do paracetamol. INTRODUCTION: The pain is defined as an unpleasant experience, and control of postoperative pain a great challenge in healthcare. OBJECTIVE: To compare the efficacy of Dipyrone and acetaminophen in postoperative pain after third molar surgery. MATERIAL AND METHOD: Thirty patients of the Discipline of Surgery of School of Dentistry of Araçatuba - UNESP, that needed to extract their third included molars, were selected. Among these, 15 received Dipyrone (group I) and the other received acetaminophen (group II) in the postoperative. All patients were treated pre-operatively with dexamethasone 4 mg and amoxycillin 1 g, one hour before surgery. Pain intensity was evaluated by a visual analogue scale by forty eight hours postoperative period and in intervals of six hours. The exclusion criteria were: presence of systemic disorders, drugs hypersensitivity, pregnant, lactic and local contraindications. The scores obtained were submitted to the Mann-Whitney test (p < 0,05) for comparison of the pain intensity in the 6 hours intervals, in the initial 24 hours, in the last 24 hours and in the total period of 48 hours. RESULT: There was no statistical difference among the analgesics in the 6 hours intervals, however, in the last 24 hours and in the total period of 48 hours, the group I presented smaller medium values, significant statistically, when compared to group II. CONCLUSION: The analgesic efficacy of dipyrone was superior to paracetamol. UNIARA - Centro Universitário de Araraquara Clínica Integrada e do Mestrado em Implantodontia USC - Universidade Sagrado Coração Cirurgia e Traumatologia Bucomaxilofacial e Fisiologia I e II UNESP - Univ Estadual Paulista Faculdade de Odontologia Cirurgia e Traumatologia Bucomaxilofacial Escola de Odontologia de Cuiabá Especialista em Implantodontia UNESP - Univ Estadual Paulista Faculdade de Odontologia UNIC - Universidade de Cuiabá Disciplina de Cirurgia e Traumatologia Bucomaxilofacial UNESP - Univ Estadual Paulista Faculdade de Odontologia Departamento de Diagnóstico e Cirurgia UNESP - Univ Estadual Paulista Faculdade de Odontologia Cirurgia e Traumatologia Bucomaxilofacial UNESP - Univ Estadual Paulista Faculdade de Odontologia UNESP - Univ Estadual Paulista Faculdade de Odontologia Departamento de Diagnóstico e Cirurgia

The aims of this investigation were to review the clinical behavior of deep neck infections (DNIs) treated in our institution in order to identify the predisposing factors of life-threatening complications and propose valuable recommendations for management and treatment. A total of 365 adult patients with DNIs were retrospectively identified. One-hundred and thirty-nine patients (38.1%) underwent surgical drainage. Overall, 226 patients (61.9%) responded effectively to intravenous antimicrobial therapy only. There were 67 patients (18.4%) developing life-threatening complications. Diabetes mellitus (odd ratio 5.43; P < 0.001) and multiple deep neck spaces involvement (odd ratio 4.92; P < 0.001) were the strongest independent predictors of complications. The mortality rate was 0.3%. Airway obstruction and descending mediastinitis are the most troublesome complications of DNIs. In selected patients, a trial of intravenous antibiotic therapy associated with an intensive computed tomography-based wait-and-watch policy may avoid an unnecessary surgical procedure. However, about one-fourth of patients present significant comorbidities, which may negatively affect the course of the infection. In these cases and in patients with large or multiple spaces infections, a more aggressive surgical strategy is mandatory.

The aim of the present investigation is to evaluate the outcome after induction chemotherapy and concurrent multi-drug chemoradiotherapy (IC/CCRT) with or without post-chemoradiation neck dissection in medically fit elderly patients with loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). Retrospective study including 44 elderly patients (median age 71 years; range 66–77 years) with previously untreated, inoperable, histologically proven non-metastatic stage III or IV HNSCC. Following one cycle of IC, two cycles of cis-platinum and 5-fluorouracil CCRT with conventional fractionated radiotherapy up to a dose of 66–70 Gy were administrated. A neck dissection was recommended for patients with node metastasis larger than 3 cm regardless of the response to therapy and for patients who had suspected persistent neck disease 8–12 weeks after completing treatment. Salvage surgery was considered for histologically proven persistent or recurrent tumor in the primary site. Time-to-event data were described using Kaplan–Meier actuarial curves. Overall, 37 patients (84.1%) completed the planned treatment. There were no cases of treatment-related deaths. Twenty-nine patients (65.9%) developed severe toxicities with grade 4 toxicity accounting for 22.7%. The median follow-up time in survivors was 41 months. Three-year overall survival, progression-free survival, and functional progression-free survival estimates were 70.9, 67.0, and 57.3%, respectively. In selected medically fit elderly patients with loco-regionally advanced HNSCC, cis-platinum-based chemoradiotherapy can be successfully applied, with moderate adverse events, in attempt to preserve a functional upper aerodigestive tract.

Purpose The outcome of a prospective case series of 47 patients with newly diagnosed resectable locoregionally advanced oropharyngeal squamous cell carcinoma treated with platinum-based induction-concurrent chemoradiotherapy (IC/CCRT) was compared with the outcome of 47 matched historical control patients treated with surgery and postoperative RT. Methods and Materials A total of 47 control patients with locoregionally advanced oropharyngeal squamous cell carcinoma were identified from review of a prospectively compiled comprehensive computerized head-and-neck cancer database and were matched with a prospective case series of patients undergoing IC/CCRT by disease stage, nodal status, gender, and age (±5 years). The IC/CCRT regimen consisted of one cycle of induction chemotherapy followed by conventionally fractionated RT to a total dose of 66–70 Gy concomitantly with two cycles of chemotherapy. Each cycle of chemotherapy consisted of cisplatinum, 100 mg/m 2 , and a continuous infusion of 5-fluorouracil, 1,000 mg/m 2 /d for 5 days. The survival analysis was performed using Kaplan-Meier estimates. Matched-pair survival was compared using the Cox proportional hazards model. Results No significant difference was found in the overall survival or progression-free survival rates between the two groups. The matched analysis of survival did not show a statistically significant greater hazard ratio for overall death (hazard ratio, 1.35; 95% confidence interval, 0.65–2.80; p = .415) or progression (hazard ratio, 1.44; 95% confidence interval, 0.72–2.87; p = .301) for patients undergoing IC/CCRT. Conclusion Although the sample size was small and not randomized, this matched-pair comparison between a prospective case series and a historical cohort treated at the same institution showed that the efficacy of IC/CCRT with salvage surgery is as good as primary surgical resection and postoperative RT.

The aim of this study was to evaluate the long-term quality of life (QoL) in survivors with oropharyngeal carcinoma (OC) treated with surgery and postoperative radiotherapy (PORT) versus concurrent chemoradiation (CRT) using the European Organization for Research and Treatment of Cancer QoL Questionnaires. The study group consisted of 57 patients. The scores for physical (P=0.043) and social (P=0.036) functioning were significantly more favorable in the chemoradiation group. Surgical patients showed statistically higher problems with fatigue (P=0.047), pain (P=0.027), swallowing (P=0.042), social eating (P=0.038) and social contact (P=0.002). CRT group reported significantly greater problems with teeth (P=0.049), open mouth (P=0.036), dry mouth (P=0.022) and sticky saliva (P=0.044). The global QoL score was higher in CRT group (P=0.027). These results support an organ preservation approach with CRT in patients with advanced OC. However, considering the absence of randomized trial comparing outcomes after surgical versus nonsurgical approaches, severe xerostomia following CRT, the higher postoperative morbidity in the setting of salvage surgery, future prospective clinical trials on greater samples of patients are needed to confirm our conclusions.