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Objective: To verify the likelihood of dysphonia in firefighters and its relationship with individual and occupational factors and mental health., Method: This cross-sectional observational study with 442 firefighters collected data on sociodemographic, occupational, and lifestyle aspects and screening for common mental disorders (CMD). Individuals were divided into two groups: those slightly likely and those moderately/highly likely to have dysphonia, according to the Brazilian Dysphonia Screening Tool. The questionnaire's items addressed their sex, age, race, marital status, education, work schedule, administrative or field activity, alcohol consumption, smoking, and CMD. Those who answered "yes" to the question about having a hoarse voice were considered to have dysphonia with an indication for clinical voice assessment. The suspicion of a CMD was measured with the SRQ-20 Self Report Questionnaire. Data were subjected to descriptive and association analysis. Statistical tests were performed assuming a significance level of 5%., Results: The moderate/high likelihood of dysphonia was 6.12%. Most firefighters were males (90.31%), aged over 30 (52.47%), multiracial (44.39%), living with a partner (61.39%), and with a bachelor's or higher degree (42.35%). Individuals self-declared as Black or multiracial had a higher percentage of dysphonia (8.10%). Black and multiracial individuals were approximately 2.5 times more likely to pass the dysphonia screening than Whites and other races. Individuals with symptoms of CMD were also 2.7 times as likely to have dysphonia., Conclusion: The results of the study show that Black and multiracial firefighters and those with symptoms of CMD were moderately/highly likely to have dysphonia. Firefighters with the highest likelihood of having dysphonia are indicated for clinical voice assessment to confirm the diagnosis., Competing Interests: Declaration of Competing Interest We state that there is no conflict of interest., (Copyright © 2024 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: To describe a protocol to achieve consensus on valid and important indicators to assess primary health care (PHC) quality regarding all clinical contexts of PHC in European health systems., Study Design: Qualitative study using the Delphi technique to gain consensus among European panels of experts comprising a heterogeneous professional background., Methods: Potential candidate indicators were extracted and translated according to a set of informative elements (i.e., name, description, formula, unit of analysis, and sources). This list was then independently reviewed, and duplicates were removed totaling 1726 indicators. To guarantee a good response rate, indicators were distributed across 57 Delphi panels organized by clinical context. Each panel is a Delphi process, assessing between 23 to 33 indicators. Experts' opinions on the validity and importance of the extracted indicators will be obtained through two rounds of online questionnaires, using a 9-point Likert scale and free-text boxes. To prevent biased responses, participation will be anonymous to other participants and to the team administrating panels. Consensus will be considered if at least 70% of ratings (≥7 assuming 10 participants) lie within the 7-9 range and less than 15% of ratings (<2 assuming 10 participants) are in the 1-3 range. Analysis of results will be streamlined and generalizable across panels using scripts., Conclusions: This protocol will contribute to improve the quality of PHC in Europe by achieving a consensual and concise list of PHC quality indicators retrieved from the scientific literature that fit current clinical guidelines and populations' needs in countries from the European region according to the World Health Organization., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lobo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Acute lymphoblastic leukemia (ALL), a complex malignancy, displays varying expression profiles of PIP4K2-related genes in adult patients. While PIP4K2A expression is elevated in ALL bone marrow cells compared to healthy bone marrow cells, PIP4K2B is downregulated, and PIP4K2C remains relatively unchanged. Despite the correlation between increased PIP4K2A expression and increased percentage of peripheral blood blasts, clinical outcomes do not strongly correlate with the expression of these genes. Here we investigated the therapeutic potential of three PIP4K2 inhibitors (THZ-P1-2, a131, and CC260) in ALL cell models. THZ-P1-2 emerges as the most effective inhibitor, inducing cell death and mitochondrial damage while reducing cell viability and metabolism significantly. Comparative analyses highlight the superior efficacy of THZ-P1-2 over a131 and CC260. Notably, THZ-P1-2 uniquely disrupts autophagic flux and inhibits the PI3K/AKT/mTOR pathway, indicating a distinct molecular mechanism. In summary, our findings elucidate the differential expression of PIP4K2-related genes in ALL and underscore the potential role of PIP4K2A in disease pathogenesis. The therapeutic promise of THZ-P1-2 in ALL treatment, along with its distinct effects on cell death mechanisms and signaling pathways, enriches our understanding of PIP4K2's involvement in ALL development and offers targeted therapy prospects., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The aim of the present study is to analyze scientific evidence about associations between psychosocial factors at work and teachers' illness. A systematic literature review based on the PRISMA statement was conducted. Biblioteca Virtual em Saúde, Medical Literature Analysis and Retrievel System Online, Cumulative Index of Nursing and Allied Health Literature, Scopus, Web of Science, PsycINFO, and Excerpta Medica Database databases were searched. Articles in Portuguese, English and Spanish, published in the past 11 years, were of interest. In total, 861 articles were identified, but only 15 of them met all the eligibility criteria and were included in the review. Eleven articles (73.3%) used validated instruments to assess psychosocial factors, and the Job Content Questionnaire was the most cited one. Low social support, heavy workload, high job demands, and low job control were the most commonly investigated factors and showed statistically significant associations with teachers' illness., Competing Interests: Conflicts of interest: None

Some advantages of using cameras as sensor devices on feedback systems are the flexibility of the data it represents, the possibility to extract real-time information, and the fact that it does not require contact to operate. However, in unstructured scenarios, Image-Based Visual Servoing (IBVS) robot tasks are challenging. Camera calibration and robot kinematics can approximate a jacobian that maps the image features space to the robot actuation space, but they can become error-prone or require online changes. Uncalibrated visual servoing (UVS) aims at executing visual servoing tasks without previous camera calibration or through camera model uncertainties. One way to accomplish that is through jacobian identification using environment information in an estimator, such as the Kalman filter. The Kalman filter is optimal with Gaussian noise, but unstructured environments may present target occlusion, reflection, and other characteristics that confuse feature extraction algorithms, generating outliers. This work proposes RMCKF, a correntropy-induced estimator based on the Kalman Filter and the Maximum Correntropy Criterion that can handle non-Gaussian feature extraction noise. Unlike other approaches, we designed RMCKF for particularities in UVS, to deal with independent features, the IBVS control action, and simulated annealing. We designed Monte Carlo experiments to test RMCKF with non-Gaussian Kalman Filter-based techniques. The results showed that the proposed technique could outperform its relatives, especially in impulsive noise scenarios and various starting configurations.

Objective: To analyze the association between communicative competence self-assessment and interpersonal communication self-perception and voice symptoms in university professors., Method: Cross-sectional, analytical, observational study in 322 professors, who answered sociodemographic and occupational questions and three self-perception protocols: Self-Assessment of Communication Competence (SACCom), Interpersonal Communication Competence Scale (ICCS), and Voice Symptom Scale (VoiSS). The dependent variable was SACCom's yes/no answers. Univariate and multivariate descriptive and inferential data analyses were performed through logistic regression., Results: Most professors were females (55.3%), worked 40 hours (96.6%), and self-reported voice symptoms (72.7%). The largest portion had been in the career for 11-22 years (38.2%). The final multivariate model demonstrated that better self-assessed communicative competence among professors (SACCom) is related to an absence of voice complaints (odds ratio (OR) = 2.17; 95% confidence interval (CI) 1.29-3.65) and better self-perceived interpersonal communication (ICCS) (OR = 1.05; 95% CI 1.02-1.08). The older the professor (OR = 1.03; 95% CI 1.01-1.06), the better their communicative competence (SACCom)., Conclusions: Study professors' self-assessed communicative competence is predominantly high. Those with a better communicative competence self-assessment are older and vocally healthy and self-perceive greater interpersonal communication skills., Competing Interests: Declaration of Competing Interest The article entitled “University Professors’ Communicative Competence and Its Relationship With Interpersonal Communication and Voice Symptoms,” authored by Caroline Azevedo Maciel, Adriane Mesquita de Medeiros, and Letícia Caldas Teixeira, has been submitted for analysis by the editorial board of the Journal of Voice for possible publication. The authors state that there is no conflict of interest., (Copyright © 2023 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

The expanding use of hybrid nanomaterials in many applications necessitates evaluation of their environmental risks. This study investigates the acute toxicity and bioaccumulation of graphene oxide - gold (GO-Au) nanohybrid in neonates (<24 hrs old) of Daphnia magna after exposure to a wide range of concentrations (1-100 mg/L). No significant mortality or immobilisation was observed after the exposure period. Microscopic observation showed an uptake of the nanohybrid and internal damage in the gut of the exposed organisms. Bioaccumulation of the GO-Au nanohybrid also occurred in a concentration-dependant manner. Continuous evaluation of the environmental risks from exposure to this nanohybrid and other advanced materials is imperative to avert disruption to the ecosystem., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: To determine the prevalence of common mental disorders in university professors and to analyze the same with sociodemographic and occupational data, self-perceived interpersonal communication, and vocal symptoms., Methods: A Cross-sectional analytical observational quantitative study with 322 university professors. Four assessment instruments: the Sociodemographic and Work Information Questionnaire, the Self-Report Questionnaire, the Brazilian Dysphonia Screening Tool, the Interpersonal Communication Competence Scale, and the Voice Symptom Scale. The study performed descriptive and association analyses. The measure of association was the prevalence ratio, estimated with Poisson regression with robust invariance, considering common mental disorders as a dependent variable., Results: The prevalence of common mental disorders in university professors was 27.6%. There was a significant association between such disorders and self-perceived vocal complaints, the suspicion of dysphonia, and self-perceived difficulties in regards to being heard with a mask (sometimes/always). The higher the score in the self-disclosure domain of the Interpersonal Communication Competence Scale the higher the prevalence of common mental disorders in university professors., Conclusion: The prevalence of common mental disorders in university professors is high and influences their self-perception of vocal symptoms and interpersonal relationships. Hence, it reinforces the need for measures to maintain university professors' vocal and mental health., (Copyright © 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction: The voice disorder can cause limitations at work, as it affects the communication and the performance of the teaching function., Objective: To analyze the limitation at work because of the voice and to examine possible associations with sociodemographic characteristics, life and health habits and work conditions among Basic Education teachers in Brazil., Methods: Cross-sectional epidemiological study, with a representative sample, carried out between October 2015 and March 2016, with 6,324 teachers working in Basic Education in Brazil. Data collection was carried out through the application of a questionnaire via telephone with questions regarding health and working conditions. The "limitation at work because of the voice" was considered a dependent variable, whose response options were a scale with four Likert items that varied from frequently to never. The independent variables were grouped in blocks for ordinal logistic regression analysis with hierarchical entry. The magnitude of the association was assessed by the Odds Ratio (OR) with the respective confidence intervals (95% CI)., Results: One third of Brazilian teachers (32.7%) reported some frequency of limitation at work (sometimes; rarely, frequently) because of the voice at some moment in the month before the survey and, of these, 5% declared high frequency. The factors that increased the chance of a greater frequency of limitation at work because of the voice were: being female (OR = 1.32; 95% CI = 1.15-1.51); teaching for elementary school (OR = 1.35; 95% CI = 1.02-1.78); use anxiolytic or antidepressant medications (OR = 1.46; 95% CI = 1.20-1.78); losing sleep due to concerns (OR = 1.69; CI = 95% = 1.46-1.95); high noise at school (OR = 2.09; 95% CI = 1.78-2.46); agitated environment by students' indiscipline (OR = 1.37; 95% CI =1.15-1.63); high demands at work (OR = 1.18; 95% CI = 1.02-1.36); not having social support (OR = 1.19; 95% CI = 1.04-1.38); having suffered verbal violence by the students (OR = 1.43; 95% CI = 1.23-1.67). On the other hand, the practice of regular physical activity (OR = 0.86; 95% CI = 0.75-1.00) and the fact of having enough time to complete work tasks (OR = 0.71; 95% CI = 0,62-0.82) decreased the chance of a higher frequency of limitation at work due to vocal problems. The perception that the work limits the teaching performance because of the voice was more frequent among teachers in the North (OR=1.41; 95% CI = 1.17-1.71) and Northeast (OR=1.46; 95% CI = 1.22-1.76) compared to the Southeast region., Conclusion: Factors associated with an increase in the chance of higher frequency of reporting work limitations due to the voice: being female, lack of physical activity, losing sleep due to concern, using anxiolytic or antidepressant medication, school location in the North and Northeast, teaching for the elementary school stage, high noise at school and psychosocial aspects of work organization. The Brazilian educational sector needs public policies that take into account regional inequalities and the health and work conditions of teachers., (Copyright © 2020 The Voice Foundation. All rights reserved.)

The treatment of acute leukemia is challenging because of the genetic heterogeneity between and within patients. Leukemic stem cells (LSCs) are relatively drug-resistant and frequently relapse. Their plasticity and capacity to adapt to extracellular stress, in which mitochondrial metabolism and autophagy play important roles, further complicates treatment. Genetic models of phosphatidylinositol-5-phosphate 4-kinase type 2 protein (PIP4K2s) inhibition have demonstrated the relevance of these enzymes in mitochondrial homeostasis and autophagic flux. Here, we uncovered the cellular and molecular effects of THZ-P1-2, a pan-inhibitor of PIP4K2s, in acute leukemia cells. THZ-P1-2 reduced cell viability and induced DNA damage, apoptosis, loss of mitochondrial membrane potential, and the accumulation of acidic vesicular organelles. Protein expression analysis revealed that THZ-P1-2 impaired autophagic flux. In addition, THZ-P1-2 induced cell differentiation and showed synergistic effects with venetoclax. In primary leukemia cells, LC-MS/MS-based proteome analysis revealed that sensitivity to THZ-P1-2 is associated with mitochondrial metabolism, cell cycle, cell-of-origin (hematopoietic stem cell and myeloid progenitor), and the TP53 pathway. The minimal effects of THZ-P1-2 observed in healthy CD34 + cells suggest a favorable therapeutic window. Our study provides insights into the pharmacological inhibition of PIP4K2s targeting mitochondrial homeostasis and autophagy, shedding light on a new class of drugs for acute leukemia., (© 2022. The Author(s).)

Background: Cholangiocarcinoma (CC) is a rare tumor that arises from the epithelium of the bile ducts. It is classified according to anatomic location as intrahepatic, perihilar, and distal. Intrahepatic CC (ICC) is rare in patients with cirrhosis due to causes other than primary sclerosing cholangitis. Mixed hepatocellular carcinoma-CC (HCC-CC) is a rare neoplasm that shows histologic findings of both HCC and ICC within the same tumor mass. Due to the difficulties in arriving at the correct diagnosis, patients eventually undergo liver transplantation (LT) with a presumptive diagnosis of HCC on imaging when, in fact, they have ICC or HCC-CC., Aim: To evaluate the outcomes of patients with intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma on pathological examination after liver transplant., Methods: Propensity score matching was used to analyze tumor recurrence (TR), overall mortality (OM), and recurrence-free survival (RFS) in LT recipients with pathologically confirmed ICC or HCC-CC matched 1:8 to those with HCC. Progression-free survival and overall mortality rates were computed with the Kaplan-Meier method using Cox regression for comparison., Results: Of 475 HCC LT recipients, 1.7% had the diagnosis of ICC and 1.5% of HCC-CC on pathological examination of the explant. LT recipients with ICC had higher TR (46% vs 11%; P = 0.006), higher OM (63% vs 23%; P = 0.002), and lower RFS (38% vs 89%; P = 0.002) than those with HCC when matched for pretransplant tumor characteristics, as well as higher TR (46% vs 23%; P = 0.083), higher OM (63% vs 35%; P = 0.026), and lower RFS (38% vs 59%; P = 0.037) when matched for posttransplant tumor characteristics. Two pairings were performed to compare the outcomes of LT recipients with HCC-CC vs HCC. There was no significant difference between the outcomes in either pairing., Conclusion: Patients with ICC had worse outcomes than patients undergoing LT for HCC. The outcomes of patients with HCC-CC did not differ significantly from those of patients with HCC., Competing Interests: Conflict-of-interest statement: All authors have no conflicts of interest to disclose., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

The COVID-19 pandemic has created enormous challenges for society due to the various ways of impacting health. This paper focuses on the impact of the COVID-19 pandemic on people's food consumption patterns in the online environment. We investigate food app reviews and examine whether countries with a high rate of success with COVID-19 control consume more unhealthy food through mobile apps. We also investigate whether the population of countries with low social welfare eat more unhealthy food during the COVID-19 pandemic compared to countries with high social welfare. We take a hybrid multi-criteria decision making (MCDM) approach to calculate indexes based on the technique for order of preference by similarity to an ideal solution, complex proportional assessment, and VlseKriterijuska Optimizacija I Komoromisno Resenje. Results show that country social welfare and success in COVID-19 control negatively affect the perceived utility of the apps. Also, success in COVID-19 control and the perceived utility of food apps positively affect the proportion of unhealthy reviews, whereas social welfare has a negative impact. The results have important implications for public health policymakers, showing that the online food environment can be an important setting for interventions that seek to incentivize healthy eating., (© 2022 Elsevier Ltd. All rights reserved.)

The study aimed to present the methodological proposal entitled "Prompt Response", modelled in the cities of Belo Horizonte (Minas Gerais State) and Natal (Rio Grande do Norte State), Brazil. The proposal aims to identify and demarcate priority areas for timely targeting of surveillance activities, aiming to reduce the intensity and velocity in the spread of epidemics in endemic urban areas. The methodology uses three variables that represent the necessary causes for the production and reproduction of dengue: notified cases (virus), Aedes eggs (vector), and population (host). This was an ecological study that used data from three information planes aggregated in finer temporal and spatial scales of 3 to 4 weeks and 400 to 600-meter grids, respectively. The prompt response areas were defined by Scan statistical analysis with definition of simultaneous spatial clusters for the three planes via the SaTScan program. In Natal, the areas defined as prompt response occupied, on average, 15.2% of the city's territory and concentrated 67.77% of the dengue cases in the period following demarcation of the prompt response areas. In Belo Horizonte, the observed proportions were 64.16% of cases in 23.23% of the territory. These results were obtained in two cities with different socioenvironmental and geographic realities and distinct epidemiological profiles, indicating that the methodology can be applied to different urban realities, allowing control programs to concentrate on reduced portions of the territory and impacting a high percentage of cases in timely fashion.

Objective: To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2., Methods: The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated., Results: A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies., Conclusion: The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests.

Objective: The objective of this study was to analyse abundance and spatial distribution of Aedes aegypti and Aedes albopictus oviposition in the city of Natal-RN, 2016 to 2018., Methods: Three hundred and seven oviposition traps were installed covered the whole city and were monitored weekly from January 2016 to December 2018. To verify the abundance of the vector based on its location, the formation of oviposition clusters was studied using the Kernel statistics. Egg Density Index (EDI) and Oviposition Positivity Index (OPI) values were calculated., Results: Temperature and humidity presented weak and very weak correlation, respectively, with the oviposition indicators. The median of oviposition positivity index (OPI) was 60.5%, and the egg density index (EDI) was 45.4 eggs/trap. The OPI (71.1%) was higher in the second quarter of the year. The areas with the most persistent oviposition are located in a continuous strip that extends from the extreme of the northern district and extends along the western district of the city. Also noteworthy is the proximity to the strategic points., Conclusion: The spatio-temporal distribution of oviposition revealed that there is spatial segregation and marked seasonality. Therefore, this study highlights the importance of maintaining surveillance targeting and control strategies focused on these areas, especially during the most important period of the year., (© 2020 John Wiley & Sons Ltd.)

The first autochthonous case of chikungunya virus (CHIKV) infection in Brazil was in September 2014 in the State of Amapá, and from there it rapidly spread across the country. The present study was conducted in 2016 in the state of Rio Grande do Norte, and the aims were to describe the epidemiological and the clinical aspects of the CHIKV outbreak. Biological samples from 284 chikungunya suspected cases were screened for CHIKV and Flavivirus (FV) RNA using qRT-PCR. Negative PCR samples were also screened for anti-CHIKV and anti-FVIgM by ELISA. CHIKV RNA were detected in 125 samples mostly occurring from January through March (46%), mainly affecting adults and older adults. We found a gradual decrease in viral RNA over the disease time. Anti-CHIKV IgM was found in 47.5% after negative CHIKV qRT-PCR. Interestingly, 45.0% simultaneously had positive results for CHIKV and FV IgM, suggesting the occurrence of virus co-circulation. The most frequent symptom was fever (91%). Women presented more chance to develop nausea and abdominal pain compared to men. Our data described and allows us to better understand the clinical and epidemiological aspects of the 2016 chikungunya outbreak in Rio Grande do Norte and can help in the early clinical diagnosis of the virus., Competing Interests: No authors have competing interests.

Aim: Investigating the association among vocal symptoms, vocal resources, and work environment in university professors., Methods: Online questionnaire answered by 334 professors from a federal public university in Belo Horizonte County, Brazil. The questionnaire addressed sociodemographic data, self-perception about one's voice, vocal resources and work environment, and included the Vocal Signs and Symptoms Questionnaire. Professors presenting five or more vocal symptoms were compared to those who reported fewer symptoms. The association between the number of symptoms and the other variables was assessed through univariate and multivariate logistic regression analyses., Results: The mean of symptoms reported by the herein investigated professors was 3.1 (SD ± 2.75); 24% (n = 82) of them reported five or more vocal symptoms. Factors such as female sex, incidence of noise, high speaking rate, as well as high fundamental frequency and loud voice, were associated with the incidence of five or more vocal symptoms., Conclusions: University professors belonging to the female sex, who perceive the noise in the work environment as unsatisfactory, speak fast, or present high fundamental frequency and loud voice reported the largest number of vocal symptoms. It is recommended developing education programs focused on raising professors' awareness about voice-related risk factors and about the importance of improving their communicative performance., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To evaluate epidemiological aspects of priapism in patients with sickle cell disease, and these aspects impact on adult sexual function., Methods: This was a cross-sectional study including individuals with sickle cell disease who were evaluated at a reference center for sickle cell. Participants completed a structured questionnaire about their sociodemographic characteristics and priapism events. Sexual function was assessed using validated two instruments, the Erection Hardness Score and one about the sex life satisfaction., Results: Sixty-four individuals with median aged of 12 (7 to 28) years were interviewed. The prevalence of priapism was 35.9% (23/64). The earliest priapism episode occurred at 2 years of age and the latest at 42 years. The statistical projection was that 71.1% of individuals of the study would have at least one episode of priapism throughout life. Patients with episodes of priapism (10/23) had significantly worse erectile function Erection Hardness Score of 2 [1-3]; p=0.01 and were less satisfied with sexual life 3 [3-5]; p=0.02., Conclusion: Priapism is usually present in childhood, and severe episodes are associated with cavernous damage, impairment in the quality of the erection, and lower sexual satisfaction.

Background: In Brazil, the Model for End-Stage Liver Disease (MELD) score is used to prioritize patients for deceased donor liver transplantation (DDLT). Patients with hepatocellular carcinoma (HCC) receive standardized MELD exception points to account for their cancer risk of mortality, which is not reflected by their MELD score., Objective: To compare DDLT rates between patients with and without HCC in Rio Grande do Sul, the Southernmost state of Brazil., Methods: - We retrospectively studied 825 patients on the liver-transplant waiting list from January 1, 2007, to December 31, 2016, in a transplant center located in Porto Alegre, the capital of Rio Grande do Sul, to compare DDLT rates between those with and without HCC. The time-varying hazard of waiting list/DDLT was estimated, reporting the subhazard ratio (SHR) of waiting list/DDLT/dropout with 95% confidence intervals (CI). The final competing risk model was adjusted for age, MELD score, exception points, and ABO group., Results: Patients with HCC underwent a transplant almost three times faster than patients with a calculated MELD score (SHR 2.64; 95% CI 2.10-3.31; P<0.001). The DDLT rate per 100 person-months was 11.86 for HCC patients vs 3.38 for non-HCC patients. The median time on the waiting list was 5.6 months for patients with HCC and 25 months for patients without HCC., Conclusion: Our results demonstrated that, in our center, patients on the waiting list with HCC have a clear advantage over candidates listed with a calculated MELD score.

OBJECTIVE To present an overview of systematic reviews on throughput interventions to solve the overcrowding of emergency departments. METHODS Electronic searches for reviews published between 2007 and 2018 were made on PubMed, Cochrane Library, EMBASE, Health Systems Evidence, CINAHL, SciELO, LILACS, Google Scholar and the CAPES periodicals portal. Data of the included studies was extracted into a pre-formatted sheet and their methodological quality was assessed using AMSTAR 2 tool. Eventually, 15 systematic reviews were included for the narrative synthesis. RESULTS The interventions were grouped into four categories: (1) strengthening of the triage service; (2) strengthening of the ED's team; (3) creation of new care zones; (4) change in ED's work processes. All studies observed positive effect on patient's length of stay, expect for one, which had positive effect on other indicators. According to AMSTAR 2 criteria, eight revisions were considered of high or moderate methodological quality and seven, low or critically low quality. There was a clear improvement in the quality of the studies, with an improvement in focus and methodology after two decades of systematic studies on the subject. CONCLUSIONS Despite some limitations, the evidence presented on this overview can be considered the cutting edge of current scientific knowledge on the topic.

Introduction: Evidence indicates an increase in the prevalence of enuresis in individuals with sickle cell disease. The present study aims to evaluate the prevalence and impact of enuresis on quality of life in individuals with sickle cell disease., Materials and Methods: This cross-sectional study evaluated individuals with sickle cell disease followed at a reference clinic, using a questionnaire designed to evaluate the age of complete toilet training, the presence of enuresis and lower urinary tract, and the impact on quality of life of these individuals., Results: Fifty children presenting SCD (52% females, mean age ten years) were included in the study. Of those, 34% (17/50) presented as HbSC, 56% with HbSS (28/50), 2% Sα-thalassemia (1/5) and 8% the type of SCD was not determined. The prevalence of enuresis was 42% (21/50), affecting 75% of subjects at fi ve years and about 15% of adolescents at 15 years of age. Enuresis was classifi ed as monosymptomatic in 33.3% (7/21) and nonmonosymptomatic in 66.6% (14/21) of the cases, being primary in all subjects. Nocturia was identifi ed in 24% (12/50), urgency in 20% (10/50) and daytime incontinence 10% (5/50) of the individuals. Enuresis had a signifi cant impact on the quality of life of 67% of the individuals., Conclusion: Enuresis was highly prevalent among children with SCD, and continues to be prevalent throughout early adulthood, being more common in males. Primary nonmonosymptomatic enuresis was the most common type, and 2/3 of the study population had a low quality of life., Competing Interests: None declared., (Copyright® by the International Brazilian Journal of Urology.)

Chronic Hepatitis C relapse after liver transplantation can lead to graft failure within a short time period. The high efficacy and good safety profile of direct-acting antivirals has led to consensual recommendations for using interferon-free treatment after liver transplantation. However, pegylated interferon may still be required for genotype 3 non-responders. We treated a liver graft recipient with grade 1 fibrosis in the biopsy with daclatasvir and sofosbuvir for 12 weeks. He did not respond and progressed to grade 3 fibrosis. Lacking other options, we obtained a sustained virological response with pegylated interferon, ribavirin and sofosbuvir for 12 weeks. The combination of pegylated interferon, ribavirin and sofosbuvir is a viable option after the failure of direct acting antivirals in economically disadvantaged countries.

Objective: To evaluate different weight loss (WL) cut-off points as prognostic markers of 3-month survival after diagnosis of stage IV non-small cell lung cancer (NSCLC)., Methods: This was a prospective study involving 104 patients with metastatic (stage IV) NSCLC who were admitted to a cancer treatment center in southern Brazil between January of 2014 and November of 2016. We evaluated total WL and WL per month, as well as WL and WL per month in the 6 months preceding the diagnosis. The patients were followed for 3 months after diagnosis. A Cox proportional hazards regression model and Kaplan-Meier curves were used in order to evaluate 3-month survival., Results: The median WL in the 6 months preceding the diagnosis was 6% (interquartile range, 0.0-12.9%). Patients with WL ≥ 5% had a median survival of 78 days, compared with 85 days for those with WL < 5% (p = 0.047). Survival at 3 months was 72% for the patients with WL ≥ 5% (p = 0.047), 61% for those with WL ≥ 10% (p < 0.001), and 45% for those with WL ≥ 15% (p < 0.001). In the multivariate analysis, the hazard ratio for risk of death was 4.51 (95% CI: 1.32-15.39) for the patients with WL ≥ 5%, 6.34 (95% CI: 2.31-17.40) for those with WL ≥ 10%, and 14.17 (95% CI: 5.06-39.65) for those with WL ≥ 15%., Conclusions: WL in the 6 months preceding the diagnosis of NSCLC is a relevant prognostic factor and appears to be directly proportional to the rate of survival at 3 months.

Objective: To identify scientific literature on oncology nurses who provide patient navigation services as nurse navigators., Methods: Integrative review of literature searches in the databases LILACS, MEDLINE/PubMed, SCOPUS, SciELO, Web of Science and Science Direct based on the descriptors patient; navigation; nurse; professional; cancer; oncology; navigator; and navigators., Results: Seventeen articles were identified and grouped according to the following thematic approach: Care Processes; Patients; and Health Workers. It was observed that scientific literature on nurse navigators mostly comes from the United States, Australia, Canada, Sweden, and Demark, where the first nurse navigator programmes were introduced. No studies were found in local journals or populations., Conclusions: The nurse navigator offer a unique service for the provision of quality care. Although international research is recent, further studies on the role of these professionals are clearly needed.

Background: the objective of this study was to describe the frequency of cystic lesions in a Brazilian population of patients histopathologically diagnosed in the first and second decade of life., Material and Methods: Retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of a Brazilian referral center between 1980 and 2016., Results: A total of 2.114 biopsy records of pediatric patients were analyzed with oral and maxillofacial lesions. Data such as gender, age, anatomical location, and histopathological diagnosis were collected and categorized. Among all oral and maxillofacial lesions (n=2.114), were diagnosed 294 cases of odontogenic cysts (13.9%) and 16 cases of non-odontogenic cysts (0.8%). The most frequent lesions in each group were, respectively: radicular cyst (n=145) and epidermoid cyst (n=4). These lesions were most common in female (n=158), with a mean age of 14 years. For intraosseous lesions, the mandible (n=148) was the most affected anatomic site; moreover, the floor of the mouth (n=6) was most affected by cysts in soft tissues., Conclusions: Odontogenic cysts were relatively common in population studied, but non-odontogenic cysts were rare in these patients.

Objective: to report the vigi@dengue experience, held in the municipality of Natal-RN, Brazil, from October/2015 to May/2016., Methods: entomological indicators were obtained from the oviposition traps, epidemiological indicators from notifications on the online Information System for Notifiable Diseases (Sinan-dengue), active search for cases and viral RNA detection (RTq-PCR) in arthropods and human serum samples; risk levels have been created based on these indicators; categories of interventions for each risk level have been established., Results: early identification of epidemics in three areas of the municipality, with guidance for field work for the most vulnerable areas; the municipality presented ovitrap positivity index (OPI) of 40% and eggs density index (EDI) of 51 eggs/ovitraps; identification of CHIKV, DENV-1 and DENV-3 in Natal-RN., Conclusion: the strategy identified the early emergence of epidemics in specific locations; it was helpful in the guidance of control measures for the areas of major risk.

Background: Sick leave can be envisaged as an important public health indicator. Health problems and trouble at work are predictors of absenteeism., Objective: Within the context of reforming the judicial system, the aim of this study was to examine whether individual characteristics and working conditions influenced reports of sick leave amongst a population of Brazilian magistrates., Methods: A web-based survey was conducted in 2011 in such a way as to reach the entire population of Brazilian Labor-law magistrates across the country. The variable of interest related to the question: "Have you taken any medical leave due to illness over the last 12 months?", Results: Less than a quarter of the population participated in the survey, despite widespread publicity produced by the professional association. Among the work-related factors, experiences of violence in the courthouse were shown to be associated with the outcome. No significant association with the material or psychosocial working conditions or with the workload was found. Female, worse health assessment, not participating in social activities and having a mother with higher schooling level were significantly associated with absenteeism among the magistrates., Conclusion: It is desirable to formulate sectorial policies focusing on controlling and monitoring violent events in the courthouse.

Granular cell tumor (GCT) is an uncommon benign soft tissue neoplasm, which usually presents as a solitary nodule, appearing especially in the tongue. There are few cases of multiple oral GCT in the English-language literature, with only three cases reported in the last 20 years. This report describes a case of two oral GCT in a young patient and provides a literature review from 1995 to 2015. Clinical characteristics of the reviewed cases were retrieved and compared with the present case. Exceptionally, the current case was the only one that occurred in an adolescent and solely affected the oral cavity. Besides the oral cavity, the other cases also observed GCT lesions in the skin. Although rare, it is important to know multiple oral GCT clinical and histopathological characteristics so they can be correctly diagnosed, treated and followed up.

Objective: The objective of this study was to evaluate the association between psychological, hormonal, and genetic factors with the development of burning mouth syndrome (BMS) and secondary oral burning (SOB) in order to provide a better characterization and classification of these conditions., Design: Cross sectional study., Setting: Patients with complaints of mouth burning registered at the Oral Diagnostic Service of the Federal University of Rio Grande do Norte between 2000 and 2013., Subjects: The sample consisted of 163 subjects divided into a group of patients with BMS (n = 64) and a group of subjects with SOB (n = 99)., Methods: The following variables were analyzed: passive and stimulated saliva flow, stress levels and phase, depression, anxiety, serum cortisol and dehydroepiandrosterone (DHEA) levels, and the presence of polymorphisms in the interleukin 6 (IL-6) gene., Results: The results showed significant differences in the presence of xerostomia (p = 0.01), hyposalivation at rest (p < 0.001) and symptoms of depression (p = 0.033) between the two groups, which were more prevalent in the BMS group. DHEA levels were lower in the BMS group (p = 0.003) and were sensitive and specific for the diagnosis of this condition. Genetic analysis revealed no significant association between the polymorphisms analyzed and the development of BMS., Conclusion: These results suggest a possible role of depression, as well as of reduced DHEA levels, as associated factors for development of BMS., (© 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects., Methods: The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05)., Results: Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each)., Conclusion: In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

Background: Oral lichen planus (OLP) is a relatively common chronic inflammatory disease whose etiopathogenesis is not completely understood. Several factors have been proposed in an attempt to explain the variety of clinical manifestations and periods of exacerbation and remission of symptoms of these lesions. The objective of this study was to associate local factors, systemic diseases, and level of anxiety with clinical characteristics of OLP., Methods: The following factors were analyzed in 37 patients with OLP: presence of smoking, alcohol consumption, diabetes mellitus, hypertension, and hepatitis C virus infection. Anxiety was measured by the Spielberger State-Trait Anxiety Inventory. These variables were associated with clinical form and symptoms (chi-squared/Fisher's exact test)., Results: The erosive form was the most prevalent presentation (57.1%). Symptoms were reported by 45.7% of the patients. Most patients were non-smokers (97.3%), and none of them was an alcoholic. Diabetes and hypertension were present in 10.8% and 16.2% of the patients, respectively. Only one patient was hepatitis C virus seropositive, and 78.4% presented moderate levels of anxiety. No significant association was observed between the variables studied and clinical form or symptoms., Conclusions: In this study, no association was observed between local and systemic factors or level of anxiety and clinical characteristics of OLP., (© 2014 The International Society of Dermatology.)

Background: To investigate whether the immunohistochemical expression of GLUT-1 and HIF-1α is related to the diagnosis and pathogenesis of oral vascular lesions., Study Methods: Thirty cases each of pyogenic granuloma (PG) and hemangioma were studied. Antibodies against GLUT-1 and HIF-1α were detected by immunoperoxidase staining in 3-μm histological sections, and the results were analyzed qualitatively and quantitatively, respectively. Positive and negative cells were counted, and the mean number of positive cells was calculated for each case., Results: The initial diagnosis of hemangioma was maintained in only 7 (23%) of the 30 cases studied, which were positive for GLUT-1. The remaining 23 cases were reclassified as vascular malformation (VM) (n = 13) and PG (n = 10) due to the absence of staining. The endothelium of blood vessels was negative for GLUT-1 in all cases initially diagnosed as PG (n = 30). The percentage of HIF-1α-positive cells was higher in cases of PG, followed by hemangiomas and VMs (P = 0.005)., Conclusions: Histological features are not sufficient to establish the correct diagnosis of oral hemangiomas, and an accurate anamnesis is essential in these cases. In addition, these findings demonstrate that vascular lesions express mediators of angiogenesis, HIF-1α, and suggest that his process may play a role in the pathogenesis of vascular., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. FCOD is usually asymptomatic. In severe cases, focal expansion may occur due to infection. Management of the symptomatic patient is more difficult due to the avascular nature of the lesion which contributes to susceptibility severe infection, bone sequestration, and osteomyelitis when surgery is performed., Case Report: This paper presents a rare case of severe FCOD; the black woman patient was diagnosed based on clinical and radiographic findings and treated conservatively. The examination of panoramic radiographs revealed a multiple sclerotic masses with radiolucent borders, found in the mandible and maxilla which were symmetrical at presentation. The patient continuous with the follow-up., Discussion: This report confirms that a diagnosis can be made with accurate clinical and radiographic assessment. The correct selection of treatment for FCOD depends on this information.

Peripheral ameloblastoma is an uncommon, extraosseous counterpart of solid ameloblastoma, which occurs in the soft tissues overlying tooth-bearing areas or the alveolar mucosa of the mandible and maxilla. In this paper, the authors report a case of peripheral ameloblastoma located in the maxillary gingiva of a 54-year-old woman and review the literature regarding clinicopathological features, differential diagnosis and therapeutic management of peripheral ameloblastomas.

Objective: This study estimates the prevalence of absenteeism due to voice disorders among teachers and investigates individual and contextual factors associated with it., Methods: The study involved 1,980 teachers from 76 municipal schools. The response rate was 85%. The survey was carried out between May 2004 and July 2005 using a self-administered structured questionnaire containing sociodemographic, lifestyle, health, and work-related questions. The dependent variable was obtained from answers to the following question: In the last 2 weeks, have you missed work because of voice problems? Logistic regression analysis was used to determine the associated factors., Results: Voice-related absenteeism in the prior 2 weeks was reported by 66 teachers (3.35%). During their entire careers, approximately one-third of teachers missed work at least once due to voice problems. In the final model, factors associated with recent absenteeism were as follows: witnessing violence by students or parents one or more times (OR = 2.10; 95% CI = 1.14-3.90), presence of depression or anxiety (OR = 2.03; 95% CI = 1.09-3.78), upper respiratory problems in the prior 2 weeks (OR = 2.85; 95% CI = 1.53-5.29), and absenteeism because of voice problems during the preceding 6 months (OR = 15.79; 95% CI = 8.18-30.45)., Conclusions: The results encourage new approaches to the problems of absenteeism in the educational sector and contribute to addressing the weaknesses of economic and administrative approaches to the phenomenon.

Background: In recent decades several groups of researchers have been interested in describing and understanding vocal morbidity in teachers in order to explain the large number of teachers diagnosed with dysphonia and account for the absenteeism attributed to vocal disability., Aims: To determine the proportion of teachers who reported a diagnosis of dysphonia and measure associations between individual and contextual factors and the event of interest., Methods: Teachers were recruited from the city of Belo Horizonte and invited to complete a web-based institutional intranet questionnaire., Results: In total, 649 teachers responded; 32% (CI 28.5-35.5) reported that they had received a physician diagnosis of dysphonia. This prevalence was significantly higher among female teachers (prevalence ratio (PR) 2.33; CI 1.41-3.85), and groups who reported limited technical resources and equipment (PR 1.56; CI 1.14-2.15), a diagnosis of gastritis (PR 1.59; CI 1.28-1.98), not being summoned for an annual physician examination (PR 0.47; CI 0.32-0.68), or absenteeism (PR 1.39; CI 1.06-1.81)., Conclusions: The high prevalence of dysphonia in teachers was not associated with any individual variables, except for sex and comorbidity (diagnosis of gastritis). Limited technical resources and equipment were associated with dysphonia and suggests policy change is important in preventing dysphonia.

Molluscum contagiosum (MC) is a contagious disease caused by a virus of the poxvirus family. In children, the disease commonly manifests as a variable number of discrete umbilicated papules on the face and trunk. In healthy and immunosuppressed adults, the disease appears on or near the genital organs and is often sexually transmitted. MC involving the intraoral mucosa has been documented but is rare. We report a case of MC involving the oral mucosa exclusively and discuss the main clinical, histopathologic, and therapeutic characteristics, comparing the findings with cases of this rare oral presentation described in the literature., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To evaluate the immunohistochemical expression of MMP-1, -2, -7, -9 and -26 in oral squamous cell carcinomas (SCCs) according to tumour site and histological grade of malignancy., Study Design: Fifteen cases of SCC of the lower lip and 15 cases of tongue SCC were selected and divided into low grade malignancy (n = 17) and high grade malignancy (n = 13)., Results: Higher immunohistochemical expression of MMPs by neoplastic cells was observed in tongue SCCs, with a statistically significant difference for MMP-9 (P < 0.05). High-grade SCCs showed a higher expression of MMPs, except for MMP-2, with a statistically significant difference for MMP-7 (P < 0.05) and MMP-26 (P < 0.05). In addition, a direct association was observed between morphological scores of malignancy and MMP immunoreactivity, with the association being significant for MMP-7 and MMP-26., Conclusion: The present results demonstrate the important role of MMPs in the development of SCCs of the lower lip and tongue., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to evaluate oral epithelial cells by exfoliative cytology in burning mouth syndrome (BMS)., Material and Methods: Oral smears were collected from clinically normal-appearing mucosa by liquid-based exfoliative cytology in 40 individuals (20 BMS patients and 20 healthy controls matched for age and gender) and analysed for cytological and cytomorphometric techniques., Results: Mean values of nuclear area (NA) for experimental and control groups were, respectively, 67.52 and 55.64 μm² (p < 0.05). Cytoplasmic area (CA) showed the following mean values: 1258.0 (experimental) and 2069.0 μm² (control). Nucleus-to-cytoplasm area ratio for the experimental group was 0.07, besides the control group was 0.03 (p < 0.05). Morphologically, oral smears exhibited normal epithelial cells in both experimental and control groups. There was a significant predominance of nucleated cells of the superficial layer in the smears of BMS patients (p = 0.00001)., Conclusion: This study revealed that oral mucosa of BMS patients exhibited significant cytomorphometric changes in the oral epithelial cells. These changes probably are associated with epithelial atrophy and a deregulated maturation process that may contribute to the oral symptoms of pain and discomfort in BMS., (© 2010 The Gerodontology Society and John Wiley & Sons A/S.)

Objectives: To examine the impact of voice on the quality of life of teachers and to assess whether the degree of dysphonia and otorhinolaryngologists' (ORL) diagnostics are correlated with the quality of life., Methods: Eighty-eight female teachers from the municipal schools of Belo Horizonte who were in speech therapy at the Speech Therapy Clinic of the Hospital das Clínicas of Minas Gerais participated in the study. The variables studied were age, ORL diagnosis, perceptual-hearing assessment of voice through GRBAS scale, and vocal activities and participation profile (VAPP) protocol. Statistical analysis was performed through the descriptive analysis of the data and the Spearman coefficient of correlation., Results: The average age of the participants was 38 years. Vocal deviation: degree 1-56 teachers (63.6%); degree 2-27 teachers (30.6%); and without vocal deviation-five teachers (5.6%). It was found that 57.9% of the teachers presented combined ORL diagnosis. No statistically significant relationship was observed among the ORL diagnosis, the degree of dysphonia, and the parameter values of quality of life assessed by VAPP., Conclusions: The examined participants of this study presented light degree of vocal deviation and ORL combined diagnosis. According to the figures obtained by VAPP, there was negative impact of voice on the quality of life of female teachers, but these impacts were not correlated with ORL diagnosis and grade of dysphonia., (Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.)

A descriptive study aiming to describe a nursing consultation protocol tested for patients after myocardial revascularization. The protocol is implemented in a hospital cardiac unit, has goals that must be achieved during the consultation period or in between. For reaching each goal, it has been established that nursing actions should be implemented by the nurse, displayed in three tables: Strategies for nursing consultation related to the first care; Strategies for nursing consultations related to the second, third and forth nursing visits; Strategies for nursing consultations related to the fifth nursing visit, referring to the sixth month after surgery. It is believed that the implementation of the protocol allows a systematic evaluation of the patient, raising their real problems, for planning and implementation of nursing interventions, especially those related to behavioral changes.

Sialolipoma is a rare benign neoplasm characterized by a well-circumscribed mass composed of neoplastic mature adipose tissue and non-neoplastic salivary gland elements. A 72-year-old woman presented with a painless swelling located in the hard palate, which had been identified 15 days earlier. Microscopically, the tumor was well-circumscribed consisting of lobular proliferation of the lipomatous tissue with thin fibrous tissue septa containing clustered salivary gland elements. Both the glandular and adipose components were found in almost equal proportion. No atypia in the adipose tissue was observed. The definitive diagnosis was sialolipoma. The patient showed no signs of recurrence 8 months after surgical excision. Including the present case, 35 cases of sialolipoma have been reported in the English literature. Of these 35 cases, 16 cases were located in minor salivary glands. Gender was identified in 14 of these cases with 4 males (28.5%) and 10 females (71.5%). The age distribution was from 27 to 84 years (mean, 61.6 years) and the tumor size ranged from 0.9 to 4 cm (mean, 1.7 cm). The most frequently reported clinical presentation was of a painless swelling (56.3%).

This study evaluated the expression of fibronectin, tenascin and type I collagen in ameloblastomas and adenomatoid odontogenic tumors (AOTs) aiming to contribute with the comprehension of the differences in the biological behavior of these tumors. Immunohistochemical technique was performed in 20 cases of ameloblastoma (16 solid and 4 desmoplastic) and in 10 cases of AOT. All tumors presented moderate fibronectin expression in the stroma. Solid ameloblastomas showed intense expression of fibronectin at the epithelial-mesenchymal interface, whereas desmoplastic ameloblastomas revealed no immunoexpression of fibronectin at this site. Ameloblastomas presented stronger immunoreactivity to tenascin than AOTs, especially at the epithelial-mesenchymal interface. AOTs and desmoplastic ameloblastomas showed intense labeling for type I collagen. The patterns of expression of the proteins studied agree with the locally more invasive behavior of ameloblastomas in comparison to AOTs. Our results might suggest a less invasive behavior of desmoplastic ameloblastoma in comparison to solid ameloblastoma.

Objective: The purpose of this study was to investigate the association between regular physical activity and the prevalence of dysphonia., Method: A cross-sectional study was conducted with 3142 teachers from 129 municipal public schools in the city of Belo Horizonte, Brazil. The dependent variable, dysphonia, was classified (absent or present) according to reported symptoms (fatigue when speaking and loss of voice quality), their frequency (occasionally and daily), and duration (past 15 days). The independent variable was regular physical activity. The degree of association was estimated based on the prevalence ratio and a 95% confidence interval obtained by the Poisson regression adapted for cross-sectional studies., Results: In the study sample, the prevalence of dysphonia in teachers was 15.63%. Nearly half (47.52%) of the teachers reported no regular practice of physical exercises. The remaining teachers (52.48%) walked and did physical exercises, sports, and other activities; 31.25% undertook these activities once or twice a week, and 21.23% exercised three or more times a week. Teachers who did not practice physical activity were more likely to present dysphonia compared to those that exercised three or more times a week., Conclusion: Regular physical activity was associated positively with the prevalence of dysphonia.

The objective of this study is to establish the prevalence of dysphonia and associated factors in public school female teachers working in Belo Horizonte. This cross-sectional study was conducted on a random sample of schools between May 2004 and July 2005. There were 2103 elementary education daytime teachers from 83 schools included in the study. Self-applied questionnaires were used for data collection. These included questions on social and demographic matters, general health and mental health (General Health Questionnaire-12 [GHQ-12]), the environment and organization of work, and voice-related aspects. The variable dysphonia was classified as absent, possible, or probable based on the association between frequency of fatigue when speaking and worsened voice quality during the past 15 days. Multinomial logistic regression was used to analyze factors independently associated with dysphonia in each response subgroup and in total. One third of the female teachers did not report voice symptoms during the past 15 days (33%). The prevalence of probable dysphonia was 15%, and the prevalence for possible dysphonia was 52%. Factors associated with probable dysphonia were presence of recent upper airway problems (odds ratio [OR]=5.95, 95% confidence interval [CI]=4.06-8.71), problems at work because of voice (OR=65.30, 95% CI=19.33-220.59), other activities with intense voice use (OR=1.71, 95% CI=1.08-2.71), high noise levels (OR=2.55, 95% CI=1.72-3.76), poor ventilation in the classroom (OR=2.00, 95% CI=1.24-3.22), current mental disorder (OR=3.20, 95% CI=2.18-4.70), sedentary life style (OR=1.94, 95% CI=1.21-3.09), and marriage (OR=1.70, 95% CI=1.16-2.47). Associations between probable dysphonia, poor working conditions, health-related aspects, and professional jeopardy indicate the complexity of dysphonia in female teachers and the need for collective intervention strategies.