Artigos - Oftalmo/Otorrino e CCP - FMB

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New Insights into the Impact of Human Papillomavirus on Oral Cancer in Young Patients: Proteomic Approach Reveals a Novel Role for S100A8
(2023-05-01) Miranda-Galvis, Marisol; Carneiro Soares, Carolina; Moretto Carnielli, Carolina; Ramalho Buttura, Jaqueline; Sales de Sá, Raisa; Kaminagakura, Estela [UNESP]; Marchi, Fabio Albuquerque; Paes Leme, Adriana Franco; Lópes Pinto, Clóvis A.; Santos-Silva, Alan Roger; Moraes Castilho, Rogerio; Kowalski, Luiz Paulo; Squarize, Cristiane Helena; University of Michigan School of Dentistry; Universidade Estadual de Campinas (UNICAMP); University of Vienna; Brazilian Center for Research in Energy and Materials (CNPEM); A.C.Camargo Cancer Center (CIPE); Universidade Estadual Paulista (UNESP); Cancer Institute of the State of São Paulo (ICESP); Universidade de São Paulo (USP); A.C.Camargo Cancer Center; University of Michigan
Human papillomavirus (HPV) infection has recently been linked to a subset of cancers affecting the oral cavity. However, the molecular mechanisms underlying HPV-driven oral squamous cell carcinoma (OSCC) onset and progression are poorly understood. Methods: We performed MS-based proteomics profiling based on HPV status in OSCC in young patients, following biological characterization and cell assays to explore the proteome functional landscape. Results: Thirty-nine proteins are differentially abundant between HPV (+) and HPV (−) OSCC. Among them, COPS3, DYHC1, and S100A8 are unfavorable for tumor recurrence and survival, in contrast to A2M and Serpine1, low levels of which show an association with better DFS. Remarkably, S100A8 is considered an independent prognostic factor for lower survival rates, and at high levels, it alters tumor-associated immune profiling, showing a lower proportion of M1 macrophages and dendritic cells. HPV (+) OSCC also displayed the pathogen-associated patterns receptor that, when activated, triggered the S100A8 and NFκB inflammatory responses. Conclusion: HPV (+) OSCC has a peculiar microenvironment pattern distinctive from HPV (−), involving the expression of pathogen-associated pattern receptors, S100A8 overexpression, and NFκB activation and responses, which has important consequences in prognosis and may guide therapeutic decisions.
Postoperative serum magnesium levels as a predictor for the need for calcium replacement after total thyroidectomy: a prospective study
(2023-01-01) Soares, Carlos Segundo Paiva [UNESP]; de Oliveira, Cristiano Claudino; Koga, Katia Hiromoto [UNESP]; Moriguchi, Sonia Marta [UNESP]; Terra, Simone Antunes [UNESP]; Tagliarini, José Vicente [UNESP]; Mazeto, Gláucia Maria Ferreira da Silva [UNESP]; Universidade Estadual Paulista (UNESP); A.C.Camargo Cancer Center
Objective: Our aim was to assess the ability of serum magnesium (Mg), measured on the first postoperative day (Mg1PO), to predict the need for calcium (Ca) replacement in patients undergoing total thyroidectomy (TT). Subjects and methods: Eighty patients undergoing TT, with Mg1PO and PTH dosage in the first (PTH1h) and eighth (PTH8h) hours after TT, were evaluated for the need for Ca replacement. Data were evaluated by uni/multivariate logistic regression and Receiver Operating Characteristic (ROC) curve. Results: 32 patients (40%) required Ca replacement. Median PTH1h, PTH8h and Mg1PO were higher in the no replacement group: 17 versus (vs) 3 pg/mL (p < 0.001), 18.2 vs 3.0 pg/mL (p < 0.001) and 2 vs 1.6 mg/dL (p < 0.001), respectively. Mg1PO was the isolated predictor for this replacement (odds ratio = 0.0004, 95% confidence interval: 0.000003-0.04; p = 0.001), with the cut-off value of 1.8 mg/dL showing sensitivity and specificity of 78.1% and 87.5%, respectively. Conclusions: In this group of patients, serum Mg1PO was the isolated predictor for the need for Ca replacement. Arch Endocrinol Metab. 2023;67(3):355-60.
Propolis effects in periodontal disease seem to affect coronavirus disease: a meta-analysis
(2023-01-01) Sales-Peres, Silvia Helena de Carvalho; de Azevedo-Silva, Lucas José; Castilho, Ana Virginia Santana Sampaio; Castro, Marcelo Salmazo; Sales-Peres, Silvia Helena de Carvalho [UNESP]; Moreira Machado, Maria Aparecida de Andrade; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
This meta-analysis aimed to investigate the effects of propolis on the severity of coronavirus disease symptoms by reducing periodontal disease. PubMed, EMBASE, SciELO, Web of Science, and SCOPUS databases were systematically searched. Studies have been conducted analyzing propolis’s effects on COVID-19 and periodontitis. The study was conducted according to the PRISMA statement and registered in PROSPERO. Risk of Bias (RoB) assessment and meta-analysis of clinical studies were performed (Review Manager 5, Cochrane). The certainty of the evidence was assessed using GradePro (GDT). Studies have shown propolis flavonoids inhibit viral replication in several DNA and RNA viruses, including coronaviruses. Propolis components have an aminopeptidase inhibitor activity that can inhibit the main proteases of SARS viruses and seem to inhibit protein spikes, which are sites of most mutations in SARS-CoV strains. The meta-analysis showed favorable results with the use of propolis on probing depth (95%CI: 0.92; p < 0.001), clinical attachment level (95%CI: 1.48; p < 0.001), gingival index (95%CI: 0.14; p = 0.03), plaque index (95%CI: 0.11; p = 0.23), and blending on probing (95%CI: 0.39; p < 0.001). The antibacterial activity of propolis could be mediated through its direct action on microorganisms or the stimulation of the immune system, activating natural defenses. Thus, propolis inhibits the replication of SARS-CoV-2 as well as its bacterial activity. Treatment with propolis improves general health and facilitates the activation of the immune system against coronavirus.
Efficacy of Injectable Laryngoplasty With Hyaluronic Acid and/or Calcium Hydroxyapatite in the Treatment of Glottic Incompetence. Systematic Review and Meta-analysis
(2023-01-01) Henriques, Débora Pereira [UNESP]; Martins, Regina Helena Garcia [UNESP]; Cataneo, Antônio José Maria [UNESP]; Universidade Estadual Paulista (UNESP)
Background: Injectable laryngoplasty with hydroxyapatite and hyaluronic acid is frequently used for the treatment of glottic incompetence. The effectiveness of these substances is controversial due to the heterogeneity of studies. Objectives: To evaluate the effectiveness of the treatment for glottic incompetence using hydroxyapatite and hyaluronic acid. Study design: Systematic review and meta-analysis. Data sources: MEDLINE, PUBMED, LILACS, SCOPUS, EMBASE, Cochrane, clinicaltrials.gov, published and unpublished trials, Web of Science. Eligibility criteria: Studies that evaluated vocal fold function before and after 4-6 weeks and 6 months of hydroxyapatite and hyaluronic acid injection in adults with glottic incompetence. Exclusion criteria: studies with outcome, follow-up time or type of intervention outside the predetermined pattern or systematic review and meta-analysis. Synthesis of methods: Primary outcome - Maximum Phonation Time. Secondary outcomes - Voice Handicap Index (VHI)-30, Parameters G and B of GRBAS Scale. Outcomes were analyzed for mean differences with the corresponding 95% CI. Results: Six hundred forty-four studies identified, 12 included (5 CaHA; 6 HA; 1 HA and CaHA). After 4-6 weeks the mean difference were: MPT (+5.86), IDV (-39.32), G (-1.14), and B (-1.46). After 6 months: MPT (+5.97), IDV (-30.13), G (-1.33), and B (-1.33). Limitations: Studies comparing injectable drugs are small, as well as the number of patients in each one, making the isolated comparison of substances difficult. Conclusions and implications: There is an evidence that the injectable substances HA and CaHA are effective in the treatment of glottic incompetence, however, it is important that more studies are carried out comparing the two substances.
Anterior versus posterior retractor reinsertion with a lateral tarsal strip for involutional entropion repair: A multicentric experience
(2023-01-01) Mateos-Olivares, Milagros; Belani-Raju, Minal; Sánchez-Tocino, Hortensia; Ye-Zhu, Cristina; Sales-Sanz, Marco; Bragante, André [UNESP]; Fernandes de Sousa Meneghim, Roberta Lilian [UNESP]; Schellini, Silvana A. [UNESP]; Galindo Ferreiro, Alicia; Hospital Clínico Universitario de Valladolid (HCUV); Hospital Universitario Río Hortega; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS); IMO Grupo Miranza; Universidade Estadual Paulista (UNESP)
Purpose: The aim was the comparison of two different approaches to re-insert the inferior eyelid retractors within addition to lateral tarsal strip at lower eyelid involutional entropion (LEIE) surgical correction. Method: This multicentric retrospective case series involved 233 consecutive patients (195 eyelids) who underwent LEIE repair. All the lids had a lateral tarsal strip (LTS) in addition to the reinsertion of retractors onto the tarsal plate via the anterior approach (group 1) or the posterior approach (group 2). The desired normal position of the eyelids at 6-month follow-up was considered ‘surgical successes, while entropion recurrence and overcorrection (ectropion) were considered ‘surgical failures’. Results: One-hundred ninety-one (82%) surgeries were included in group 1 and 42 (18%) in group 2. The success rate was 92.1% (176 lids) in group 1 and 85.7% (36 lids) in group 2 (p = 0.188). The recurrence rate was statistically higher for group 2 (14.3%) than for group 1 (3.7%) (p = 0.016). Overcorrection only described in group 1 (3.1%). Both groups had a similar complication rate (p = 0.268), with trichiasis being the most frequent (14, 6%). Ten eyelids (47.6%) from the 21 overall failures were satisfactorily reoperated, and the remaining ones were treated conservatively. Conclusion: The anterior or posterior approach to reinsert lower eyelid retractors to tarsal plate in addition to LTS to correct LEIE can provide a similar outcome. However, the anterior approach achieves a slightly higher success rate with fewer recurrences but with a higher overcorrection rate.
Anti-inflammatory effects of α-humulene and β-caryophyllene on pterygium fibroblasts
(2022-01-01) Hata Viveiros, Magda Massae [UNESP]; Silva, Márcia Guimarães [UNESP]; da Costa, José Galberto Martins; de Oliveira, Anselmo Gomes [UNESP]; Rubio, Carolina [UNESP]; Padovani, Carlos Roberto [UNESP]; Rainho, Cláudia Aparecida [UNESP]; Schellini, Silvana Artioli [UNESP]; Universidade Estadual Paulista (UNESP); Regional University of Cariri
• AIM: To investigate the anti-inflammatory effects of the sesquiterpenes α-humulene and β-caryophyllene on pterygium fibroblasts. • METHODS: Primary cultures of pterygium fibroblasts were established. Third passage pterygium fibroblasts were exposed to α-humulene and β-caryophyllene separately and together. The cell viability was assessed by 3-(4,5-dimethylthiazolyl-2) -2,5-diphenyltetrazolium bromide (MTT) assay at 12, 24, 48, and 72h after exposure. The levels of the inflammatory cytokines interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α and IL-10 in the conditioned culture medium were assessed by enzyme-linked immunosorbent assay (ELISA) at 12, 24 and 48h after exposure. Data were statistically analyzed using Friedman repeated measures analysis of variances on ranks. • RESulTS: The 25 μmol/L β-caryophyllene induced significant decrease in the IL-6 production by pterygium fibroblasts 48h after the exposure (P=0.041). The levels of IL-1β, IL-8, IL-10, and TNF-α were very low and had no statistically significant variations after exposure to α-humulene, β-caryophyllene, or both compounds together. • COnCluSIOn:Theexposureto25μmol/Lofβ-caryophyllene significantly reduce the production of IL-6 by pterygium fibroblasts after 48h. This sesquiterpene may be a potential alternative adjuvant agent for the treatment of pterygium.
Concentration of Fibroblasts in the Vocal Fold of Elderly
(2022-01-01) Carneiro, Neemias S. [UNESP]; Pessin, Adriana B.B. [UNESP]; Rodrigues, Sergio A. [UNESP]; Pellizon, Claudia H. [UNESP]; Xavier, Claudia M. [UNESP]; Martins, Regina H.G. [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: To study the concentration of fibroblasts in the vocal folds of elderly people. Material and Methods: The vocal folds of 13 cadavers were removed and divided into two age groups: Control group: n-5, 18-40 years; Elderly group: n-8, ≥75 years). The vocal folds were dissected and prepared for immunohistochemical analysis using the SA100 antibody to fibroblasts. The sites analyzed were maculae flavae and medial (or vibrating) portion of the vocal folds. The AVsoft program was used to count the cells. Results: A higher concentration of fibroblasts was identified in the maculae flavae of the larynx of young adults and in the medial portion of the vocal folds of the elderly. However, these results did not determine statistically significant differences, allowing us to conclude that there was no effect of age on the concentration of fibroblasts in the vocal folds. Conclusion: In the larynx of the elderly, the fibroblast population remains similar to the young adults, both in the maculae flavae and in the body of the vocal folds, possibly being responsible for the constant production of fibrous matrix in the lamina propria. Functional changes in these cells are probably more marked than quantitative ones.
A triple blind, placebo controlled, randomised controlled trial of betahistine dihydrochloride in the treatment of primary tinnitus
(2023-01-01) Castilho, Gustavo Leão [UNESP]; Dias, Norimar Hernanes [UNESP]; Martins, Regina Helena Garcia [UNESP]; Universidade Estadual Paulista (UNESP)
Objectives: To evaluate the effectiveness of betahistine in the treatment of primary tinnitus. Design: To evaluate the effectiveness of betahistine in the treatment of primary tinnitus. Setting: Universidade estadual Paulista Julio de Mesquita Filho, Botucatu Medical School, São paulo, Brazil. Participants: Adult patients with primary tinnitus who had not undergone treatment for tinnitus in the last 6 months were included. Patients with profound sensorineural deafness, hearing aid users and patients with metabolic, neurological, psychiatric or decompensated cardiovascular diseases were excluded. Study groups: in the betahistine group, patients received betahistine 24 mg every 12 h for 90 days; in the control group, patients received placebo tablets every 12 h for 90 days. Mean Outcome Measures: Primary outcome measure: Tinnitus Handicap Inventory (THI). Secondary outcome measures: Clinical Global Impression Improvement (CGI-I) and a question of ‘Yes’ or ‘No’ to participants about their perception of improvement in symptoms. Results: Of 284 participants initially identified, 62 were randomised (betahistine group n = 31; control group n = 31). Median age (IQR) 54 (48–60) years, with a balanced number of men and women. There was no difference in THI outcome between the study groups (median difference, −2 points; 95% CI, −8 to 6 points); the THI after the intervention was a median (IQR) 4 (−4 to 14) lower points in the betahistine group, and a median (IQR) 2 (−6 to 10) in the control group. There was no statistical difference in secondary outcome measures. Adverse events were mild and there was no statistical difference between groups. Conclusions: Betahistine dihydrochloride was ineffective in the treatment of primary tinnitus in adults.
OPHTHALMOLOGICAL ASSESSMENT OF PRESCHOOL CHILDREN: EYE BLINK AND PUPILLARY DIAMETER
(Nova Science Publishers, Inc, 2010-01-01) Lavezzo, Marcelo Mendes; Schellini, Silvana Artioli [UNESP]; Colombo, L.; Bianchi, R.; Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
Introduction: Nevertheless the eyes have a fast development mainly in the early childhood, there are many difficulties in eyes examination, leading to late diagnosis to various condition;. Conventional ophthalmic tests are difficult to implement in preschool children. Digital image processing system might provide important informations about the eyeblink and pupil evaluation. Purpose: To investigate, using a digital image processing system, the eyelid dynamics and the pupillary areas and diameters of normal preschool children. Methods: 50 newborns and 200 preschool children were examined. Images were recorded using a digital camera during three minutes. Complete and incomplete blink rates, opening, closing and complete blink times were calculated. Moreover, pupil diameter and pupil area of the preschool children were evaluated during attentive and spontaneous gaze. Data were expressed in pixels and arithmetic means of each parameter were calculated. Results: The complete eye blink was more common and the blink rate increased with age. The incomplete blink rate was the same for all ages. The eyelid opening and closing times and the complete blink time were similar for both sexes. The closing eyelid time was slower. The mean pupil diameter and area were similar for both eyes, presenting values of 18.5 and 311.7 pixels during attentive and 15.4 and 237.6 pixels during spontaneous gaze, respectively. There were no differences between sexes. However, six-year-old children showed lower pupil diameter and area. Conclusion: The digital image processing system is a very good method to evaluate children and permitted to observe the complete blink rate increases with age. Pupil diameter and area were larger during attention and similar for both eyes.
Vocal Folds Leukoplakia: The Efficacy of Vitamin a in the Initial Treatment
(Georg Thieme Verlag Kg, 2022-11-10) Botini, Dayane Silvestre [UNESP]; Rodrigues, Sergio Augusto [UNESP]; Castilho, Gustavo Leao [UNESP]; Mercuri, Gustavo [UNESP]; Martins, Regina Helena Garcia [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction Laryngeal leukoplakia corresponds to a white lesion in the mucosa developed by the deposit of keratin in the epithelium, potentiated by chronic smoking. It is considered a preneoplastic lesion. Surgery is the most adopted treatment; however, non-surgical treatment is advocated by some authors. Objective To evaluate the effectiveness of vitamin A in the management of vocal fold leukoplakia. Methods Patients with videolaryngoscopy diagnosis of vocal fold leukoplakia were selected. The endoscopic images were photographed and with the aid of the ImageJ software (National Institutes of Health, Bethesda, MD, USA), the proportion of the size of the leukoplakia was calculated. Eligible patients were prescribed 50,000U of vitamin A, twice daily for 2 months, at which point videolaryngostroboscopy was repeated for comparative analysis between pre and posttreatment. The efficacy of the treatment was classified as: outcome I - complete improvement of the lesion, outcome II - partial improvement, and outcome III - no difference or increased lesion size. Results Fifteen patients (eight women, seven men) were included, six of whom had bilateral lesions. Smoking was reported in 86.8% of patients. Complete improvement of the lesion was found in 7 cases (33.4%, outcome I), partial improvement in 6 (28.6%, outcome II), and worsening of the injury in 8 (38.1%, outcome III). Of the latter, 6 underwent microsurgery; histopathology indicated absence of dysplasia in 3, and mild dysplasia in 3. Conclusions In this study, the treatment with vitamin A at a dose of 100,000IU daily for 2 months was effective in reducing the laryngeal leukoplakia size in 62% of cases.
Reinke Edema: Factors that Interfere with Vocal Recovery after Surgery
(Georg Thieme Verlag Kg, 2022-09-27) Lima Neto, Jose Luiz [UNESP]; Bueno da Fonseca, Antonio Rodrigues [UNESP]; Mendes Tavares, Elaine Lara [UNESP]; Joia Gramuglia, Andrea Cristina [UNESP]; Garcia Martins, Regina Helena [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction Dysphonia and lower pitch after surgery of Reinke edema are common. They are caused especially due to chronic smoking but, probably, other factors should be associated. Objectives To evaluate the results of laryngeal microsurgery in patients with Reinke edema, following a standardized postoperative guidance protocol in our service. Methods Retrospective study. Thirty patients (3 males; 27 females) were included, 70% between 41 and 60 years old. The parameters analyzed in the pre- and postoperative (between 4 and 6 months) of patients undergoing laryngeal microsurgery for Reinke edema were: smoking, vocal symptoms, videolaryngostroboscopy, voice therapy, perceptual and acoustic vocal evaluation, histopathological report. Results Smoking was reported by 100% of the patients and maintained in the postoperative period by 80%. Complete improvement of symptoms in the postoperative period was reported by 43% of them, partial improvement by 40%, and maintenance by 17%. There was low adherence to voice therapy in the pre- and postsurgery. Postoperative videolaryngoscopy indicated congestion (19), atrophy and bowed vocal fold (1), subepithelial edema (2), and normal findings (8). The histological findings were subepithelial edema, enlargement of vessels, inflammation, epithelial hyperplasia, and thickening of the basement membrane. The perceptual and acoustic vocal analyzes indicated improvement of the analyzed parameters. Conclusions The maintenance of some vocal symptoms and laryngeal alterations in videolaryngoscopy after microsurgery of Reinke edema is frequent, even in patients who follow the recommendations of vocal rest and control of gastroesophageal reflux. Vocal symptoms are attributed to changes in the laryngeal mucosa caused by chronic smoking, aggravated by the maintenance of addiction in the postoperative period.
Telemedicine as an auxiliary tool in trichiasis treatment follow-up
(2022-01-01) Kamano, Guilherme [UNESP]; Bellote, Filipe Lemos [UNESP]; de Oliveira, Philipe Renee Rodrigues [UNESP]; Schellini, Silvana Artioli [UNESP]; Universidade Estadual Paulista (UNESP)
Trichiasis is a disorder of the eyelid margin characterized by misdirected eyelash growth toward the ocular surface, where they touch and irritate the cornea(1). It is most commonly observed in older adults and the majority of cases are caused by persistent inflammation of the eyelid margin(2). Laser thermal ablation is a rapid and easy treatment for milder manifestations of this condition and is recommended when there are 10 or fewer affected lashes. Following the treatment, a three-month follow-up is required to assess new lash growth
Comparison of two techniques for surgical eyebrow suspension
(2022-09-01) Sugino, P. [UNESP]; Meneghim, R. L.F.S. [UNESP]; Schellini, S. A. [UNESP]; Universidade Estadual Paulista (UNESP)
Purpose: Brow ptosis can interfere with blepharoplasty results and can be corrected using several techniques. The present study was performed to compare two techniques for brow suspension, both with concomitant upper eyelid blepharoplasty. Method: A prospective, interventional, randomized study involving 27 female patients was performed to compare the effects of two different techniques of brow suspension: eyebrow suspension with nylon thread (ESN) and internal browpexy fixation (IBF), both combined with upper lid blepharoplasty. Qualitative assessment was carried out using a questionnaire, and quantitative angular measurement analysis of the brow position was performed using digital photographs taken with a Vectra H1 camera before, 60, and 120 days after surgery. The data were transferred to an Excel table and statistically analyzed. Results: ESN was performed in 14 patients and IBF in 13 patients. Both groups were homogeneous in terms of age. The main preoperative complaints were excess skin on the upper eyelid (81.4%) and reduced visual field (59.2%) in both groups. Most of the patients expected aesthetic improvement, and the surgical results were considered satisfactory for all of them. There was no significant difference between ESN and IBF in the quantitative evaluation of eyebrow position. Conclusion: Both ESN and IBF resulted in a high degree of patient satisfaction. Both techniques provided similar brow suspension, emphasizing that IBF is technically easier to perform and produces less scarring.
Possible Association between Vogt-Koyanagi-Harada Disease and Coronavirus Disease Vaccine: A Report of Four Cases
(2022-01-01) de Queiroz Tavares Ferreira, Felipe; Araújo, Daniel Cunha [UNESP]; de Albuquerque, Leonardo Mendonça; Bianchini, Priscila Monaro; Holanda, Erick Carneiro; Pugliesi, Alisson; Hospital Geral de Fortaleza; Universidade Estadual de Campinas (UNICAMP); Universidade Estadual Paulista (UNESP)
Vogt-Koyanagi-Harada (VKH) syndrome is an autoimmune, multisystemic disease characterized by severe bilateral granulomatous posterior, which can occur due to viral infection or vaccination. We report four cases that had a likely association between VKH disease and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Two patients had VKH symptoms within 1 and 2 weeks after receiving the ChAdOx1 nCoV-19 vaccine. One patient presented with VKH symptoms 5 days after receiving the BNT162b2 vaccine, and one patient had symptoms within 4 weeks after receiving the CoronaVac vaccine. Early diagnosis and treatment of VKH disease are essential for the visual prognosis of this aggressive disease. Further in-depth studies are necessary to investigate this likely association to enable ophthalmologists to identify new assumed correlations between the diseases described in this study.
Oral language skills in Brazilian children with obstructive sleep apnea
(2022-09-01) Corrêa, Camila de Castro; Maximino, Luciana Paula; Abramides, Dagma Venturini Marques; Weber, Silke Anna Theresa [UNESP]; Planalto University Center of Distrito Federal (UNIPLAN); Universidade de São Paulo (USP); Universidade Estadual Paulista (UNESP)
Background: Obstructive sleep apnea (OSA) is associated with a negative impact on neurocognitive development in children. Receptive/expressive oral language is a complex process, with limited investigations on the repercussion of OSA. This study aimed to analyze receptive and expressive oral language skills in children with obstructive sleep apnea (OSA). Methodology: This study included 52 children (27 females, 51.92 %) with a mean age of 7 ± 2 years (age range of 4–11 years), which underwent type 3 polysomnography (PSG). The participants were divided into N-OSA (n = 16) and OSA (n = 36) groups based on the apnea-hypopnea index. The speech-language therapist evaluated hearing and oral language for phonology, expressive semantics, syntax, receptive semantics (Peabody Image Vocabulary Test), pragmatics, and understanding of verbal instructions (Token Test). Results: Oral language assessments showed a difference in the pragmatics subsystem (p = 0.047), with positive correlation between OSA severity and oral language functions such as pragmatics and syntax (desaturation index, p = 0.045). Conclusion: Obstructive sleep apnea (OSA) had a negative impact on oral language skills, including the syntax and pragmatics subsystems.
Recurrent and recalcitrant upper lid cicatricial entropion following combined chemotherapy: Clinical and pathology correlation
(2021-10-01) Galindo-Ferreiro, Alicia; De Prado Otero, Diego; Marquez, Pilar G.; Schellini, Silvana [UNESP]; Rio Hortega University Hospital; Clinic University Hospital; Universidade Estadual Paulista (UNESP)
We report a case of recalcitrant bilateral upper eyelid cicatricial entropion associated with distichiasis/trichiasis which followed an adjuvant systemic chemotherapy. The chemotherapy, administered for treatment of breast cancer, consisted of docetaxel, carboplatin, and herceptin. Shortly following the combined chemotherapy treatment, epiphora and eyelash abnormalities commenced. The patient presented with a swollen eyelid margin and tarsal conjunctival inflammation associated with cicatricial entropion and diffused distichiasis/trichiasis affecting the upper lids, with greater severity observed in the medial portion. Despite manual epilation and multiple argon laser sessions, no improvement was noted. Surgical treatment was performed using a lid split, distichiasis excision of the right upper lid, and homolateral tarsoconjunctival graft. The biopsy examination showed chronic inflammation, dermal fibrosis with squamous metaplasia process, and an abnormal epithelial differentiation. After 6 months, entropion recurred. Tarsal marginal rotation associated with posterior lamella advancement was performed. However, cicatricial entropion and distichiasis/trichiasis recurred. The patient was prescribed bandage contact lenses and topical lubrication to relieve symptoms.
Applications of Bioceramics in the Management of Orbital Floor Fractures and Anophthalmic Cavity: A Review
(2022-06-01) Schellini, Silvana Artioli [UNESP]; Ferraz, Lucieni Cristina Barbarini; Rahdar, Abbas; Baino, Francesco; Universidade Estadual Paulista (UNESP); Bauru State Hospital; University of Zabol; Politecnico di Torino
Biocompatible ceramics, commonly known as “bioceramics”, are an extremely versatile class of materials with a wide range of applications in modern medicine. Given the inorganic nature and physico-mechanical properties of most bioceramics, which are relatively close to the mineral phase of bone, orthopedics and dentistry are the preferred areas of usage for such biomaterials. Another clinical field where bioceramics play an important role is oculo-orbital surgery, a highly cross-and interdisciplinary medical specialty addressing to the management of injured eye orbit, with particular focus on the repair of orbital bone fractures and/or the placement of orbital implants following removal of a diseased eye. In the latter case, orbital implants are not intended for bone repair but, being placed inside the ocular cavity, have to be biointegrated in soft ocular tissues. This article reviews the state of the art of currently-used bioceramics in orbital surgery, highlighting the current limitations and the promises for the future in this field.
Impacts of COVID-19 pandemic and public policies on corneal transplantations in Brazil
(2022-01-01) Garcia, Ana Maria Guimarães; de Sousa, Luciene Barbosa; Shiguematsu, Alvio Isao [UNESP]; Associação Pan-Americana de Banco de Olhos; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual Paulista (UNESP)
Purpose: The study aimed to evaluate the impact of coronavirus disease 2019 (COVID-19) pandemic and public policies on corneal donations and transplantations in Brazil and get reliable indicators to support effective measures for improving the system of obtaining, processing, distributing, using, and controlling donated ocular tissues. Methods: A questionnaire was applied by the Brazilian office of the Pan-American Association of Eye Banks (APABO) to Brazilian Eye Banks to collect data from January to August 2020 and generate reliable indicators about the impact of the COVID-19 pandemic on corneal donations and transplantations in Brazil. Results: Data from 37 Eye Banks showed that 76.1% of the 3,060 donations and 74.5% of the 3,167 transplants occurred in the pre-pandemic period. From the 6,052 processed corneas, 71.8% were provided for therapeutic purposes: 72.9% were transplanted, 26.1% ended up being discarded (45% of which qualified for optical transplantation), and 1% remained in stock in glycerin. Of the 1,706 corneas that could not be eligible for therapeutic use, 47.9% were excluded due to tissue conditions, 43.6% for serological reasons, 6.7% due to contraindications found in clinical history after retrieval, and 1.8% for other factors. Conclusions: The negative impact of the COVID-19 pandemic on corneal donations and transplantations in Brazil resulted from the recommendation of the Health Ministry to suspend the retrieval of ocular tissues from donors in cardiopulmonary arrest for almost six months. The indicators reveal the compelling requirement for updating both the classification and cornea provision criteria by the Eye Banks and improving the Brazilian corneal distribution system.
Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study
(2022-01-01) Colenci, Renato [UNESP]; Minicucci, Marcos Ferreira [UNESP]; Soares, Carlos Segundo Paiva [UNESP]; Oliveira, Cristiano Claudino de [UNESP]; Marques, Mariângela Esther de Alencar [UNESP]; Tagliarini, José Vicente [UNESP]; Mazeto, Gláucia Maria Ferreira da Silva [UNESP]; Universidade Estadual Paulista (UNESP)
Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Subjects and methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusions: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.
Effect of Aging on the Vocal Muscle
(2022-01-01) Peres, André de Carvalho Sales [UNESP]; Pessim, Adriana Bueno Benito [UNESP]; Rodrigues, Sergio Augusto [UNESP]; Martins, Regina Helena Garcia [UNESP]; Universidade Estadual Paulista (UNESP)
Introduction: Sarcopenia is a common and natural condition in the elderly, and leads to loss of muscle mass and function. In the presbylarynx there is atrophy of the vocal folds, however the degree of vocal muscle atrophy is poorly studied and the results are contradictory. Aims: The aim of this study was to evaluate the effect of aging on the vocal muscle (thyroarytenoid muscle). Methods: Thirteen larynxes removed during necropsy from 13 cadavers were included into two age groups: Control group – G1 (n5), between 25 and 40 years; Elderly Group - GI (n-8), aged 70 years or older. The vocal folds were dissected and prepared for scanning electron microscopy, ensuring a cross-section in the musculature area to allow measurements of muscle fiber parameters. Images were analyzed and photographed at different magnifications. Through the ImageJ software, ten distinct fields of each part were selected. Parameters studied: area, perimeters and diagonals of the thyroarytenoid muscle bundles of both groups. Results: The cross-sectional areas, perimeters and diagonals of the muscle fibers of the thyroarytenoid muscle of the elderly group were significantly smaller than those of the control group. Conclusion: We demonstrated that the vocal muscle is affected in the presbylarynx, with a reduction of its muscle fibers, corresponding to muscle atrophy. However, these findings may not be directly related to vocal symptoms because the patient may develop muscle compensatory mechanisms capable of reducing glottic insufficiency

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