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Background Radiotherapy is widely used in contemporary head and neck cancer treatment protocols. The ability of head and neck radiotherapy (HNRT) to cause direct radiogenic destruction to the teeth is one of the most controversial topics in the field of oral oncology. Therefore, this systematic review aimed to investigate ionising radiation as an independent factor for physical and chemical changes on the dentine-enamel junction (DEJ), a pivotal dental topography for the onset and progression of radiation-related caries (RRC) and enamel delamination. Material and Methods Systematic searches were conducted on three databases: Scopus, MEDLINE (Via PubMed) and Embase (Elsevier). Laboratory studies evaluating the effects of simulated or in vivo HNRT on the DEJ were included. The GRADE tool adapted for in vitro studies was used to assess the methodological quality. Results Of the 154 initially selected studies, eight met the inclusion criteria, from which five studies were graded as high quality of evidence, two studies were graded as moderate quality and one as low quality. Two studies did not demonstrate DEJ alterations following HNRT while the other six articles described several organic and inorganic changes in the DEJ of irradiated teeth samples. These radiogenic events were mostly detected through micro and nanoindentation, Raman micro-spectroscopy, confocal microscopy, Western blotting and optical coherence tomography. Conclusions HNRT may have a negative impact on the physical and chemical aspects of the DEJ, predisposing cancer patients to RRC and enamel delamination. Key words:Cancer, radiotherapy, radiation-related caries, dentin-enamel junction, systematic review.

Background Although new digital pathology tools have improved the positive cell quantification, there is a heterogeneity of the quantification methods in the literature. The aim of this study was to evaluate and propose a novel dendritic cells quantification method in squamous cell carcinoma comparing it with a conventional quantification method. Material and Methods Twenty-six squamous cell carcinomas HIV-positive cases affecting the oropharynx, lips and oral cavity were selected. Immunohistochemistry for CD1a, CD83, and CD207 was performed. The immunohistochemical stains were evaluated by automated examination using a positive pixel count algorithm. A conventional quantification method (unspecific area method; UA) and a novel method (specific area method; SA) were performed obtaining the corresponding density of positive dendritic cells for the intratumoral and peritumoral regions. The Mann-Whitney U test was used to verify the influence of the quantification methods on the positive cell counting according to the evaluated regions. Data were subjected to the ANOVA and Student’s t-test to verify the influence of the tumour location, stage, histological grade, and amount of inflammation on the dendritic cells density counting. Results The cell quantification method affected the dendritic cells counting independently of the evaluated region (P-value

Acute cholecystitis (AC), frequently responsible for presentation to the emergency department, requires expedient diagnosis and definitive treatment by a general surgeon. Ultrasonography, usually performed by radiology technicians and reported by radiologists, is the first-line imaging study for the assessment of AC. Targeted point-of-care ultrasound (POCUS), particularly in the hands of the treating surgeon, may represent an evolution in surgical decision-making and may expedite care, reducing morbidity and cost.This consensus guideline was written under the auspices of the European Society of Trauma and Emergency Surgery (ESTES) by the POCUS working group. A systematic literature search identified relevant papers on the diagnosis and treatment of AC. Literature was critically-appraised according to the GRADE evidence-based guideline development method. Following a consensus conference at the European Congress of TraumaEmergency Surgery (Valencia, Spain, May 2018), final recommendations were approved by the working group, using a modified e-Delphi process, and taking into account the level of evidence of the conclusion.We strongly recommend the use of ultrasound as the first-line imaging investigation for the diagnosis of AC; specifically, we recommend that POCUS may be adopted as the primary imaging adjunct to surgeon-performed assessment of the patient with suspected AC. In line with the Tokyo guidelines, we strongly recommend Murphy's sign, in conjunction with the presence of gallstones and/or wall thickening as diagnostic of AC in the correct clinical context. We conditionally recommend US as a preoperative predictor of difficulty of cholecystectomy. There is insufficient evidence to recommend contrast-enhanced ultrasound or Doppler ultrasonography in the diagnosis of AC. We conditionally recommend the use of ultrasound to guide percutaneous cholecystostomy placement by appropriately-trained practitioners.Surgeons have recently embraced POCUS to expedite diagnosis of AC and provide rapid decision-making and early treatment, streamlining the patient pathway and thereby reducing costs and morbidity.

BACKGROUND: INCA estimated, for 2020 – 2022, Brazil would have 8,460 new pediatric cancer cases and 5% are bone cancer. Pain is the most prevalent symptom and is present in 75% - 90%. Advanced ill patients have 40% pain undertreated. OBJECTIVE: This study was to evaluate pain in pediatric bone cancer patients and investigate if there was a difference between those who survived and those at end-of-life. PROCEDURE: Patients were registered at INCA Pediatric Department, January 2011 – October 2016, with the diagnosis confirmed of primary bone cancer and under 19 years old. Pain was evaluated and registered at three moments during their treatment: at registration, three months after and the last visit before the end of this study or patients death, using pain scores. RESULTS: 157 patients were bone cancer, 15 (9.6%) had lost the follow up; 142 were analyzed, osteosarcoma 69.7% and Ewing sarcoma 30.3%, metastatic patients 50.7%. At the registration 53.5% had pain, 69.71% were receiving pain treatment and 42.25% had pain medications changed. Comparison of the three study moments was observed a decrease of pain status, with the absence of excruciating pain, and an increased use of opioids. There was no difference (p = 0.68) in pain status between groups of who survived and who died (39.4%). CONCLUSION: Pain management resulted in reduction of pain complaint and reduction in pain intensity, together with increasing opioid use. End-of-life patients did not have more pain than others, but disease progression was associated to more pain.

Laryssa Pinheiro Costa Silva,1 Jairo Pinto Oliveira,2 Wanderson Juvencio Keijok,2 André Romero da Silva,3 Anderson Rocha Aguiar,1 Marco Cesar Cunegundes Guimarães,2 Carolina Magri Ferraz,1 Jackson Victor Araújo,4 Fernando Luiz Tobias,5 Fábio Ribeiro Braga1 1Department of Parasitology, University Vila Velha, Vila Velha, Espírito Santo, Brazil; 2Morphology Department, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil; 3Federal Institute of Education, Science and Technology of Espírito Santo, Aracruz, Espírito Santo, Brazil; 4Department of Veterinary Medicine, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil; 5Department of Microbiology, University Vila Velha, Vila Velha, Espírito Santo, Brazil Abstract: The biosynthesis of metallic nanoparticles (NPs) using biological systems such as fungi has evolved to become an important area of nanobiotechnology. Herein, we report for the first time the extracellular synthesis of highly stable silver NPs (AgNPs) using the nematophagous fungus Duddingtonia flagrans (AC001). The fungal cell-free filtrate was analyzed by the Bradford method and 3,5-dinitrosalicylic acid assay and used to synthesize the AgNPs in the presence of a 1 mM AgNO3 solution. They have been characterized by UV–Vis spectroscopy, X-ray diffraction, transmission electron microscopy, dynamic light scattering, Zeta potential measurements, Fourier-transform infrared, and Raman spectroscopes. UV–Vis spectroscopy confirmed bioreduction, while X-ray diffractometry established the crystalline nature of the AgNPs. Dynamic light scattering and transmission electron microscopy images showed approximately 11, 38 nm monodisperse and quasispherical AgNPs. Zeta potential analysis was able to show a considerable stability of AgNPs. The N–H stretches in Fourier-transform infrared spectroscopy indicate the presence of protein molecules. The Raman bands suggest that chitinase was involved in the growth and stabilization of AgNPs, through the coating of the particles. Our results show that the NPs we synthesized have good stability, high yield, and monodispersion. Keywords: silver nanoparticles, green synthesis, nematophagous fungi, Duddingtonia flagrans

En la investigaci?n planteada se sustenta en el dise?o de estrategias, constituido en funci?n de la divulgaci?n de las buenas pr?cticas asociativas, las mismas que deben ser desarrolladas y adquiridas por cada uno de los socios, aplicando directrices b?sicas de responsabilidad social, aspecto que implica el aseguramiento de la protecci?n del medio ambiente, con m?todos ecol?gicamente seguros, higi?nicamente aceptables y econ?micamente factibles. La metodolog?a aplicada en la investigaci?n versa en la utilizaci?n de una modalidad bibliogr?fica y documental al coadyuvar a la definici?n de pr?cticas asociativas y responsabilidad social, el enfoque que se aplic? fue cualitativo y cuantitativo, por implicarse en una realidad social al emplear una entrevista, y un cuestionario estructurado, ejecutado mediante la encuesta como t?cnica, para recoger informaci?n que fue objeto de an?lisis e interpretaci?n, revelando que las asociaciones de agricultores del ?Cant?n Quero? no cuentan con conocimientos previos sobre la responsabilidad social, adem?s de carecer de lineamientos referentes a las buenas practicas asociativas en funci?n de su labor de agricultores, problema que ser? subsanado mediante la presentaci?n de estrategias, que detallen de forma precisa las pr?cticas asociativas basadas en la responsabilidad social, que contribuya a establecer un medio ambiente sustentable. Las estrategias fueron proporcionadas a los socios los mismos, que tiene un firme compromiso de aplicar cada una de las pr?cticas asociativas.

Stafne’s bone defect (SBD) is an uncommon bone alteration that affects the mandible and usually presents as an asymptomatic radiolucency located in the posterior region of body or angle of the mandible, below the alveolar canal. Although clinical and radiographic features are more often sufficient for the diagnosis, other lesions and bone alterations have been described in the differential diagnosis and may lead to a misinterpretation and an incorrect diagnosis. Herein, we report a case of an 89-yearold man with metastatic prostate cancer to multiple bones, presenting an asymptomatic solitary well-defined radiolucent image on the right side of the posterior body of the mandible, in close contact with its inferior border. A bone depression was confirmed by computed tomography scans of the mandible and a metastatic inclusion was ruled out by bone scintigraphy with a final diagnosis of SBD. The aim of this report was to highlight the importance of differentiating SBD from metastases in cancer patients and to reinforce the usefulness of multiple imaging modalities in the differential diagnosis of SBD. Key words:Stafne’s bone defect, Mandible, Depression, Metastases, Imaging modalities.