CHRISTINA MAY MORAN DE BRITO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
5 resultados
Resultados de Busca
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bookPart Reabilitação após cirurgia da cabeça e pescoço(2013) BRITO, Christina May Moran de; CAMARGO, Fernanda Pereira; TONINI, Paula; BATISTELLA, Linamara Rizzo- Botulinum toxin type A as an adjunct treatment to radiation-induced trismus(2013) ANDRADE, R. G.; LIMA, M. C.; BRITO, C. M. M.Purpose of study: To report a case of trismus (lockjaw) that began after completion of radiation therapy for head and neck cancer that we treated with botulinum toxin type A. Methods used: Case report. Summary of results: A white woman, 60 years old, was diagnosed with squamous cell carcinoma (SCC) of the left oral mucosa in April 2010. She underwent resection of the SCC in June 2010 with neck dissection and construction of a left supraclavicular flap. Subsequently, she underwent radiotherapy from 25 October 2010 to 14 December 2010. About 30 days after the radiation therapy, she noticed a decreased range of motion associated with jaw pain, and she experienced difficulty with feeding and oral hygiene. She was referred to speech therapy for rehabilitation but had little improvement. In our first physiatric evaluation on 13 June 2011, we identified a maximal inter-incisal distance of 0.5 cm, pain score assessed by visual analog scale (VAS) of 4, and Short Form 36 (SF-36) score of 676. We requested a facial and temporomandibular joint MRI, which eliminated recurrence of disease, osteonecrosis and muscle fibrosis as possible causes of the trismus. We chose to treat her trismus with botulinum toxin type A (Prosigne®, Lanzhou Biological Products Institute, Lanzhou, China), with 60 U in the masseter and 40 U in the temporalis muscle, with resumption of the speech therapy exercises while we monitored the toxin therapy. Two weeks after injection, the patient showed a maximal inter-incisal distance of 2.0 cm, a 2-point improvement in the VAS, an improved SF-36 score of 742, and she reported relief of pain. She even reported complete resolution of a previous headache, which she had not mentioned in her first evaluation. Conclusions: We suggest the use of botulinum toxin type A as an adjunct treatment to radiation-induced trismus, especially in severe cases that are refractory to conventional treatment. Trials with this treatment are indicated in order to evaluate the role of BTX-A in trismus.
conferenceObject Rehabilitation in lung cancer(2013) BRITO, C. M. M.; ALMEIDA, E. M. P. de; SAUL, M.; CECATTO, R. B.; ANDRADE, R. G.; IMAMURA, M.; BATTISTELLA, L. R.conferenceObject Guidelines on rehabilitation in breast cancer-related lymphedema(2013) SAUL, M.; BRITO, C. M. M.; LOURENCAO, M. I. P.; BAZAN, M.; OTSUBO, P.; IMAMURA, M.; BATTISTELLA, L. R.- Evaluation of acupuncture for cancer symptoms in a cancer institute in Brazil(2013) D'ALESSANDRO, Eduardo; BRITO, Christina de; CECATTO, Rebeca; SAUL, Maira; ATTA, Jose Antonio; LIN, Chin AnIntroduction Acupuncture has been progressively included in the practice of mainstream medicine in recent decades. The State of Sao Paulo Cancer Institute is a public hospital established in 2008 and its acupuncture service follows the experience and model of several oncology centres in the USA, aiming to optimise the treatment of symptoms such as postoperative pain, oncological pain, neuropathic pain, nausea, vomiting, xerostomia and fatigue induced by chemotherapy. This paper describes the population given acupuncture treatment and the effects of the intervention on symptom management. Methods One hundred and eighty-three patients from our service were enrolled in the study. Baseline and final symptom intensity was recorded using a visual analogue score (VAS) ranging from 0 to 10 cm, with a higher score meaning higher symptom intensity. Results Fifty-four (29.50%) were receiving active treatment with chemotherapy and/or radiotherapy, 29 (15.85%) were receiving hormone therapy and 100 (54.65%) were considered to be in remission. The main symptoms were: oncological pain in 44 (24.04%), chemotoxicity in 34(18.6%), lumbar pain in 53 (28.96%) and chronic postoperative pain in 54(28.4%). The mean (SD) initial symptom score was 7.04 (1.8), which was reduced to 2.56 (2.75) after treatment (p<0.001), an improvement of 63.6% in control of the symptoms. Further analysis of the data showed that the effect was similar in different indications for acupuncture treatment. Conclusions Use of acupuncture may have improved symptom control in patients enrolled in this study.