Establishment and characterization of a primary calcifying epithelial odontogenic tumor cell population.

UNLABELLED: Calcifying epithelial odontogenic tumors (CEOTs) are rare neoplasms derived from dental tissue with the unique characteristic of calcifying amyloid-like material. OBJECTIVES: To establish primary CEOT epithelial-derived cell populations, investigate the expression of enamel matrix proteins (EMPs), and identify potential ameloblastin (AMBN) and patched 1 (PTCH1) gene alterations. MATERIALS AND METHODS: A 28-year-old patient with a lesion of the posterior maxilla, radiographically characterized by a radiolucency with well-defined borders containing mixed radiopacities, agreed to participate with informed consent. The patient's biopsy confirmed the diagnosis of CEOT, and a small representative tumor fragment was ascertained for cell culture. Explant cultures were established and used to establish primary cell populations. These were analyzed for morphology, cell proliferation, mineralization activity, expression of epithelial-associated markers (qRT-PCR and immunocytochemistry), and gene mutations of AMBN or PTCH1. DNA was extracted from tumor cells and gene coding and exon-intron boundaries overlapping fragments amplified. PCR products were bidirectional DNA sequenced and compared against reference sequence. RESULTS: A CEOT cell population was established and proliferated in culture and could be maintained for several passages. Expression of EMPs, cytokeratin 14 and 17, and patched (PTCH1), as well as ALP activity, was detected. These cells also had the ability to mineralize, similar to the primary tumor. Two AMBN alterations were identified in the sample: c.1323G>A/A441A (rs7680880) and c.1344*+111delA. Two single-nucleotide polymorphisms were identified in the PTCH1 gene. CONCLUSIONS: Our data support the establishment of a CEOT-derived cell population, which expresses known epithelial-associated proteins.

Prevalence of oral mucosal lesions in an adult population from eight communities in Santo Domingo, Dominican Republic.

The purpose of the study was to evaluate the prevalence of Oral Mucosal Lesions (OMLs) in an adult population from Santo Domingo, Dominican Republic. 751 subjects from eight communities from Santo Domingo accepted the invitation to participate in an oral screening from October 2016 to January 2017. 248 subjects were evaluated and clinically examined, age range 18-86 years. A validated instrument was designed to record demographic factors, age group, gender, anatomical location, presence or absence of OMLs, risk factors such as tobacco consumption and its frequency, and different forms of tobacco and alcohol use. A systematic oral clinical examination was conducted by a specialist. The presence or absence, and anatomic location of OMLs were recorded. The sample consisted of 44.4% males and 55.6 % females. 228 subjects had 1 or more lesions (91.9%), the median was 3 lesions per patient. In relation to risk factors, tobacco use in general was reported by 26.2 % of the subjects, with cigarette smoking reported by 75.4%, followed by other forms as "hookah" 9.2 %, marihuana 9.2%, cigars ("puros")4.6% and pipe smoking 1.5%. Among the oral lesions detected by screening, the nonpathological group was prevalent, and included physiologic melanin pigmentation as the most frequent (25.0%) followed by palatal/mandibular tori (20.2%), Fordyce granules (7.9%), and Exostosis (5.6%). Potentially malignant disorders (Oral Leukoplakia, Oral Lichen Planus and Actinic Cheilitis) corresponded to 2.2%, 0.3 %, and 0.3%, respectively. No malignancy was observed clinically. This study Authorutes to determining the prevalence of OMLs in Dominican Republic and to identifying risk factors. This is the first study reporting the prevalence of oral mucosal lesions among the Dominican adult population. This information is vital for establishing a public health program targeting the high-risk group to improve the oral health status in this population.

El objetivo del presente estudio fue evaluar la prevalencia de lesiones de la mucosa oral (LMO) en una población adulta proveniente de Santo Domingo, República Dominicana. 751 individuos procedentes de ocho comunidades de la provincia de Santo Domingo, respondieron a la invitación para participar en el examen bucal, desde Octubre 2016 a Enero 2017. 248 sujetos con un rango de edad de 18-86 años, fueron evaluados y examinados clínicamente. Se diseñó y validó un instrumento para obtener datos de factores demográficos, grupos de edad, género, localización anatómica, presencia o ausencia de lesiones de la mucosa oral, factores de riesgo tales como: consumo de tabaco, frecuencia, diferentes formas de uso de tabaco y alcohol. Un especialista en el área, realizó un examen clínico bucal sistematizado en el cual se evaluó y registró la presencia o ausencia de lesiones y su localización anatómica. De acuerdo a la distribución por género, 44.4% correspondió a masculino y 55.6 % femenino. 228/248 sujetos presentaron 1 o más lesiones (91.9%), siendo la media de 3 lesiones por paciente. En relación a los factores de riesgo, el tabaco se reportó en 26.2%, siendo el fumar cigarrillos el 75.4%, seguido de otras formas como "hookah" 9.2%, marihuana 9.2%, cigarros ("puros") 4.6% y pipa fumada 1.5 %. En cuanto a las lesiones bucales detectadas en el examen, el grupo de condiciones no patológicas fue el más frecuente e incluía a pigmentaciones fisiológicas melánicas (25.0%), seguida de torus palatino/mandibulares (20.2 %), gránulos de Fordyce (7.9%) y exostosis (5.6%),respectivamente. Las lesiones potencialmente malignas detectadas (Leucoplasia oral, Liquen plano oral y Queilitis actínica) correspondieron al 2.2%, 0.3 % y 0.3%, respectivamente. Clínicamente, no se observó malignidad. Este estudio Authoruye a determinar la prevalencia de LMO en República Dominicana e identificar factores de riesgo. Los hallazgos representan el primer estudio que muestra la prevalencia de las lesiones de mucosa oral en la población adulta dominicana. Se recomienda la creación de un programa de salud pública orientado a grupos de alto riesgo para mejorar el estatus de salud oral en esta población.

New Surgical Approach for Labial Stabilization: A Long-Term Follow-up Case Series.

Lip repositioning surgery is a predictable surgical technique that provides a solution for patients with excessive gingival smile. This case series presents four patients with 6 to 8 mm of excessive gingival display who received a modified surgical technique using internal horizontal mattress sutures to immobilize the labial superior elevator muscle. None of the patients exhibited complications, and their healing was uneventful. All patients demonstrated predictable results and presented with stability over an average of 3.5 years of follow-up. The modified lip repositioning surgery with internal horizontal mattress sutures seems to provide reliable long-term results in patients with an excessive gingival display.

Epstein Barr Virus detection and latent membrane protein 1 in oral hairy leukoplakia in HIV+ Venezuelan patients.

PURPOSE: To determine the prevalence of Epstein Barr virus (EBV) in oral hairy leukoplakia lesions (OHL) in HIV+ Venezuelan patients. MATERIAL AND METHOD: In this case study, we evaluated 21 HIV+ adult patients with clinically present OHL lesions, 11 who were undergoing antiretroviral therapy, 10 who were not undergoing therapy and 10 HIV-negative adult patients with hyperkeratotic oral mucosal lesions. All of the subjects were assessed at the Infectious Disease Center, Faculty of Dentistry, Central University of Venezuela, and were clinically examined to detect oral mucosal lesions with the confirmed histopathologic diagnosis. Nested-PCR was used to determine the EBV infection and the latent membrane protein-1 (LMP-1) expression by immunohistochemistry. RESULTS: Of the subjects, 16/21 (76%) of the HIV+/AIDS patients tested positive for EBV, whereas 5/10 (50%) of the HIV-negative subjects tested positive for EBV. CONCLUSIONS: In the present study, a higher EBV prevalence was observed in HIV-positive patients when compared to HIV-negative patients without oral hairy leukoplakia, confirming the etiologic role in this entity. The LMP-1 in OHL patients who were both HIV+ and EBV+ was highly expressed (60%) at the epithelial basal cells. No association between the alcohol and tobacco consumption was observed among the EBV-positive cases.

Human papillomavirus and Epstein Barr virus in oral hairy leukoplakia among HIV positive Venezuelan patients.

Oral hairy leukoplakia (OHL) is commonly found in individuals infected with HIV and represents the most frequent oral manifestation. The purpose of this study was to detect the presence of Human Papillomavirus (HPV) and Epstein Barr Virus (EBV) in OHL of HIV+ Venezuelan patients. We evaluated 21 HIV+ adult patients with clinically present OHL lesions: 11 under antiretroviral therapy, 10 without therapy, and 10 oral mucosal samples as controls. Nested-PCR was used to detect EBV and HPV infection. The INNO-LiPA HPV Genotyping v2 was applied to determine the HPV genotype. The EBV genome was found in 16/21 (76%) of the HIV+ patients with OHL. No difference was observed in EBV+ and EBV- patients related to antiretroviral therapy viral load and CD4+ Tcell coant. HPV-DNA was observed in 7/21 HIV positive cases (33%). The HPV genotypes detected were: 6, 11, 31, 33, 52, and 56/74. The most frequently HPV found was genotype 6 in 7/7, while two cases were HPV-11 and two HPV-52. Of the positive cases, 5/7 (71%) presented co-infection with more than one HPV genotype and 4/7 (57%) had HPV coinfection with high and low risk types. No case was EBV or HPV positive in the control group. In this study, a higher EBV prevalence was observed in OHL-HIV+ patients, confirming the etiologic role in this entity. A considerable number of cases were positive for HPV infection, and many patients presented coinfection with more than one HPV genotype as well as the presence of high oncogenic risk HPV in OHL.

Granulomatous foreign-body reaction involving oral and perioral tissues after injection of biomaterials: a series of 7 cases and review of the literature.

PURPOSE: Injectable implants used for soft-tissue augmentation may lead to a granulomatous foreign-body reaction. The aim of this report is to present 7 new cases of foreign-body granulomas involving the oral and perioral tissues, after injection of biomaterials to achieve soft-tissue augmentation. In addition, the clinical and epidemiological profile of this condition is summarized, based on a review of the English-language literature of all previously described cases. PATIENTS AND METHODS: We report on 7 new cases of granulomatous foreign-body reaction involving the oral and perioral tissues after the injection of biomaterials. A comprehensive literature review is also presented. RESULTS: The literature search revealed 49 cases of this condition affecting the oral and perioral tissues. Our 7 patients were female, with a mean age of 52.8 years (range, 34 to 70 years). The lower lip was affected in 4 cases, 1 case was located in the upper lip, 1 case in the buccal mucosa, while 1 case involved 2 different sites (upper lip and buccal mucosa). Histopathologic examination revealed numerous cells with clear, often multiple, cytoplasmic vacuoles, bearing a resemblance to lipoblasts. Immunohistochemistry revealed diffuse positivity for the histiocytic marker CD68. CONCLUSIONS: The diagnosis of granulomatous foreign-body reactions may be challenging because of their microscopic resemblance to liposarcoma, and because of the occasional reluctance of patients to report the previously performed esthetic procedure. A clinical history, histopathologic examination, and immunohistochemical analysis (as needed) are essential in achieving an accurate diagnosis.

Prevalence of oral soft tissue lesions in an elderly venezuelan population.

AIM: The purpose of the present study was to determine the prevalence of the oral soft tissue lesions in patients referred to the geriatric unit "Dr. Joaquin Quintero", National Institute of Gerontology. STUDY DESIGN: 340 patients were clinically evaluated, of these 266 were institutionalized and 74 were seen at the outpatient clinic, age ranging 60 to 104 years. 212 were females and 128 males. The statistical analysis was done using the SPSS software (11.0) to a significant level of 5% (p<0.05). RESULTS: Fifty seven percent of the studied population presented one or more oral lesions, associated to prosthetic use, trauma and tobacco consumption. Females were more affected than males. The lesions were more frequently observed between 60 to 74 years of the institutionalized group of patients of these, 34% exhibited only one oral lesion. Few cases presented up to 4 oral lesions. The most common alterations observed were: denture stomatitis, oral leukoplakia, hemangioma, oral melanotic macule, traumatic fibroma, inflammatory fibrous hyperplasia and angular cheilitis. CONCLUSIONS: The findings observed in this population are important to be considered when clinically evaluating oral soft tissue in elderly. Close follow up and systematic evaluation is required in this population.

Oral and oropharyngeal cancer in a Venezuelan population.

The aim of this work was to analyze diagnosed cases of Oral Cancer (OC) and Oropharyngeal Cancer (OPC) in a Venezuelan population. We clinically evaluated 130 patients with OC and OPC and a histopathologic diagnosis of squamous cell carcinoma. The patients were analyzed according to gender age, and use of alcohol and tobacco and the tumors were classIfied based on anatomic location, staging parameters, and degree of difFerentiation. Ninety one patients (70%) were male and 39 (30%) were female. Patients' age ranged from 26 to 86 years old. Use of smoking tobacco, alcohol or both was reported by 84.3%, 49.1% and 45.4% of patients, respectively, and was more frequent in males. The most common oropharyngeal anatomic location was the base of the tongue (22.3%), followed by the tonsils (13.9%), while the most frequently affected oral location was the oral tongue (19.2%) followed by the gingiva and alveolar mucosa (10.8%), and the floor of mouth (7.7%). The majority of tumors (77.7%) were diagnosed at an advanced stage (Stage III or IV); metastasis to the regional lymph nodes occurred in 53.1% of cases. According to degree of diferentiation, well, moderately and poorly difFerentiated tumors accounted for 45.4%, 46.1% and 8.5% of cases, respectively. Well differentiated tumors accounted for 56.7% of OC cases, while the majority of OPC cases were classified as moderately or poorly differentiated (72.3%) (p < or = 0.002). Also, non-metastatic cases (NO) showed a predominance of well-diferentiated tumors (61.2%), while metastatic tumors (N+) were classified as moderately or poorly differentiated in 89.8% of cases (p < or = 0.0001). Our study population was characterized by a predominance of smokers and/or drinkers and a predilection for male patients. Most tumors were diagnosed at an advanced stage with a high incidence of metastatic spread to the regional lymph nodes, indicating possible delays in diagnosis. Less differentiated tumors were more frequently encountered among OPC cases and accounted for the vast majority of metastatic cases, supporting the prognostic value of assessing the degree of difFerentiation.

Prevalence of oral lesions in HIV patients related to CD4 cell count and viral load in a Venezuelan population.

AIM: To determine the prevalence of oral lesions in a HIV+ group of patients, related to CD4 cell count and viral load in a Venezuelan population. MATERIALS AND METHODS: In the present study, we evaluated 75 HIV+ adult patients, attended at the Center of Infectious Diseases, at the Faculty of Dentistry, Central University of Venezuela. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by flow cytometry, as well as viral load by RT-PCR (Amplicor HIV-RNA, TM test 1.5, Roche). RESULTS: 85% (64/75) of HIV/AIDS patients showed associated HIV lesions. Oral Candidiasis constituted the most common lesion representing a 61% (39/64), followed by Oral Hairy Leukoplakia 53% (34/64); Oral Leukoplakia 34% (22/64), Melanic Hyperpigmentation 38% (18/64); Papilloma 13 (6/64), Lineal Gingival Erythema 8% (5/64); Aphtous Recurrent Stomatitis 5% (4/64) and Kaposi's Sarcoma 5% (3/64). Only one case of the following lesions were represented by Non Hodgkin Lymphoma, Multifocal Epithelial Hyperplasia, Recurrent Herpes, Histoplasmosis and Molluscum Contagiosum. The patients with a viral load of 30.000 copies/mm3 exhibited oral lesions related with HIV, independent of CD4 cell count, although patients with CD4+ levels of 200 cel/mm3 were more susceptible to develop these lesions. CONCLUSIONS: The most common oral lesion was Oral Candidiasis followed by Oral Hairy Leukoplakia, Oral Leukoplakia and Melanic Hyperpigmentation. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+ cell count.

Prevalence of oral mucosal lesions in an adult population from eight communities in Santo Domingo, Dominican Republic / Prevalencia de lesiones de mucosa oral en una población adulta de ocho comunidades en Santo Domingo, República Dominicana

ABSTRACT The purpose of the study was to evaluate the prevalence of Oral Mucosal Lesions (OMLs) in an adult population from Santo Domingo, Dominican Republic. 751 subjects from eight communities from Santo Domingo accepted the invitation to participate in an oral screening from October 2016 to January 2017. 248 subjects were evaluated and clinically examined, age range 18-86 years. A validated instrument was designed to record demographic factors, age group, gender, anatomical location, presence or absence of OMLs, risk factors such as tobacco consumption and its frequency, and different forms of tobacco and alcohol use. A systematic oral clinical examination was conducted by a specialist. The presence or absence, and anatomic location of OMLs were recorded. The sample consisted of 44.4% males and 55.6 % females. 228 subjects had 1 or more lesions (91.9%), the median was 3 lesions per patient. In relation to risk factors, tobacco use in general was reported by 26.2 % of the subjects, with cigarette smoking reported by 75.4%, followed by other forms as "hookah" 9.2 %, marihuana 9.2%, cigars ("puros")4.6% and pipe smoking 1.5%. Among the oral lesions detected by screening, the nonpathological group was prevalent, and included physiologic melanin pigmentation as the most frequent (25.0%) followed by palatal/mandibular tori (20.2%), Fordyce granules (7.9%), and Exostosis (5.6%). Potentially malignant disorders (Oral Leukoplakia, Oral Lichen Planus and Actinic Cheilitis) corresponded to 2.2%, 0.3 %, and 0.3%, respectively. No malignancy was observed clinically. This study contributes to determining the prevalence of OMLs in Dominican Republic and to identifying risk factors. This is the first study reporting the prevalence of oral mucosal lesions among the Dominican adult population. This information is vital for establishing a public health program targeting the high-risk group to improve the oral health status in this population.

RESUMEN El objetivo del presente estudio fue evaluar la prevalencia de lesiones de la mucosa oral (LMO) en una población adulta proveniente de Santo Domingo, República Dominicana. 751 individuos procedentes de ocho comunidades de la provincia de Santo Domingo, respondieron a la invitación para participar en el examen bucal, desde Octubre 2016 a Enero 2017. 248 sujetos con un rango de edad de 18-86 años, fueron evaluados y examinados clínicamente. Se diseñó y validó un instrumento para obtener datos de factores demográficos, grupos de edad, género, localización anatómica, presencia o ausencia de lesiones de la mucosa oral, factores de riesgo tales como: consumo de tabaco, frecuencia, diferentes formas de uso de tabaco y alcohol. Un especialista en el área, realizó un examen clínico bucal sistematizado en el cual se evaluó y registró la presencia o ausencia de lesiones y su localización anatómica. De acuerdo a la distribución por género, 44.4% correspondió a masculino y 55.6 % femenino. 228/248 sujetos presentaron 1 o más lesiones (91.9%), siendo la media de 3 lesiones por paciente. En relación a los factores de riesgo, el tabaco se reportó en 26.2%, siendo el fumar cigarrillos el 75.4%, seguido de otras formas como "hookah" 9.2%, marihuana 9.2%, cigarros ("puros") 4.6% y pipa fumada 1.5 %. En cuanto a las lesiones bucales detectadas en el examen, el grupo de condiciones no patológicas fue el más frecuente e incluía a pigmentaciones fisiológicas melánicas (25.0%), seguida de torus palatino/mandibulares (20.2 %), gránulos de Fordyce (7.9%) y exostosis (5.6%),respectivamente. Las lesiones potencialmente malignas detectadas (Leucoplasia oral, Liquen plano oral y Queilitis actínica) correspondieron al 2.2%, 0.3 % y 0.3%, respectivamente. Clínicamente, no se observó malignidad. Este estudio contribuye a determinar la prevalencia de LMO en República Dominicana e identificar factores de riesgo. Los hallazgos representan el primer estudio que muestra la prevalencia de las lesiones de mucosa oral en la población adulta dominicana. Se recomienda la creación de un programa de salud pública orientado a grupos de alto riesgo para mejorar el estatus de salud oral en esta población.

Immunohistochemical expression of angiogenesis-related markers in oral squamous cell carcinomas with multiple metastatic lymph nodes.

The aim of this study was to evaluate the histopathologic features and the expression of angiogenesis-related markers in primary tumors and metastatic lymph nodes of oral squamous cell carcinomas (SCCs) with multiple lymph node involvement in comparison with oral SCCs without nodal metastasis. The protein levels of the angiogenesis inhibitor endostatin, as well as those of the related molecules collagen XVIII, collagen-binding protein (CBP) 2/heat shock protein (HSP) 47, and cathepsin L, were evaluated by immunohistochemical analysis. Compared with nonmetastatic cases, primary tumors of the metastatic group exhibited significantly decreased protein levels of endostatin and its precursor collagen XVIII. Comparison between primary tumors and positive nodes of the metastatic cases revealed decreased expression of collagen XVIII and CBP2/HSP47 in metastases. Angiogenesis is essential for tumor growth and metastasis; accordingly, the observed differences in the immunohistochemical expression of angiogenesis-related proteins in oral SCC with multiple lymph node involvement may provide an explanation for the increased metastatic potential of these tumors.

Primary Sjögren syndrome in childhood: report of a case and review of the literature.

Sjögren syndrome (SS) in childhood is a rare and possibly underdiagnosed condition. The purpose of this study is to report a case of primary SS (PSS) in a 4-year-old Venezuelan girl and to review the pertinent literature. The patient presented with bilateral recurrent parotid enlargement, predominantly on the right side. She did not complain of dry mouth or eyes; however, decreased stimulated salivary flow rate and positive Schirmer and rose bengal tests were obtained. Sialography, sonograms, and a computed tomography scan of the parotid glands revealed pathologic changes consistent with SS. Anti-SS-A and anti-SS-B antibodies were present. Evaluation for antibodies against cytomegalovirus, Epstein-Barr virus, and HIV rendered negative results. Histopathologic examination of incisional biopsies of the right parotid and labial minor salivary glands revealed focal periductal lymphocytic infiltrate and sialoduct ectasia. Taken together, these findings are consistent with the diagnosis of juvenile PSS. The salient features of this rare disease are summarized on the basis of a comprehensive review of the epidemiologic, clinical, and serologic findings of the previously reported cases of PSS in children.

Oral and dental manifestations of vitamin D-dependent rickets type I: report of a pediatric case.

Vitamin D-dependent rickets type I (VDDRI) represents an autosomal recessive hereditary defect in vitamin D metabolism. Patients with VDDRI have mutations of chromosome 12 that affect the gene for the enzyme 1-alpha-hydroxylase, resulting in decreased levels of 1,25(OH)(2) vitamin D. Clinical features include growth failure, hypotonia, weakness, rachitic rosary, convulsions, tetany, open fontanels, and pathologic fractures. The oral and dental manifestations of VDDRI have not been described. Here we present the case of a 10-year-old girl affected by VDDRI, as established by the combination of clinical and radiographic findings, family history, and laboratory values. Dental examination revealed markedly hypoplastic, yellowish-to-brownish enamel in all permanent teeth, malocclusion, and chronic periodontal disease. Large quadrangular pulp chambers and short roots were evident in dental radiographs. Light microscopic and ultrastructural examination showed abnormalities of dental hard tissues, affecting both enamel and dentin. The differential diagnosis and treatment of VDDRI are discussed.

Expression of COX-2 and bcl-2 in oral lichen planus lesions and lichenoid reactions.

UNLABELLED: Oral lichen planus and lichenoid reactions are autoimmune type inflammatory conditions of the oral mucosa with similar clinical and histological characteristics. Recent data suggest that oral lichenoid reactions (OLR) present a greater percentage of malignant transformation than oral lichen planus (OLP). OBJECTIVE: To compare the expression of bcl-2 and COX-2 in OLP and OLR. METHODS: The study population consisted of 65 cases; 34 cases diagnosed as OLR and 31 as OLP. A retrospective study was done, and bcl-2 and COX-2 expression was semiquantitatively analysed. RESULTS: Fifty-three per cent (18/34) of the ORL samples tested positive for COX-2, whereas in the OLP group, 81% of the samples (25/31) immunostained positive for COX-2. The Fisher's exact test for the expression of COX-2 revealed that there are significant differences between the two groups, P = 0.035. With respect to the expression of the bcl-2 protein, 76% (26/34) of the samples were positive in OLR, while 97% (30/31) were positive in the group with OLP. The Fisher's exact test for the expression of bcl-2 revealed that there are significant statistical differences between the two groups, P = 0.028. CONCLUSIONS: The expression of bcl-2 and COX-2 was more commonly expressed in OLP when compared with OLR.

Expresión del ki-67, p53, p16 y bcl-2 en Ameloblastomas / Expression of ki-67, p53, p16 and bcl-2 in Ameloblastomas

El objetivo de la presente investigación fue determinar la expresión de Ki-67, p53, p 16 y bcl-2 en Ameloblastoma Sólido y Uniquístico. El presente estudio fue retrospectivo de tipo clínico-patológico, experimental y correlacional. Se realizó análisis clínico-patológico de las variables: género, grupos de edad, diagnóstico histopatológico y localización anatómica y análisis inmunohistoquímico siguiendo protocolo estandarizado utilizando los marcadores Ki-67, p16, p53 y bcl-2 en el Laboratorio de Histopatología Bucal "Dr. Pedro Tinoco" de la Facultad de Odontología de la Universidad Central de Venezuela durante el período 2008-2013. De las biopsias bucomaxilofaciales se tomaron como muestra 34 casos diagnosticados histopatológicamente como Ameloblastoma Uniquístico (16 casos), Ameloblastoma Sólido (9 casos), y 9 casos como control con el diagnóstico de Tumor Odontogénico Queratoquístico. Se realizó análisis estadístico para correlación de variables a través de la prueba Kruskall-Wallis empleando Software estadístico SPSS®Versión N° 20 para sistema MAC OSX con un nivel de significancia del 99% (p<0,01). Se observó predominio del género masculino entre la segunda y tercera década de vida. Localización anatómica más frecuente en sector posterior mandibular, diagnóstico histopatológico más frecuente ameloblastoma uniquístico. El análisis inmunohistoquímico reveló al marcador Ki-67 como la más expresada, seguida por p53, bcl-2 y p16 indicando transformación neoplásica y proliferación asociado a tasa de recidiva Los marcadores utilizados son de utilidad para evaluar comportamiento biológico para sugerir tratamiento quirúrgico adecuado en cada caso.

The objective of this research was to determine the expression of Ki-67, p53, p16 and bcl-2 Solid and unicystic Ameloblastoma.This study was retrospective clinicopathological, experimental and correlational. Clinico-pathological analysis of the variables were: gender, age, anatomical site and histopathological diagnosis and immunohistochemical analysis using standardized protocol following the Ki-67, p16, p53 and bcl-2 markers in the Laboratory of Oral Histopathology "Dr. Pedro Tinoco "of the Faculty of Dentistry, Central University ofVenezuela during the period 2008-2013.The maxillofacial biopsies were sampled 34 cases diagnosed histopathologically as Ameloblastoma unicystic (16 cases), Ameloblastoma Solid (9 cases), and 9 cases as control diagnosis Odontogenic Tumor Queratoquístico statistical analysis for correlation of variables was performed through the Kruskal-Wallis test using SPSS statistical software version No. 20 MAC OSX system with a significance level of 99% (p <0.01).often males between the second and third decade of life was observed. Most frequent anatomical location in mandibular posterior, more frequent histopathological diagnosis unicystic ameloblastoma. Immunohistochemical analysis revealed the marcador Ki-67 as the expressed, followed by p53, bcl-2 and p16 indicating neoplastic transformation and proliferation associated with recurrence rate markers used are useful for assessing biological behavior to suggest appropriate surgical treatment in each case.

Keratocystic odontogenic tumor associated with nevoid basal cell carcinoma syndrome: similar behavior to sporadic type?

OBJECTIVE: The objective of this study was to analyze the expression of proliferative markers and p53 in keratocystic odontogenic tumor (KCOT) sporadic type and KCOT associated with nevoid basal cell carcinoma syndrome (NBCCS). STUDY DESIGN AND SETTING: We performed a cross-sectional study. A total of 19 patients with KCOT were selected from the Oral Pathology Laboratory archives, Central University of Venezuela, from 1995 to 2005. SUBJECTS AND METHODS: Twelve cases corresponded to sporadic KCOT, and seven cases were associated with NBCCS. Immunohistochemical analysis for p53, proliferating cell nuclear antigen (PCNA), and Ki-67 was performed in all 19 cases. RESULTS: Of the seven cases associated with NBCCS, six (86%) were positive for PCNA. From the 12 sporadic cases, nine (75%) were positive for PCNA. Only one case of sporadic KCOT showed Ki-67 positivity. Five of 12 (42%) cases of sporadic KCOT were positive for p53, and only one (14%) case associated with NBCCS was positive for p53. CONCLUSION: On the basis of the analysis of the expression of PCNA, Ki-67, and p53, there appears to be no evidence to indicate higher aggressiveness in growth and infiltrative behavior in syndromic KCOT compared with the sporadic type. Therefore, surgical treatment may be approached in the same manner in KCOT sporadic and syndromic with the goal of minimizing recurrence.

Human papillomavirus in ameloblastoma.

OBJECTIVE: Ameloblastomas are benign epithelial tumors of odontogenic origin, with a high recurrence rate and local aggressiveness. A few preliminary studies have demonstrated HPV presence mainly in peripheral ameloblastomas. The purpose of this study was to detect HPV-DNA in intraosseous ameloblastomas. METHODS: Eighteen cases of intraosseous ameloblastomas of different histological variants were selected. Immunohistochemistry, CISH, nested-PCR, and INNOLiPA HPV Genotyping v2 were used. RESULTS: The predominant age group was between the third and fourth decades of life. Males were more affected with 61% and females represented 39%. Of the 18 cases, 7 were solid multicystic tumors and 11 were unicystic. Of the histological variants, the plexiform represented 3 (17%) of the 18, 2 (11%) were follicular, 2 (11%) were acanthomatous, and 1 (6%) was desmoplastic. All cases were HPV negative by immunohistochemistry and CISH. HPV-DNA was detected in 6 (33%) of the cases by nested-PCR. HPV 6 was the most frequent genotype in 4 (66%) of the 6. Two cases presented a mixture of HPV 16, 33, and HPV 6, 42 respectively. Four of the unicystic ameloblastomas were HPV positive; of these, all presented koilocytic changes and were associated with dentigerous cysts, whereas only 2 positive cases corresponded to solid ameloblastomas. None of the positive cases were related to recurrence rate. CONCLUSIONS: We may conclude that HPV low and high risk was detected in our sample of intraosseous ameloblastomas. HPV positivity was observed more in the unicystic cases than solid types.

Experiencias de la persona adulta hospitalizada respecto al cuidado brindado por la enfermera en el servicio de cirugía del hospital III ESSALUD De Chimbote. Perú / Adult inpatients experiences on nursing care at the Department of Surgery in Hospital III EsSalud, Chimbote. Peru

Resumen:

Introducción: el propósito de este trabajo de investigación fue desvelar, a través de una metodología cualitativa de enfoque fenomenológico, las experiencias de la persona adulta hospitalizada respecto al cuidado brindado por la enfermera en el Servicio de Cirugía del Hospital III EsSalud, en Chimbote (Perú). Método: en la muestra participaron 12 personas adultas de ambos sexos, hospitalizadas. Se utilizó como técnica de recolección de datos la entrevista personalizada, en la cual se aplicó la pregunta orientadora: ¿Cuáles son sus percepciones y sentimientos respecto al cuidado brindado por la enfermera a la persona adulta hospitalizada en el Servicio de Cirugía?, mediante la cual se desveló el fenómeno de estudio; respetando en todo momento los principios éticos. Resultados: a través de la trayectoria fenomenológica emergieron 87 unidades de significado, sintetizadas en 14 categorías, que fueron agrupadas de acuerdo al fenómeno de estudio en: resonancias del cuidado, disonancias del cuidado, ser cuidado: persona adulta hospitalizada, ser enfermera: persona que brinda cuidados. Discusión: según el análisis, se puede evidenciar que el cuidado puede ser percibido por la persona hospitalizada como una forma de experimentar un buen cuidado y trato adecuado, atención oportuna a sus necesidades; mientras que las divergencias a estas percepciones como la inoportuna atención de enfermería, experimentado por la deficiente atención, que se ve reflejada en errores en la comunicación e información enfermera-paciente-familia. Como conclusión resulta necesario reflexionar sobre un cuidado de enfermería altamente humanizado, con un sólido componente ético que permita crecer y desarrollar a la enfermería como profesión.

Abstract:

Introduction: Our investigation was aimed to reveal, through a phenomenologically-based qualitative method, the adult inpatients experiences on nursing care at the Department of Surgery in Hospital III EsSalud, Chimbote, Peru. Methods: Twelve adult inpatients (men and women) were included. Data were collected through an individually tailored questionnaire based on a guiding question: Tell me about your perceptions and feelings regarding nursing care for an adult inpatient at the Department of Surgery. Study phenomena were revealed through such a question; ethical principles were consistently followed throughout the study. Results: Phenomenological path revealed 87 meaning units that could be summarized into 14 categories; such categories could be then grouped according to the phenomena into: care resonances, care dissonances, cared person: adult inpatient, nurse: caring individual. Discussion: Based on our analysis, care appears to be perceived by inpatients as a way to receive good care and to be appropriately treated and have their needs adequately met; on the other hand, divergences on such perceptions include inappropriate nursing care and can be found in poor care, as reflected in nurse-patient-family communication and information failure. In conclusion, a more human nursing care based on solid ethical principles allowing professional nursing growth and development is clearly needed.

Introdução: a intenção deste trabalho da investigação, era revelar com um enfoque qualitativo da aproximação fenomenológica, as experiências da pessoa adulta hospitalizada, com respeito ao cuidado oferecido pela enfermeira no serviço da cirurgia, hospital III EsSalud- Chimbote (Perú). Método: a amostra foi de 12 pessoas de ambos sexos, hospitalizados; a entrevista personalizada foi usada como a técnica do levantamento de dados, em que a pregunta da orientação aplicada, ¿Qué são seus percepções e sentimentos com respeito ao cuidado oferecidos pela enfermeira à pessoa hospitalizada do adulto no serviço da cirurgia? Respeitando em todo momento os princípios éticos.

Resultados: com o enfoque fenomenológico, 87 unidades emergiram 87 unidades de significado, sintetizadas em 14 categorias, que foram agrupados de acordo com o fenômeno do estudo: resonance do cuidado, dissonances do cuidado, ser cuidado: pessoa hospitalizada, enfermeira: pessoa de que oferece o cuidado benfeito. Discussão: na base da análise, é possível ser demonstrado que o cuidado pode ser percebido pela pessoa hospitalizada como uma forma para experimentar um cuidado bom e um tratamento apropriado, uma atenção oportuna a suas necessidades e as divergências a estas percepções como a atenção inoportuna da enfermaria, experimentada pela atenção deficiente, que é refletida pelas famílias do paciente como um defeito de comunicação e da informação; sendo necessário para refletir em um cuidado da enfermaria altamente humanizado, com um sólido componente ético que reserve para crescer e se tornar à enfermaria como a profissão.

Cambios moleculares en los márgenes de resección en el carcinoma de células escamosas de cavidad oral / Molecular changes in the resections borders in squamous cell cancer of oral cavity

Evaluación molecular de márgenes de resección en pacientes con carcinoma de células escamosas de cavidad oral sometidos a cirugía. 16 pacientes con carcinoma escamoso de cavidad oral, en cualquiera de sus localizaciones, sin tratamientos previos, intervenidos quirúrgicamente en el 2011. La pieza operatoria fue procesada por anatomía patológica a través del método tradicional, realizándose cortes adicionales que incluían: tumor y 0,5 cm de margen no tumoral. Se realizó hematoxilina-eosina y complementó con inmunomarcaje para p53, PCNA, Ki-67, factor de crecimiento epidérmico y receptor de crecimiento endotelial vascular. De los 16 pacientes en estudio la mayoría eran del género masculino, la edad promedio fue cercana a los 60 años, la mayoría eran pacientes consumidores de tabaco y alcohol. La lengua fue la localización más frecuente y los tumores se encontraban en un estadio avanzado (estadio III y IV). Estudio molecular: todos los marcadores evaluados se encontraban positivos en los márgenes de resección en el 93,75% de los pacientes. Los marcadores de proliferación celular como el PCNA y Ki-67 así como el p-53 se encontraban positivos entre 1,5 cm a 2 cm del tumor con un marcaje intenso. Por el contrario, el factor de crecimiento epidérmico el receptor de crecimiento endotelial vascular se encontraban positivos hasta 1,5 cm pero con menor intensidad. En el cáncer oral podemos observar con frecuencia cambios moleculares en el tejido aparentemente sano que rodea el tumor hasta por lo menos 15 mm.

The molecular evaluation of resection margins in patients with squamous cell carcinoma of oral cavity who underwent surgery. Field of cancerization concept. We included 16 patients with oral cavity squamous cell carcinoma in any of their locations,without pre treatment, surgically treated in our hospital in the 2011 year. The surgical specimen was processed by the pathology department of our institution, through the traditional method, additional sectioned including the tumor and at least 0.5 cm margin non tumorigenic. Study was performed hematoxylin eosin and was supplemented with immunostaining for p53, PCNA, Ki-67, epidermal growth factor receptor and vascular endothelial growth factor receptor. The most important features of the 16 patients studied were: The majorities were male, the average age was around 60 years old; most of them were tobacco and alcohol consumers. The tongue was the most frequent location and most of the tumors were in an advanced stage (stage III y IV). In molecular evaluation all the markers were positive in the resection margins in 93.75% of all patients. The cell proliferation markers suchas PCNA and Ki-67 and the p-53 were positive 1.5 cm to2 cm tumor with intense staining. Conversely, epidermal receptor grow factors and vascular endothelial grow factor receptor were positive up to 1.5 cm but with less intensity. In oral cancer can often observe molecular changes in the apparently healthy tissue surrounding the tumor to at least 15 mm.

Prevalencia de caries dental y fluorosis en áreas de fluorosis endémica en el Estado Portuguesa, Venezuela / Prevalence of dental caries and flurosis endemic fluorosis areas of Portuguesa State, Venezuela

Determinar la prevalencia y severidad de caries y fluorosis dental en una zona de fluorosis endémica en Portuguesa. 187 individuos entre 2-62 años de edad de cuatro comunidades del Municipio Santa Rosalía fueron evaluados para caries dental según el índice CPOD/ceo (OMS) y para fluorosis dental de acuerdo al Índice de Dean. Todos los participantes en la presente investigación firmaron un consentimiento informado. Cada paciente respondió un cuestionario estructurado a tal fin y los datos fueron registrados. El examen clínico fue realizado por un examinador calibrado y se utilizó sonda WHO, espejo plano #5 y luz natural. Según el género, de los 187 pacientes, 96 fueron masculino (51%) y 91 femeninos (49%) y 90,9% de la población estudiada pertenecía a los estratos 4 y 5 de Graffar. El 69% de pacientes estaban libres de caries dental y los índices promedio CPOD y ceo fueron 1,7±3,62 y 0,41±1,15, respectivamente siendo el índice CPOD en Cogote significativamente menor (p<0,05) al compararlos con los observados en San Pablo y Playón (p>0,05), pero sin diferencias significativas al compararlo con el de Punto Fijo. El 76,9% de los individuos evaluados presentaban fluorosis dental siendo el grado de severidad promedio la categoría de moderado (Grado 4). Se le debe dar una alta prioridad a la defluoruración del agua, y en caso de que no sea posible, se debe proveer a la población de agua con concentraciones de fluoruro óptimas. No se observó asociación entre el grado de severidad de fluorosis dental y los niveles de fluoruro en el agua. Estudio parcialmente financiado por la Facultad de Odontología, UCV.

The purpose of this study was to determine the prevalence and severity of dental caries and fluorosis in an endemic area of Portuguesa State. One hundred eighty seven individuals, age ranging between 2-62 years, from four communities of Santa Rosalía Municipality were evaluated for dental caries index DMFT/dmf according to the WHO criteria and dental fluorosis using the Dean index. All participants signed the written consent to be enrolled for the study. The clinical examination was done by a calibrated examiner using the WHO probe, mirror #5 and natural light. The results from the study showed that 96/187 (51%) were male and 91/187 (49%) were female. According to socioeconomic status 90.9% of the studied population was level 4 and 5 according to Graffar criteria. Sixty nine percent of the patient was dental caries free and the mean indexes DMFT/dmf were 1.7±3.62 and 0.41±1.15, respectively. The lower DMFT scores were observed in Cogote (p<0.05) with statistical significant differences when compared to San Pablo and Playón but without differences when compares to Punto Fijo community (p>0.05). When analyzing the presence of dental fluorosis, 76.9% of the subjects had the condition being moderate (Grade 4). We may conclude that water defluoridation is of high priority in these communities, as well as to provide the population with optimal fluoride concentration in water. Our results indicate the absence of association between the fluoride concentration for water consumption and the dental fluorosis severity in endemic areas. Study partially supported by the Faculty of Dentistry, UCV.