Tumors of the labial mucosa: a retrospective study of 1045 biopsies.

BACKGROUND: To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient's age and gender and tumor's site and size may raise the suspicion of neoplasm. MATERIAL AND METHODS: Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient's age and gender and tumor's site and size; clinical-pathological diagnosis agreement was, also, evaluated. RESULTS: Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p<0.0001), site (p<0.0001) and diameter (p<0.0001). Age ≥60 years, tumor's location on the upper lip and diameter >1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p < 0.0001) or 33.6 times (p < 0.0001), respectively, more likely to have a neoplasm. Complete/partial agreement between clinical and pathological diagnosis was seen in 96.3% of the cases. CONCLUSIONS: Most lip tumors involve the lower lip and are reactive, but upper lip tumors measuring >1cm in patients≥60 years have significantly higher probability to be neoplasms.

Dexmedetomidine protects the uterus against ischemia-reperfusion injury in rats.

OBJECTIVE: This study aimed to analyze the histopathological and biochemical effects of dexmedetomidine on the rat uteri exposed to experimental ischemia-reperfusion injury. MATERIALS AND METHODS: Twenty-four female rats were randomly divided into three groups. Group 1 was defined as the control group. An experimental uterine ischemia-reperfusion model was created in Group 2. Group 3 was assigned as the treatment group. Similar uterine ischemia-reperfusion models were created for the rats in Group 3, and then, unlike the other groups, 100 µg/kg of dexmedetomidine was administered intraperitoneally immediately after the onset of reperfusion. In blood biochemical analysis, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA), interleukin 1beta (IL-1ß), interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α) levels were measured. In the histopathological analyses, endometrial epithelial glandular changes (leukocytosis, cell degeneration) and endometrial stromal changes (congestion, edema) were analyzed using the tissue damage scoring system. RESULTS: It was observed that IL-1ß, IL-6, and TNF-α levels were significantly suppressed in Group 3 compared to Group 2 (p=0.001, p<0.001 and p=0.001, respectively). MDA level was noted as the highest in Group 2. The MDA value in Group 3 was measured at 5.37±0.82, which was significantly decreased compared to Group 2 (p<0.001). An increase in antioxidant enzyme activities (SOD and GSH-PX) was observed in Group 3 compared to Group 2 (p=0.001 and p=0.006, respectively). In our histopathological analysis, a significant improvement in endometrial epithelial glandular and endometrial stromal changes was revealed in Group 3 compared to Group 2 (p<0.001). CONCLUSIONS: In our study, it has been documented that dexmedetomidine protects the uterine tissue against ischemia-reperfusion injury.

Host Modulation and Treatment of Periodontal Disease.

Periodontitis is the sixth-most prevalent disease in the world and the first cause for tooth loss in adults. With focus shifted to the inflammatory/immune response in the pathogenesis of periodontitis, there is a critical need to evaluate host modulatory agents. Synthetic and biological disease-modifying antirheumatic drugs are a cornerstone for the treatment of inflammatory diseases. Recent prospective cohort studies showed that synthetic disease-modifying antirheumatic drugs improved periodontal clinical parameters following nonsurgical periodontal treatment in patients with rheumatoid arthritis. Treatment with recombinant humanized monoclonal antibodies against CD20 (rituximab) and IL-6 receptor (tocilizumab), the latter also in clinical trials for the treatment of COVID-19 pneumonia, resulted in decreased periodontal inflammation and improved periodontal status. Studies on the effect of TNF-α inhibitors in patients with periodontitis yielded inconsistent results. Recent data suggest that probiotics provide anti-inflammatory clinical benefit, as do nutritional supplements, such as n-3 fatty acids, when combined with periodontal therapy. Probiotics reduce the production of proinflammatory cytokines/chemokines by suppressing NF-κB pathways and promote the accumulation of T regulatory cells. Statins, like aspirin, have been shown to exhibit anti-inflammatory and bone-preserving actions by upregulating production of Specialized Proresolving Mediators (SPMs). Currently, there is insufficient scientific support for the topical delivery of statins or bisphosphonates as adjuncts to periodontal therapy. Here, we present a critical review of the most recent host modulatory agents applied in humans and the key immune pathways that they target. Emerging evidence from novel drug candidates, including SPMs and complement inhibitors as previously studied in animal models and currently in human clinical trials, suggests future availability of adjunctive therapeutic strategies for the management of periodontitis.

The value of endoscopy in the diagnosis of gastric ulcer.

The ever increasing application of digestive endoscopy has provided a new argument for diagnosis in gastroenterology. Based on a personal experience of 300 cases, the authors are revising the diagnosis of gastric ulcer, comparing the data obtained by X-ray, endoscopic, histologic and bioptic investigations. In about two per cent of the cases, the endoscopic diagnosis of benign ulcer was infirmed by examination of the histologic fragments.

New data in the management of digestive steroses.

The report is a review of the perendoscopic methods of treatment of stenoses at the level of the digestive tract and of the excretion canals of the annex glands. After a short description of the methods as well as of the necessary equipment, the authors discuss the indications according to the etiology of stenoses. The indications and contraindications are enumerated and an estimation is made of the therapeutic efficiency of the endoscopic methods as compared with the classical surgical methods. Emphasis is laid on the therapeutic advantages of the endoscopic palliative methods as an alternative to the surgical methods.

Duodenal ulcer and infection with Helicobacter pylori.

The incidence of gastritis with Helicobacter pylori (HP) was studied in 225 patients with active duodenal ulcer diagnosed endoscopically. The infection was diagnosed by the urease test and in some cases by histopathological examination. Infection with Helicobacter pylori was detected in 55% of the patients, a proportion much smaller than the one generally reported in the literature, a rather surprising fact for our sanitary conditions. This might mean that in our country unlike the west-European countries other pathogenetic factors could be more important than HP.

Pulmonary involvement in systemic lupus erythematosus.

In the course of an ample study of collagen diseases carried out in the "N. Gh. Lupu" Institute of Internal Medicine--Bucharest over a long period, a group of 608 patients with systemic lupus erythematosus (SLE) hospitalized between 1974 and 1986 formed the object of the present study. Of these patients 18% presented pulmonary alterations due to SLE and 3.9% lung diseases of other etiology. The types of pulmonary involvement due to SLE were: pleurisy, interstitial pneumonia, diaphragmatic myopathy. Latent pulmonary damage could also be diagnosed in 8 patients. Most of the patients (94.1%) were females and had been hospitalized several times. Concomitantly with pulmonary damage other organ involvements have also been observed. Complex investigation of respiratory function performed in a selected group of patients revealed: restrictive syndrome, decrease of the gas transfer factor, increase of elastic recoil, hypoxemia on exercise. In most of the cases (92%) the pulmonary diseases had a chronic evolution. The treatment used was corticosteroids in 60% of the cases investigated.