Erythromycin: an alternative for the management of oral mucositis?

BACKGROUND: Oral mucositis (OM) is an important acute adverse effect of anticancer therapy. This condition presents high morbidity and may lead to the suspension of anticancer therapy. MATERIAL AND METHODS: We reviewed the literature on the pathobiology of OM and the properties of erythromycin (EM), to consider the possibility of its use for the prevention and treatment of OM. We searched the PubMed, Scopus and Web of Science databases and selected complete articles published in English or Spanish that met the inclusion criteria. The search terms "erythromycin", "inflammation", "immunomodulation" and "oral mucositis" were used. RESULTS: The control of free radicals, transcription factors and pro-inflammatory cytokines has been considered as the key to the management of OM. EM has the ability to modulate oxidative stress, acts on the transcriptional system and inhibits the production of several cytokines that have been directly implicated in OM pathobiology. CONCLUSIONS: The present review suggests that EM could be effective in the treatment of OM. Experimental studies investigating the use of EM in OM should be encouraged.

Stomatological disorders in older people: An epidemiological study in the Brazil southern.

BACKGROUND: The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. MATERIAL AND METHODS: A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. RESULTS: The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). CONCLUSIONS: Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary.

Clock genes expression and locomotor activity are altered along the light-dark cycle in transgenic zebrafish overexpressing growth hormone.

In the present work it was demonstrated that transgenic Danio rerio overexpressing growth hormone (GH-transgenic) present either altered gene expression at a determined time point, or different expression pattern along the LD cycle, when compared with non-transgenic (NT) animals, in the positive and negative loops of the circadian system. Gene expression of clock paralogs was reduced in GH fish at the beginning of the dark phase, leading to diminished expression amplitude along the LD cycle. Furthermore, although no differences were observed between NT and GH animals for bmal1a and cry2b expression at each time point, only GH fish presented amplitude along the LD cycle. Also, the locomotor activity behavior was evaluated for both groups. GH-transgenic animals presented higher locomotor activity along the whole LD cycle when compared with NT animals. These data suggest that alterations in the gene expression patterns along the LD cycle of the positive and negative loops of the circadian system, could lead to altered locomotor activity behavior in GH-transgenic fish, and GH overexpression could be responsible for these alterations, either affecting the pathways involved in the expression of genes from the circadian system or altering the metabolism.

Detection of human polyomaviruses JC and BK in liver pretransplant patients.

OBJECTIVE: This study aimed to identify and quantify polyomaviruses (BKPyV and JCPyV) in the saliva, mouthwash, blood and urine of liver pretransplant patients. MATERIALS AND METHODS: A case-control study was performed using a convenience sample of 21 end-stage liver disease patients (EG = experimental group) and 20 normoreactive controls (CG = control group). In total, 162 samples were collected. Detection and quantification of polyomaviruses were performed using real-time PCR method. RESULTS: In the EG, 21 samples (25%) were positive for BKPyV and 10 (11.90%) for JCPyV, while in the CG, 27 samples (34.61%) were positive for BKPyV and six (7.69%) for JCPyV. With regard to the number of samples positive for BKPyV and JCPyV, there was no statistically significant difference between EG and CG (p = .52 and p = .25). In the EG, we observed a panorama similar to that of the CG regarding the presence of polyomaviruses in mouthwash, blood and urine. The greatest difference between the samples was that regarding the identification of BKPyV in saliva. CONCLUSION: Cirrhotic patients on the liver transplant waiting list did not show higher prevalence of BKPyV and JCPyV compared to normoreactive controls.

Cannabidiol: an alternative therapeutic agent for oral mucositis?

WHAT IS KNOWN AND OBJECTIVE: Chemo- and radiotherapy are therapeutic modalities often used in patients with malignant neoplasms. They kill tumour cells but act on healthy tissues as well, resulting in adverse effects. Oral mucositis is especially of concern, due to the morbidity that it causes. We reviewed the literature on the etiopathogenesis of oral mucositis and the activity of cannabidiol, to consider the possibility of its use for the prevention and treatment of oral mucositis. METHODS: We searched the PubMed database and selected complete articles published in English that met the inclusion criteria for the period 1998-2016. The search terms 'cannabinoids', 'cannabidiol', 'oxidative stress', 'antioxidants' and 'oral mucositis' were used. RESULTS AND DISCUSSION: The control of oxidative stress may prevent and alleviate oral mucositis. Studies have demonstrated that cannabidiol is safe to use and possesses antioxidant, anti-inflammatory and analgesic properties. WHAT IS NEW AND CONCLUSIONS: The literature on the use of cannabidiol in dentistry is still scarce. Studies investigating the use of cannabidiol in oral mucositis and other oxidative stress-mediated side effects of chemotherapy and radiotherapy on the oral mucosa should be encouraged.

Photosynthetic responses of crustose coralline algae recruit from an upwelling area to light intensity, temperature and current flow rate in a mesocosm.

The crustose coralline algae (CCA) play an important role building carbonate habitats and enhancing species diversity in rocky shores, rhodolith beds and coral-algal reefs. Though worldwide distributed some taxonomic groups were proved to show light and temperature boundaries. Nevertheless, little is known about the biological limits of CCA recruits and photosynthetic responses in a climate change environment. In this way, experimental studies are essential to identify their optimal conditions development. The aim of the study was to test ideal environmental conditions for CCA recruits from an upwelling area to verify Fv/Fm response patterns as an indicator of photosynthetic performance. Artificial disks were fixed on a rocky shore to provide substrate for CCA recruitments and then moved to be tested in a flow-through system. The CCA tested were species of the Genus Lithophyllum and experiments were performed with CCA exposed to different levels of light, temperature and current flow rates. The photosystem II function, measured by chlorophyll a fluorescence (Fv/Fm), was used as an indicator of potential photosynthetic electron transport. There was an interaction between light intensity, flow rate and temperature. Low light intensity, high temperature and fast flow rate (20 µmol m-2. s-1; 19 and 24 °C; 0.09 m s-1 respectively) provided optimal conditions for CCA recruits.

Mucoepidermoid carcinoma: a retrospective study.

AIM: The aim of this study was to review the cases of mucoepidermoid carcinoma diagnosed at the Stomatology Service of São Lucas Hospital (PUCRS). METHODS: Medical charts were reviewed focusing on the sex and age of the patients, clinical aspect, anatomic site, signs and symptoms, size and histological grade of the lesion. RESULTS AND CONCLUSION: Of the 19383 patients who were seen between 1978 and 2009, 675 (3.48%) had a histopathological diagnosis of malignant neoplasm of the oral maxillofacial region including 12 (1.78%) cases of mucoepidermoid carcinoma. The mean age of patients with mucoepidermoid carcinoma was 43.8 years, and there was a predilection for males (58.7%). All cases occurred in the minor salivary glands, and the palate was the site most frequently affected (41.7%). Pain and local irritation were present in 50% of cases, and the size of lesions ranged from 0.3 cm to 5.0 cm. The histological classification of low- and intermediate-grade occurred at the same frequency (36.4%), and symptoms (pain, local irritation) occurred indiscriminately in different grades of tumor.

Echovirus 30 detection in an outbreak of acute myalgia and rhabdomyolysis, Brazil 2016-2017.

OBJECTIVES: To describe an outbreak of acute myalgia accompanied by elevated levels of muscle enzymes that occurred in the northeast region of Brazil from December 2016 through to May 2017. METHODS: Clinical data were analysed and laboratory tests were performed in 86 specimens obtained from 52 individuals with suspected acute myalgia. A broader reactive enterovirus real-time RT-PCR followed by a semi-nested PCR amplification of partial VP1 gene were performed to identify the causative agent. RESULTS: Eighty-six clinical samples were received in our laboratory during the myalgia outbreak. Median age of individuals was 39 years. Sudden acute myalgia and dark urine were the most common symptoms. Creatine phosphokinase levels were elevated with mean value ∼16 893 U/L. Human enterovirus was detected in 67% (58/86) of the patient's specimens (urine, serum, faeces and rectal swab). The enterovirus positivity per patient was 82.7% (43/52). Echovirus 30 (E-30) (82% of the typed specimens, 18/22; 76.4% (13/17) of the typed specimens per patient) was the main enterovirus identified. In addition to E-30, CV-A16 (1/22) and E-6 (3/22) were detected in 4% and 14% of the typed specimens, respectively. No deaths occurred. CONCLUSION: The 2016-2017 outbreak of acute myalgia that occurred in the northeast region of Brazil can be associated with E-30. Despite the clinical manifestations, a favourable outcome was observed for all patients.

Metabolic rate and reactive oxygen species production in different genotypes of GH-transgenic zebrafish.

Growth hormone overexpression increases growth and consequently increases the metabolic rate in fishes. Therefore, the objective of this study was to evaluate the effects of growth hormone overexpression in zebrafish Danio rerio in terms of growth, oxygen consumption, reactive oxygen species production, lipid hydroperoxide content, antioxidant enzyme activity and glutamate-cysteine ligase catalytic subunit gene expression. The employed models were wild type and transgenic (hemizygous and homozygous) zebrafish expressing the Odonthestes argentinensis growth hormone gene directed by the Cyprinus carpio beta-actin promoter. Higher growth parameters were observed in the hemizygous group. The homozygous group possessed higher oxygen consumption and reactive oxygen species production. Growth hormone transgenesis causes a decrease in glutamate-cysteine ligase catalytic subunit expression, an enzyme responsible for glutathione synthesis. Although the lipid hydroperoxide content was similar between groups, we demonstrate that growth hormone overexpression has the potential to generate oxidative stress in fishes.

Necrotizing sialometaplasia of the palate in a cocaine-using patient. A case report.

Cocaine abuse and the consequent prevalence of the damage associated with it have increased in the global population. The damage depends on the route of administration, where an important sequel of snorting is perforation of the nasal septum and palate. Necrosis of the palate, meanwhile, is also the manifestation of other diseases such as tertiary syphilis, necrotizing sialometaplasia and malignant neoplasms. The differential diagnosis of such lesions is important for determining appropriate treatment. A case of an ulcerated lesion in the palate of a cocaine-using patient whose diagnosis was necrotizing sialometaplasia is reported.

Pyogenic granuloma, peripheral giant cell granuloma and peripheral ossifying fibroma: retrospective analysis of 138 cases.

AIM: The present study examined retrospectively the clinical and radiographic characteristics of pyogenic granuloma (PG), peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma (POF), located in the gingiva and alveolar ridge. METHODS: Biopsy records of the Stomatology Service of São Lucas Hospital-PUCRS were reviewed between 1980 and 2006. The medical charts of patients with histopathologic diagnosis of PG, PGCG and POF were selected. The data obtained were evaluated by means of descriptive statistics, analysis of variance (ANOVA), and the chi-squared test (chi-squared), considering the 5% level of significance. RESULTS: Of the 138 cases analyzed, 57.2% corresponded to PG, 22.5% to PGCG and 20.3% to POF. PG and POF exhibited a predilection for females and PGCG for males. PG occurred in younger individuals and showed a greater tendency for bleeding (P=0.018). PG showed a greater frequency of reddish color (P<0.001), PGCG purplish (P<0.001) and POF pinkish (P<0.001). In the radiographic examination, the presence of radiopaque foci was greater in POF (P<0.001), and resorption of the subjacent alveolar bone was found more often in PGCG (P<0.001). POF exhibited a longer evolution. There was no difference in lesions with respect to local irritating factors, ulceration, size, site and recurrence. Pregnancy was a factor linked to PG. CONCLUSION: Despite the lesions investigated exhibit similar clinical characteristics, the present study demonstrated that aspects such as age of the patient and evolution, color, bleeding and radiographic characteristics can help in the differential diagnosis of these lesions.

White sponge nevus. A case report.

White sponge nevus is a rare autosomal dominant hereditary disorder manifesting upon physical examination as white symmetric, diffuse, thickened, corrugated or velvety plaques on the oral, esophageal or genital mucosa. They are also found to be bilateral and asymptomatic. The tissue changes can be present at birth or manifest during childhood or adolescence, and this disorder occurs in females more than in males. It is a benign condition since cases of malignancy have not been reported, and it does not require treatment. Therefore, it is important to establish a differential diagnosis to rule out other white lesions that occur on the oral mucosa, mainly those in which there is a risk of malignancy. A case of white sponge nevus is reported along with a discussion on the differential diagnosis and clinical management.

Concentration of elastic system fibers in the corpus cavernosum, corpus spongiosum, and tunica albuginea in the rabbit penis.

The corpus cavernosum (CC) extracellular matrix is essential for normal penile erection and is implicated in erectile dysfunction. Although investigations of these issues have used the rabbit CC, organization of its components is not well known to date. We characterized and quantified the volumetric density (Vv) of the elastic system fibers in the corpus spongiosum (CS), CC and tunica albuginea (TA) of the rabbit penis. Adult New Zealand rabbits (n = 10) were used. The penile mid-shaft fragments were fixed with 4% phosphate-buffered formalin solution and/or Bouin's liquid for 24-48 h, and processed using standard histological techniques. The sections were stained with Weigert's Fucsin-Resorcin with previous oxidation. The elastic system fibers Vv (%) was determined in 25 random fields of each fragment, using the M-42 test grid. The histochemical methods detected elastic system fibers in CS, CC and TA of all animals. The Vv of elastic fibers average was 25.03+/-2.0% for CC, 32.23+/-1.41% for CS and 22.38+/-3.61% for TA. Results for CC and CS were not significantly different. The great amount of elastic fibers distribution beneath the endothelium suggest that these fibers may have an important role in the erection process in rabbits. The present data should therefore provide important information for devising experiments and interpreting results when using the rabbit penis as a model for penile dysfunctions, especially when making comparisons with humans.

Absolute phase image reconstruction: a stochastic nonlinear filtering approach.

This paper formulates and proposes solutions to the problem of estimating/reconstructing the absolute (not simply modulo-2pi) phase of a complex random field from noisy observations of its real and imaginary parts. This problem is representative of a class of important imaging techniques such as interferometric synthetic aperture radar, optical interferometry, magnetic resonance imaging, and diffraction tomography. We follow a Bayesian approach; then, not only a probabilistic model of the observation mechanism, but also prior knowledge concerning the (phase) image to be reconstructed, are needed. We take as prior a nonsymmetrical half plane autoregressive (NSHP AR) Gauss-Markov random field (GMRF). Based on a reduced order state-space formulation of the (linear) NSHP AR model and on the (nonlinear) observation mechanism, a recursive stochastic nonlinear filter is derived, The corresponding estimates are compared with those obtained by the extended Kalman-Bucy filter, a classical linearizing approach to the same problem. A set of examples illustrate the effectiveness of the proposed approach.

Image classification for content-based indexing.

Grouping images into (semantically) meaningful categories using low-level visual features is a challenging and important problem in content-based image retrieval. Using binary Bayesian classifiers, we attempt to capture high-level concepts from low-level image features under the constraint that the test image does belong to one of the classes. Specifically, we consider the hierarchical classification of vacation images; at the highest level, images are classified as indoor or outdoor; outdoor images are further classified as city or landscape; finally, a subset of landscape images is classified into sunset, forest, and mountain classes. We demonstrate that a small vector quantizer (whose optimal size is selected using a modified MDL criterion) can be used to model the class-conditional densities of the features, required by the Bayesian methodology. The classifiers have been designed and evaluated on a database of 6931 vacation photographs. Our system achieved a classification accuracy of 90.5% for indoor/outdoor, 95.3% for city/landscape, 96.6% for sunset/forest and mountain, and 96% for forest/mountain classification problems. We further develop a learning method to incrementally train the classifiers as additional data become available. We also show preliminary results for feature reduction using clustering techniques. Our goal is to combine multiple two-class classifiers into a single hierarchical classifier.

[The use of corticosteroids in Guillain-Barré syndrome: study of 51 cases]. / O uso de corticosteróides na síndrome de Guillain-Barré: estudo de 51 casos.

This is a retrospective analysis of 51 patients admitted to the Hospital de Base do Distrito Federal (Brasília, Brazil), with the Guillain-Barré syndrome, from 1974 to 1984. Eighteen patients were treated with corticosteroids (prednisone or dexamethasone), whereas 33 did not receive such treatment. The clinical course (degree of recovery, sequelae, complications, causa mortis) and the length of the hospital stay were compared in these two groups. It is concluded that the use of corticosteroids did not have a major effect on the clinical course of the illness. Moreover, the only two cases of relapses occurred in patients that had been treated with corticosteroids.

[Giant parasellar aneurysm simulating pituitary tumor]. / Aneurisma gigante parasselar simulando tumor de hipófise.

Seven cases of compromised pituitary fossa at the conventional skull X-ray, who had the final diagnosis of giant aneurysm of the intracavernous portion of the carotid artery (6 cases) and one of the anterior communicating artery, are reported. The main findings were: headache (7/7), complex ophthalmoplegia involving the III, IV and VI cranial nerves (5/7), compromised V cranial nerve (4/7) and eyeball pain (4/7). Other manifestations were: meningeal signs (2/7), unilateral blindness (1/7), hemiparesis (1/7), cacosmia (1/7) and inferior bitemporal quadrantanopsia (1/7). Five patients with intracavernous carotid artery aneurysm showed benefits with progressive occlusion of the internal carotid artery at the cervical level. One died before surgery. The case with anterior communicating artery aneurysm improved after its surgical clipping. Our data, in accord with the literature, support the conclusion that the differential diagnosis of aneurysms in the parasellar region remains a very difficult task. The accurate final diagnosis requires cerebral angiography and the surgical treatment with progressive occlusion at the cervical portion of the internal carotid artery has a relatively low risk with promising results.

[Duration of bronchodilator effect of inhaled Salmeterol (dry powder x metered dose inhaler) in children with acute asthma attack]. / Duração do efeito broncodilatador do Salmeterol inalado (pó seco e aerossol dosificador) em crianças com asma aguda.

Patients during a mild to moderate acute attack of asthma (FEV1: 50 - 80% of predicted) were treated with Salmeterol MDI - 50mcg or Rotadisk - 50mcg or Salbutamol (MDI -200mcg). The children were followed by Spirometry, measuring FEV1 (basal) and after treatment: at 30 minutes, 60 minutes and thereafter every 60 minutes until 780 minutes, if the patients maintained the FEV1 above 80% of the predicted value and/or an increment of 20% in the VEF1 basal value. The Salmeterol group showed a significant bronchodilation at 60 minutes which was maintained in half of the patients up to 9 hours. This was not observed in the Salbutamol group: the peak bronchodilatation was observed at 30 minutes and the bronchodilation effect was observed in half of the patients up to 6 hours. There were no significant differences between both presentations of Salmeterol. This drug allowed a prolonged bronchodilator effect and is, according to the several consensus on management of asthma, an adequate option in the treatment of moderate to severe asthma.

Comparative phytosociology of tree sinusiae between contiguous forests in different stages of succession.

The Baturité Mountain Range, located in the State of Ceará (BRA), displays on its highest levels a vegetation viewed as a disjunction from the Atlantic Forest in the East of Brazil. Among the various attributes associated with this vegetation, the abundance of water resources and a high biodiversity have a more outstanding relevance. However, in view of the current accelerated deforestation process, those attributes may be threatened in a near future. Therefore, the present work is a comparative study with its focus on vegetal community organization (tree sinusiae) and the floristic similarity and the phytodiversity of two areas in different successive stages, preserved and deforested 24 years ago. The aim of that intent was to obtain information that could essentially shed light on the deforestation effects on tree vegetation and which could suggest scientific support regarding urgent projects of habitat reconstruction. The methodology used folowed the model utilized for rain forest, i.e. consisting of a random distribution of 10 x 20 m plots surveying the living woody species with DBH >/= 5 cm. The results obtained suggest that a possible new physiognomy type is emerging on the Baturite Mountain Range because of deforestation. The Myrtaceae and Mimosaceae families were the ones that contributed most significantly to species richness, being the most outstanding for Areas 1 and 2, respectively. The deforestation which occurred in Area 2 eliminated 28 species and gave birth to a current densely distinct floristic composition.

[AIDS and nursing: attitudes towards personality traits in the context of hospital care]. / AIDS e enfermagem: atitudes versus traços de personalidade no contexto do atendimento hospitalar.

The objective of the present study was to determine possible relations between attitudes towards some aspects of facing AIDS and personality traits in nursing personnel for later elaboration of a program of guidance and follow-up of professionals who treat the disease. On the basis of the attitude scales constructed by the theoretical model of FISHBEIN and AJZEN (1975), a survey was carried out on 56 professionals of the Nursing Service of the University Hospital of Ribeirão Preto to determine their attitudes towards the six dimensions of AIDS treatment: the disease itself, support treatment, the stigma attached to the patient, the impotence of the professional, the rapport with the patient, and the embarrassment due to the conditions of care provided. The personality traits of these 56 subjects were later evaluated by applying Questionnaire 16 PF of CATTEL and EBER (1954). Correlation studies and contingency analyses revealed interaction between attitudes towards some factors and the results obtained with the 16 PF, with the level of significance set at p = .05. A detailed analysis of the personality/attitudes towards AIDS relationship was then performed from the results obtained, in combination with data obtained in previous studies.