ABSTRACT
Resumen Introducción La violenta represión ocurrida en Chile durante el estallido social (2019-2020) dejó un número sin precedentes de personas lesionadas con resultado de trauma ocular y maxilofacial producto de la acción de agentes del Estado, desatando una crisis socio-sanitaria que requirió del abordaje las problemáticas de salud con énfasis en el daño estructural y funcional. Objetivo Analizar la experiencia cotidiana de personas afectadas por trauma ocular y/o maxilofacial desde una perspectiva de derechos humanos, con énfasis en aportar antecedentes que contribuyan a los procesos de apoyo funcional y psicosocial. Método Estudio de enfoque cualitativo, considerando el análisis de 3 entrevistas en profundidad centradas en la experiencia cotidiana producida a raíz de la violencia policial. Éstas se analizaron en base a la técnica de análisis de contenido, con una posterior triangulación. Resultados Se apreciaron una serie de interferencias y repercusiones cotidianas producto del trauma, generando el fenómeno de una cotidianidad interferida, además del extrañamiento de sí misma/o. Se discutió sobre el contraste entre las experiencias y expectativas de la atención en salud y procesos de reparación, que resultan aún insuficientes y tienden hacia la revictimización. Conclusión El acceso a rehabilitación funcional y psicosocial es parte fundamental de los procesos de reparación integral de las personas que vivieron estas experiencias traumáticas durante el estallido social. Es fundamental que los dispositivos sanitarios y judiciales profundicen abordajes desde una perspectiva de derechos humanos incorporando el enfoque de género para cumplir los principios de verdad, justicia, reparación y garantías de no repetición.
Resumo Introdução A violenta repressão ocorrida no Chile durante a crise social (2019-2020) deixou um número sem precedentes de pessoas feridas por traumas oculares e maxilofaciais, produto da ação de agentes do Estado, desencadeando uma crise sociossanitária que exigiu a abordagem dos problemas de saúde com ênfase nos danos estruturais e funcionais. Objetivo Analisar a experiência cotidiana de pessoas acometidas por traumas oculares e/ou maxilofaciais sob a ótica dos direitos humanos, com ênfase no fornecimento de informações básicas que contribuam para os processos de apoio funcional e psicossocial. Método Estudo com abordagem qualitativa, considerando a análise de três entrevistas em profundidade, focadas na experiência cotidiana produzida em decorrência da violência policial. Estas foram analisadas com base na técnica de análise de conteúdo, com posterior triangulação de dados. Resultados Observou-se uma série de interferências e repercussões cotidianas em decorrência do trauma, gerando o fenômeno de uma cotidianidade interferida, além do estranhamento de si mesma/o. Discutiu-se o contraste entre as experiências e expectativas da atenção em saúde e processos de reparação, que ainda são insuficientes e tendem à revitimização. Conclusão O acesso à reabilitação funcional e psicossocial é parte fundamental dos processos de reparação integral e psicossocial das pessoas que vivenciaram essas experiências traumáticas durante a crise social. É fundamental que os dispositivos sanitários e judiciais aprofundem as abordagens desde uma perspectiva dos direitos humanos, incorporando o enfoque de gênero para cumprir os princípios de verdade, justiça, reparação e garantias de não repetição.
Abstract Introduction The violent repression that occurred in Chile during the social outbreak (2019-2020) left an unprecedented number of people injured as a result of ocular and maxillofacial trauma as a result of the action by state agents, unleashing a socio-sanitary crisis that required the approach of health problems with an emphasis on structural and functional damage. Objective To analyze the daily experience of people affected by ocular and/or maxillofacial trauma from a human rights perspective, with emphasis on providing background information that contributes to functional and psychosocial support processes. Method Study with a qualitative approach, considering the analysis of three in-depth interviews focused on the daily experience produced as a result of police violence. These were analyzed based on the content analysis technique, with subsequent triangulation. Results A series of interferences and daily repercussions as a result of the trauma were observed, generating the phenomenon of an interfered daily life in addition to self-estrangement. The contrast between the experiences and expectations of health care and reparation processes was discussed, which are still insufficient and tend towards re-victimization. Conclusion Access to functional and psychosocial rehabilitation is a fundamental part of the processes of integral and psychosocial repair for the people who lived through these traumatic experiences during the social outbreak. It is essential that health and judicial mechanisms deepen approaches from a human rights perspective, incorporating the gender approach to comply with the principles of truth, justice, reparation, and guarantees of non-repetition.
ABSTRACT
BACKGROUND/AIM: During Chile's period of social unrest, numerous people suffered physical trauma due to the use of police force. However, there have been no reports regarding traumatic dental injuries (TDIs) suffered in this context. This study aims to describe the dental trauma of patients injured by police during the social unrest period in Chile from 2019 to 2021. MATERIAL AND METHODS: A case series methodology was employed. Following informed consent, clinical records of patients admitted to the Ocular and Dentomaxillofacial Prosthetic Care and Rehabilitation Program, who were affected by the violence of state agents during social mobilizations, were reviewed from October 2019 to December 2021. Information on the sociodemographic characteristics of the patients and the TDI diagnoses with their treatment needs were collected. A descriptive analysis was performed. RESULTS: Forty-six patients were identified, nine of whom agreed to the informed consent. Most were male, with a mean age of 28 years, public health insurance, and a high educational level. The most common causes of injury were kinetic impact projectiles (KIPs) and the use of physical force (punches, kicks, or pushes). Of the nine cases described, 26 teeth were affected by TDI. The most affected teeth were the central upper incisors and, in most cases, they presented lesions in both injury categories: NA0D.0 (the tooth and pulp) and NA0D.1 (periodontal tissues). Treatment needs varied and included some complex procedures, such as implant-retained crowns and removable dental prostheses. CONCLUSIONS: The use of force by police during the period of social unrest in Chile caused TDIs among demonstrators, which were mainly due to physical force from less-than-lethal weapons. Most cases presented injuries affecting the incisors with multiple teeth requiring complex treatments.
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Sjögren's syndrome (SS) is a disease with autoimmune features that affects mainly women and compromises the health-related quality of Life (HRQoL); it is important to evaluate illness experience for a better understanding of the life situation of the patient. The aim of the study was to summarize the individual life experiences and determine the impact of HRQoL and oral health-related quality of life (OHRQoL) and their correlation with health self-assessment in women with SS. The life experiences evaluation employed a concept mapping design to structure qualitative content obtained from semi-structured interviews. Hierarchical cluster analysis was used to analyze the patient's experiences. EQ-5D-5L and OHIP-14Sp were used. The correlation between appreciation of the general health status and OHIP-14 was evaluated. The experience classification by patients were analyzed and a dendrogram was obtained, identifying 10 clusters of disease experiences of SS, being limitations, pain and difficulties, coping and attitudes towards treatment the most common. Pain/discomfort in EQ-5D-5L and physical pain and psychological discomfort in OHIP-14 were the most affected dimensions in the patients. The results support the theoretical perspective that the experience of illness is relevant to describing the main difficulties of patients with SS and how it affects their quality of life.
Subject(s)
Quality of Life , Sjogren's Syndrome , Adaptation, Psychological , Female , Health Status , Humans , Pain , Quality of Life/psychology , Surveys and QuestionnairesABSTRACT
RESUMEN: Objetivo: Determinar la validez aparente, validez de constructo y confiabilidad del cuestionario IDAF-4C+ versión en español, en adultos mayores de dos servicios de atención primaria de la Región Metropolitana, Chile. Materiales y métodos: Estudio descriptivo, transversal aplicado a 42 adultos mayores de dos servicios de atención primaria de la Región Metropolitana. La validez aparente se determinó mediante el juicio de expertos, la validez de constructo a través del análisis exploratorio confirmatorio, mientras que la confiabilidad se determinó por consistencia interna, exploratorio a través del coeficiente alfa de Cronbach. Resultados: El juicio de expertos no realizó modificación al IDAF-4C+ versión en español. El análisis exploratorio confirmó la presencia de un solo factor, el cual explicó el 60,1% de la varianza, mientras que la confiabilidad arrojó un alfa de Cronbach de 0,901, considerado excelente. Conclusiones: El cuestionario IDAF-4C+ presentó una adecuada validez de contenido, validez aparente y una confiabilidad excelente. Se recomienda su uso para la medición de ansiedad dental en adultos mayores que acuden a los servicios de atención primaria evaluados.
ABSTRACT Objective: To determine the face validity, construct validity and reliability of the Spanish version of the IDAF-4C + in older adults, patients in two primary health care from the Metropolitan Region, Chile. Material and methods: Descriptive cross-sectional study, 42 older adults from two primary health care centres from the Metropolitan Region set up the sample. Face validity was determined by experts' judgment, construct validity was determined by a confirmatory factorial analysis and reliability was determined by internal consistency exploratory through Cronbach's alfa. Results: The experts did not modify the Spanish version of the IDAF-4C+. The factorial analysis confirmed the presence of only one factor which explains the 60,1% of the variance, and Cronbach's alfa resulted in 0,901, considered as excellent. Conclusions: The Spanish version of IDAF-4C+ is valid and reliable for the measurement of dental anxiety and fear and its use is recommended among older adults who visit primary health care centres in the Metropolitan Region.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Validation Study , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Sjögren's syndrome (SS) challenges everyday functioning and well-being. The aim of this study was to structure and summarize the life experiences of Chilean women with SS in an integrated model. METHODS: Interviews from a previous study yielded 75 experiences of living with SS. A sample of 30 women with SS sorted these experiences by content and rated their level of agreement with each experience. A hierarchical cluster analysis was used to structure the experiences of the participants with SS in a comprehensive overview. A team-based consensus analysis was used to define the number of clusters. The level of agreement was examined with Wilcoxon's signed rank test. RESULTS: Ten clusters were identified and grouped into 6 main categories: symptoms (clusters: mucosal dryness and related symptoms), social environment, emotion management (clusters: fears and sadness), information (clusters: uncertainty and lack of knowledge), coping strategy (clusters: resilience and self-care), and health staff relationship. The clusters that describe the more common experiences among patients were resilience, self-care, uncertainty, lack of knowledge, health staff relationship, and mucosal dryness. CONCLUSION: This study provided an integrated and structured overview of disease experiences comprising both biomedical and psychosocial aspects as being of vital importance for the health of patients with SS. The overview can be used to get a quick impression of disease experiences that are important for an individual patient, in a therapeutic goal setting, and in the construction and evaluation of medical and nonmedical interventions or education.
Subject(s)
Cost of Illness , Life Change Events , Sjogren's Syndrome/complications , Women's Health , Adaptation, Psychological , Adult , Aged , Attitude of Health Personnel , Checklist , Chile , Cluster Analysis , Female , Health Knowledge, Attitudes, Practice , Health Status , Humans , Interviews as Topic , Mental Health , Middle Aged , Patient Education as Topic , Professional-Patient Relations , Quality of Life , Sjogren's Syndrome/diagnosis , Sjogren's Syndrome/physiopathology , Sjogren's Syndrome/psychologyABSTRACT
INTRODUCCIÓN: La ansiedad dental impacta profundamente en la salud oral de un paciente, determinando el pronóstico y adherencia a tratamiento, sin embargo, existe poca información de instrumentos validados que evalúen este constructo. El OBJETIVO de este estudio es evaluar las propiedades psicométricas del Dental Anxiety Scale versión en español en adultos en servicios de atención primaria de la Región Metropolitana, Chile. MATERIAL Y MÉTODO: Estudio transversal descriptivo aplicado a 169 adultos acompañantes de un servicio de atención primaria. La validez de contenido se determinó con metodología Delphi, la validez de constructo a través del análisis factorial confirmatorio y la confiabilidad a través de análisis de consistencia interna mediante Alfa de Cronbach. RESULTADOS: El juicio de expertos no modificó la versión en español. El análisis factorial confirmó la presencia de un solo factor, el cual explicó el 65,44% de la varianza, mientras que la confiabilidad arrojó un alfa de Cronbach de 0,822, considerado bueno. DISCUSIÓN: El Dental Anxiety Scale presentó una adecuada validez de contenido, validez de constructo y buena confiabilidad. Se recomienda su uso para la medición de ansiedad dental en adultos que acuden a servicios de atención primaria en la Región Metropolitana.
INTRODUCTION: Dental anxiety can strongly affect oral health, modifying the prognosis and treatment's adherence. The level of dental anxiety has to be considered when proposing a treatment plan. The AIM of this study is to measure the psychometric properties of the Dental Anxiety Scale in the Spanish version, applied to adults in primary health institutions of the Metropolitan Region, Chile METHODS: 169 adults were recruited. To determine content validity, the Delphi method was used; the confirmatory factor analysis was used to demonstrate the construct validity. Reliability was measured in terms of internal consistency with the Cronbach's alpha coefficient. RESULTS: The experts did not modify the Spanish version of DAS. The factorial analysis confirmed that there was a single factor that accounted for 65,44% of variance. A 0,882 Cronbach's alfa is considered as good reliability. CONCLUSION: Dental Anxiety Scale presents an appropriate construct and content validity, and a good reliability. It is a proper instrument to be used in adults in primary health care centers in the Metropolitan Region.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Primary Health Care , Surveys and Questionnaires , Dental Anxiety/diagnosis , Dental Anxiety/psychology , Psychometrics , Socioeconomic Factors , Chile , Oral Health , Cross-Sectional Studies , Reproducibility of Results , Factor Analysis, Statistical , Delphi TechniqueABSTRACT
RESUMEN: El carcinoma oral de células escamosas es la neoplasia maligna más frecuente en la cavidad oral. Sin embargo, los estudios sobre supervivencia general en pacientes con cáncer oral son escasos en Chile. Objetivo: Determinar las características sociodemográficas y la supervivencia general de pacientes diagnosticados con carcinoma en labio y cavidad oral en el Servicio de Anatomía Patológica de la Facultad de Odontología, Universidad de Chile. Material y métodos: Se seleccionaron los casos de carcinoma oral de células escamosas diagnosticados entre los años 2000-2012. Se incluyeron sólo los primeros diagnósticos y las recidivas fueron excluidas. Resultados: De 134 casos registrados, 120 cumplían los criterios de inclusión. El 60% correspondió a hombres (razón hombre-mujer 1,3:1) y la media de edad fue 63 años. La supervivencia general a dos años fue 48,3% y a cinco años 33,9% según estimación de Kaplan-Meier. Se detectó una mayor supervivencia en el grupo de pacientes que tenían menos de 55 años (p<0,05). 79,2% de los casos fallecidos registra como causa de muerte cáncer oral. Conclusiones: El mayor porcentaje de personas diagnosticadas fueron hombres y adultos mayores. La supervivencia general a cinco años fue menor a lo determinado en reportes nacionales previos. Los adultos de 55 años y mayores presentaron una menor supervivencia general.
ABSTRACT: Oral squamous cell carcinoma is the most common malignant neoplasm of oral cavity. Research about general survival rates in patients with oral cancer is limited in Chile. Objective: To determine the sociodemographic characteristics and general survival of patients diagnosed with lip and oral carcinoma in the Pathological Anatomy Service at the School of Dentistry, University of Chile. Material and methods: All cases of oral squamous cell carcinoma selected were diagnosed between the years 2000 and 2012. All cases included in this study corresponded to the first diagnosis and tumor recurrence was excluded. Results: The 134 registered cases, 120 were selected with inclusion criteria. 60% were men (male and female ratio of 1.3: 1) and median age 63 year-old. Overall survival at two years was 48.3% and at five years 33.9%, according to Kaplan-Meier estimate. A higher survival was detected in the group of patients younger than 55 years old (p <0.05). In 79.2% of dead patients, the cause of death was registered as oral cancer. Conclusions: The highest percentage of patients diagnosed was men and elders. Five-year survival was lower than previously reported in national reports. Adults aged 55 years and older had a lower overall survival.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Survival , Universities , Mouth Neoplasms , Squamous Cell Carcinoma of Head and Neck , Chile , Observational StudyABSTRACT
ABSTRACT: Dental anxiety can be a barrier to following healthy behaviours. Musical distraction is an effective strategy to reduce dental anxiety and improve treatment adherence. The aim was to determine the effect of musical distraction on dental anxiety and treatment adherence in 6-year-old children. Multicenter randomized control trial with 176 children who were allocated into two parallel groups. One group received usual dental care (N 88), and the other was exposed to musical distraction during usual dental care (N 88). The primary outcome was dental anxiety and secondary was oral health status and oral health care behaviours. Both were assessed at baseline, discharged and six-month follow-up. Mid/high dental anxiety was exhibited by 16.1 % of the children. Musical distraction had no effect on dental anxiety levels in the experimental compared with the control group at any of the time points assessed. The size effect was 0.35 and 0.15 (Cliff's Delta) for baseline-discharge and 0.57 and 0.35 for baseline-six month. Only 47.7 % of the sample attended at 6-month follow-up. Dental anxiety is not prevalent in the sample and is not beneficially reduced by musical distraction. The educational actions of the dental care programme are not sufficient to attain permanent long-term changes in oral health behaviour.
RESUMEN: La ansiedad dental puede ser una barrera para seguir conductas saludables. La distracción musical es una estrategia efectiva para reducir la ansiedad dental y mejorar la adherencia al tratamiento. El objetivo fue determinar el efecto de la distracción musical sobre la ansiedad dental y la adherencia al tratamiento en niños de 6 años. Ensayo multicéntrico de control aleatorizado con 176 niños asignados a dos grupos paralelos. Un grupo recibió atención dental habitual (n 88) y el otro estuvo expuesto a distracción musical durante el cuidado dental habitual (N 88). El resultado primario fue la ansiedad dental y secundaria fue el estado de salud oral y las conductas de salud oral. Ambos fueron evaluados al inicio, dados de alta y seguidos durante seis meses. La ansiedad dental media / alta fue exhibida por 16,1 % de los niños. La distracción musical no tuvo ningún efecto sobre los niveles de ansiedad dental en el grupo experimental en comparación con el grupo control en ninguno de los momentos evaluados. El efecto del tamaño fue 0,35 y 0,15 (Cliff's Delta) para el inicio y el alta y 0,57 y 0,35 para el inicio y los seis meses de seguimiento. Solo el 47,7 % de la muestra asistió a los 6 meses de seguimiento. La ansiedad dental no prevalece en la muestra y no se ve beneficiada por la distracción musical. Las acciones educativas del programa de atención dental no son suficientes para lograr cambios permanentes a largo plazo en el comportamiento de salud oral.
Subject(s)
Humans , Male , Female , Child , Dental Anxiety , Music Therapy , Software Design , Patient Compliance , Dental Care for Children , Manifest Anxiety ScaleABSTRACT
OBJECTIVE: The aim of this study was to determine the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in older participants. BACKGROUND: In elders, xerostomia is a permanent and progressive condition that significantly affects their quality of life. The treatment for progressive xerostomia is currently restricted to palliative measures, and saliva substitutes are indicated. A lack of evidence on the effectiveness of the saliva substitutes in the relief of symptoms of xerostomia has been reported. MATERIALS AND METHODS: Seventy-four elderly participants presenting xerostomia of diverse origin were selected. Herbal saliva substitute and carboxymethyl cellulose conventional saliva substitute were tested using a double-blind, randomised, cross-sectional clinical trial. RESULTS: Every participant of the study exhibited dry mouth sensation. A sensation of thick saliva was described in 59.5% of the participants. The need for liquid intake to swallow food, the sensation of difficulty in swallowing and the burning sensation in the tongue were observed in 54.1, 56.8 and 27.0% of the participants, respectively. The most prevalent diseases were hypertension, depressive symptoms and arthritis. Results of the clinical tests showed that the herbal saliva substitute produced a greater relief of dry mouth symptoms, thick saliva sensation and the sensation of difficulty in swallowing than the conventional substitute (Wilcoxon test p < 0.05). CONCLUSIONS: New chamomile- and linseed-based saliva substitute was effective in relieving xerostomia symptoms in older participants of this study.
Subject(s)
Chamomile , Flax , Herbal Medicine/methods , Phytotherapy/mortality , Plant Extracts/therapeutic use , Saliva, Artificial/therapeutic use , Xerostomia/drug therapy , Aged , Double-Blind Method , Female , Humans , Male , Salivation/drug effectsABSTRACT
El objetivo fue identificar el nivel de ansiedad dental en una muestra de adultos chilenos que concurren a un servicio de atención de salud primaria. Se realizó un estudio transversal, obteniendo una muestra de 174 adultos, con edades entre los 20 y 70 años, pertenecientes al área urbana de Santiago de Chile, y que acudían en calidad de acompañantes de niños(as) que asistían a atención dental. Se registraron datos socio-demográficos y fecha de último control dental. Se aplicó la escala de ansiedad dental de Corah. Se realizaron estadísticos descriptivos, prueba t, prueba U de Mann Whitney y prueba de Spearman. Se trabajó con un error de significancia del 5 %. Un 37,9% de la muestra presentó ansiedad dental, en sus niveles moderado (16,1 %), severo (13,2 %) y fobia dental (8,6 %). A nivel educacional, los sujetos con educación básica completa presentaron la mayor frecuencia (57,1 %) de ansiedad, mientras que los de educación superior incompleta presentaron la menor frecuencia (25 %). No se observaron asociaciones entre ansiedad dental y edad, sexo, nivel educacional, índice per cápita y último control dental. La muestra de adultos encuestados de Santiago de Chile presentó altos niveles de ansiedad dental en comparación con países desarrollados. Se recomienda realizar más estudios en dicha población para determinar las variables que explican el problema de la ansiedad dental en la población chilena.
The objective of this study is to identify the level of dental anxiety in a sample of Chilean adults who attend a service of primary health care. A cross-sectional study was carried out. The sample consisted of 174 caregivers of pediatric dental patients, aged between 20 and 70 years, belonging to the urban area of Santiago de Chile. A questionnaire that included socio-demographic information (sex, age, educational level, income per capita index and last dental visit) were registered. Corah's Dental Anxiety Scale was applied. Descriptive statistics and t-test, U-Mann Whitney test and Spearman test was used. An error of significance of 5% was applied. 37.9 % of thesample shows dental anxiety in their moderate levels (16.1 %), severe (13.2 %) and dental phobia (8.6 %). Of the subjects who had dental anxiety, the majority had moderate anxiety (42.4 %). In an educational level, subjects with complete basic education have the highest rate (57.1 %) of anxiety, while incomplete higher education had the lowest rate (25 %). Adults between 50 and 59 years reported greater presence of dental anxiety. There were not significant associations between dental anxiety and age, sex, educational level, per capita rate and last dental visit. The sample of adults surveyed in Santiago de Chile presented high levels of dental anxiety compared to other developed countries. We recommend further studies in this population to determine the variables that explain the problem of dental anxiety in the Chilean population.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Primary Health Care/statistics & numerical data , Dental Anxiety/psychology , Dental Anxiety/epidemiology , Socioeconomic Factors , Chile , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
BACKGROUND: Sjögren's syndrome and the associated dryness can have multiple consequences. The aim of the present qualitative study was to give an in-depth account of the life experiences of women with primary Sjögren's syndrome (pSS) and health-related behaviours, and to summarize these experiences in an integrated model. METHODS: Twelve women diagnosed with pSS who regularly attended the Hospital of the University of Chile participated in detailed interviews. The data were analysed using qualitative methods based on the principles of grounded theory. RESULTS: Selective coding identified three categories: illness experience, social interaction and psychological response. An integrated model was developed connecting these dynamic aspects and suggesting how they could lead to a life cycle crisis in cases of maladjustment. We found that problem-solving strategies, reconstruction of identity, acceptance and a social support may prevent this life cycle crisis. DISCUSSION: Xerostomia and other consequences of pSS can have a profound influence on daily life. However, the severity of the consequences depends on individual experiences with the illness, social influences and the psychological responses of the patient. Physicians, dentists and other healthcare professionals can help the patient by listening to their problems and exploring solutions based on a psychological approach.
Subject(s)
Sjogren's Syndrome/psychology , Adaptation, Psychological , Aged , Female , Humans , Middle Aged , Sjogren's Syndrome/physiopathology , Social AdjustmentABSTRACT
OBJECTIVE: Graft-versus-host disease (GVHD) is one of the main complications after haematopoietic stem cell transplantation. Clinical features of GVHD include either an acute (aGVHD) or a chronic (cGVHD) condition that affects locations such as the oral mucosa. While the involvement of the host's dendritic cells (DCs) has been demonstrated in aGVHD, the origin (donor/host) and mechanisms underlying oral cGVHD have not been completely elucidated. In this study, we intend to determine the origin of DCs present in mucosal tissue biopsies from the oral cavity of transplanted patients affected by cGVHD. METHODS: We purified DCs, from oral biopsies of three patients with cGVHD, through immunobeads and subsequently performed DNA extraction. The origin of the obtained DCs was determined by PCR amplification of 13 informative short tandem repeat (STR) alleles. We also characterised the DCs phenotype and the inflammatory infiltrate from biopsies of two patients by immunohistochemistry. RESULTS: Clinical and histological features of the biopsies were concordant with oral cGVHD. We identified CD11c-, CD207- and CD1a-positive cells in the epithelium and beneath the basal layer. Purification of DCs from the mucosa of patients affected by post-transplantation cGVHD was >95%. PCR-STR data analysis of DCs DNA showed that 100% of analysed cells were of donor origin in all of the evaluated patients. CONCLUSION: Our results demonstrate that resident DCs isolated from the oral tissue of allotransplanted patients affected by cGVHD are originated from the donor. Further research will clarify the role of DCs in the development and/or severity of oral cGVHD.
Subject(s)
Dendritic Cells/pathology , Graft vs Host Disease/pathology , Hematopoietic Stem Cell Transplantation/methods , Mouth Diseases/etiology , Mouth Diseases/pathology , Mouth Mucosa/pathology , Transplantation Chimera , Adolescent , Adult , Antigens, CD/analysis , Antigens, CD1/analysis , CD11c Antigen/analysis , Female , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Lectins, C-Type/analysis , Male , Mannose-Binding Lectins/analysis , Microsatellite Repeats/genetics , Middle Aged , Mouth , Transplantation, Homologous , Young AdultABSTRACT
BACKGROUND: Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. MATERIAL AND METHODS: A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. RESULTS: There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). CONCLUSIONS: The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. KEY WORDS: Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia.
ABSTRACT
BACKGROUND: Deregulation of beta-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear beta-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: Cross sectional study. Immunodetection of beta-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. RESULTS: Nuclear expression of beta-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups (p < 0.05). CONCLUSIONS: Our results are consistent with most of the reports which show increased presence of beta-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear beta-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of beta-catenin could be a possible immune marker in the detection of oral displasia
Subject(s)
Humans , beta Catenin/analysis , Mouth Neoplasms/pathology , Precancerous Conditions/pathology , Carcinoma/pathology , Biomarkers, Tumor/analysis , Focal Epithelial Hyperplasia/pathologyABSTRACT
BACKGROUND: Deregulation of ß-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear ß-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: Cross sectional study. Immunodetection of ß-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. RESULTS: Nuclear expression of ß-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups (p < 0.05). CONCLUSIONS: Our results are consistent with most of the reports which show increased presence of ß-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear ß-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of ß-catenin could be a possible immune marker in the detection of oral dysplasia.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Cell Transformation, Neoplastic , Mouth Mucosa/metabolism , Mouth Mucosa/pathology , Mouth Neoplasms/metabolism , Mouth Neoplasms/pathology , beta Catenin/biosynthesis , Adult , Aged , Aged, 80 and over , Cell Nucleus/metabolism , Cross-Sectional Studies , Epithelium/abnormalities , Epithelium/metabolism , Epithelium/pathology , Female , Humans , Male , Middle Aged , Mouth Mucosa/abnormalitiesABSTRACT
Introducción: La xerostomía es una condición crónica que afecta a un alto porcentaje de adultos mayores, que deben ser tratados paliativamente mediante el uso de sustitutos salivales; sin embargo estos productos no se encuentran disponibles en el mercado nacional. Objetivos Evaluar la eficacia de un nuevo sustituto salival a base de manzanilla y semillas de linaza en la disminución de la sintomatología asociada a xerostomía en individuos adultos mayores. Metodología Se incluyeron 34 voluntarios adultos mayores con xerostomía de diverso origen. Un nuevo sustituto salival a base de manzanilla y semillas de linaza y un sustituto convencional a base de carboximetilcelulosa fueron testados en un ensayo clínico aleatorizado, cruzado, con período de blanqueamiento. Resultados El 100 por ciento de los sujetos presentó sensación de boca seca, el 58,8 por ciento sensación de saliva espesa, el 52,9 por ciento necesitaba beber líquidos para deglutir los alimentos y tenía sensación de dificultad para tragar. La sensación de ardor lingual se registró en el 23,5 por ciento de los individuos. Las enfermedades más frecuentes en la muestra analizada fueron la hipertensión arterial y la artritis. Los resultados del ensayo clínico indican que el sustituto salival a base de manzanilla y semillas de linaza disminuye significativamente la sensación de boca seca y la sensación de saliva espesa (test de Wilcoxon p < 0,05). Conclusión El nuevo sustituto salival a base de manzanilla y semillas de linaza es efectivo en el alivio de la sintomatología asociada a xerostomía en adultos mayores, por lo que puede contribuir a mejorar la calidad de vida de la población afectada por esta condición.
Introduction: Xerostomia is a common chronic health condition that affects a great number of elderly people. Palliative treatment, such as salivary substitutes should be used, but these products are not accessible in the Chilean market. Objectives To evaluate the efficacy of a new Chamomile and linseed based saliva substitute in the reduction of xerostomía-associated symptomatology in elderly people. Methodology Forty elderly subjects presenting with xerostomia of various origins were selected. Chamomile and linseed based saliva substitute and a carboxymethylcellulose based conventional artificial saliva were tested using a double-blind, randomized, cross-over clinical trial with an intervining wash out period. Results All (100 percent) of subjects had a sensation of dry mouth, and 58.8 percent mentioned a sensation of thick saliva, 52.9 percent needed to drink liquids to swallow, and with a sensation of swallowing difficulty. Burning tongue sensation was recorded in 23.5 percent of the patients. The most frequent pathologies in the sample were arterial hypertension and arthritis. Results of the clinical tests showed that Chamomile and linseed based saliva substitute significantly relieves the sensation of dry mouth and the sensation of thick saliva (Wilcoxon test P < .05). Conclusion New chamomile and linseed based saliva substitute was effective in relieving xerostomia symptoms in elderly people, and could improve the quality of life of population affected by this condition.
Subject(s)
Humans , Male , Female , Middle Aged , Plant Extracts/therapeutic use , Flax/chemistry , Matricaria/chemistry , Saliva, Artificial/therapeutic use , Xerostomia/drug therapy , Chamomile/chemistryABSTRACT
Human papillomavirus (HPV) is the causal agent of cervical, anogenital and a subset of oropharyngeal carcinomas. In addition, the role of HPV in oral carcinogenesis has been suggested, although the findings are inconclusive. In this study, using conventional polymerase chain reaction (PCR) and genotyping by specific PCR and DNA sequencing, we analyzed the HPV presence in 80 oral squamous cell carcinomas (OSCCs) from Chilean subjects. In addition, we determined the expression of p16, p53, pRb and Ki-67 using immunohistochemistry (IHC). The CDKN2A (p16) promoter methylation was evaluated using methylation-specific PCR (MSP). HPV sequences were found in 9/80 (11%) OSCCs. Non-statistically significant association with p53, pRb, Ki-67 and p16 levels were found (p=0.77; 0.29; 0.83; 0.21, respectively). HPV-16 and 18 were the most prevalent HPV genotypes in 8/9 (89%) OSCCs. In addition, CDKN2A (p16) was methylated in 39% of OSCCs. No association with HPV presence (p=0.917) was found. These results suggest that HPV positive OSCCs are entities that do not resemble the molecular alterations of HPV-associated tumors in a Chilean population. More studies are warranted to determine the role of HPV in OSCCs.
Subject(s)
Carcinoma, Squamous Cell/virology , Mouth Neoplasms/virology , Mouth/virology , Papillomaviridae/isolation & purification , Papillomavirus Infections/virology , Aged , Aged, 80 and over , Biomarkers, Tumor , Carcinoma, Squamous Cell/pathology , Chile , Cyclin-Dependent Kinase Inhibitor p16/genetics , Cyclin-Dependent Kinase Inhibitor p16/metabolism , DNA, Viral/genetics , Female , Genotype , Human papillomavirus 16/genetics , Human papillomavirus 16/isolation & purification , Human papillomavirus 18/genetics , Human papillomavirus 18/isolation & purification , Humans , Immunohistochemistry , Ki-67 Antigen/genetics , Ki-67 Antigen/metabolism , Male , Middle Aged , Mouth/pathology , Mouth Neoplasms/pathology , Papillomaviridae/genetics , Promoter Regions, Genetic , Tumor Suppressor Protein p53/genetics , Tumor Suppressor Protein p53/metabolismABSTRACT
Sarcomatoid Carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. The diagnosis often represents a clinical-pathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. The reported cases related to oral mucosa are limited. In this work we present two SC cases where the use of IHC allowed us to achieve a conclusive diagnosis.
