Natural History and Predictors of Progression to Sjögren's Syndrome Among Participants of the Sjögren's International Collaborative Clinical Alliance Registry.

OBJECTIVE: To explore changes in the phenotypic features of Sjögren's syndrome (SS), and in SS status among participants in the Sjögren's International Collaborative Clinical Alliance (SICCA) registry over a 2-3-year interval. METHODS: All participants in the SICCA registry who were found to have any objective measures of salivary hypofunction, dry eye, focal lymphocytic sialadenitis in minor salivary gland biopsy, or anti-SSA/SSB antibodies were recalled over a window of 2 to 3 years after their baseline examinations to repeat all clinical examinations and specimen collections to determine whether there was any change in phenotypic features and in SS status. RESULTS: As of September 15, 2013, a total of 3,514 participants had enrolled in SICCA, and among 3,310 eligible, 771 presented for a followup visit. Among participants found to have SS using the 2012 American College of Rheumatology (ACR) classification criteria, 93% again met the criteria after 2 to 3 years, and this proportion was 89% when using the 2016 ACR/European League Against Rheumatism (EULAR) criteria. Among those who did not meet ACR or ACR/EULAR criteria at baseline, 9% and 8%, respectively, had progressed and met them at followup. Those with hypergammaglobulinemia and hypocomplementemia at study entry were, respectively, 4 and 6 times more likely to progress to SS by ACR criteria than those without these characteristics (95% confidence interval 1.5-10.1 and 1.8-20.4, respectively). CONCLUSION: While there was stability over a 2-3-year period of both individual phenotypic features of SS and of SS status, hypergammaglobulinemia and hypocomplementemia at study entry were predictive of progression to SS.

The SSB-positive/SSA-negative antibody profile is not associated with key phenotypic features of Sjögren's syndrome.

OBJECTIVE: To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-negative antibody profile is associated with key phenotypic features of SS. METHODS: Among registrants in the Sjögren's International Collaborative Clinical Alliance (SICCA) with possible or established SS, we compared anti-SSA/anti-SSB reactivity profiles against concurrent phenotypic features. We fitted logistic regression models to explore the association between anti-SSA/anti-SSB reactivity profile and each key SS phenotypic feature, controlling for potential confounders. RESULTS: Among 3297 participants, 2061 (63%) had negative anti-SSA/anti-SSB, 1162 (35%) had anti-SSA with or without anti-SSB, and 74 (2%) anti-SSB alone. Key SS phenotypic features were more prevalent and had measures indicative of greater disease activity in those participants with anti-SSA, either alone or with anti-SSB, than in those with anti-SSB alone or negative SSA/SSB serology. These between-group differences were highly significant and not explained by confounding by age, race/ethnicity or gender. Participants with anti-SSB alone were comparable to those with negative SSA/SSB serology in their association with these key phenotypic features. Among SICCA participants classified with SS on the basis of the American-European Consensus Group or American College of Rheumatology criteria, only 2% required the anti-SSB-alone test result to meet these criteria. CONCLUSIONS: The presence of anti-SSB, without anti-SSA antibodies, had no significant association with SS phenotypic features, relative to seronegative participants. The solitary presence of anti-SSB antibodies does not provide any more support than negative serology for the diagnosis of SS. This serological profile should thus be interpreted cautiously in clinical practice and potentially eliminated from future classification criteria.

Analysis of the epidemiological features of oral cancer in the city of Buenos Aires.

Oral cancer comprises 0.6 to 5% of all human malignant tumors. It is accepted in the literature that the clinical evolution of oral cancer has a bad prognosis, i.e. the five year survival rate ranges from 34% to 56%. The aim of the present study was to present a metaanalysis of the most relevant publications on oral cancer in the city of Buenos Aires, including our own series. The publications reviewed herein include the following series: 517 cases (1950-1970), 243 cases (1961-1968), 336 cases (1972-1984), and 274 cases (1992-2000). The clinical end-points evaluated were: age, distribution by sex, tumor site, presence of metastatic adenopathies, and clinical stage. A comparative statistical evaluation of the clinical parameters assessed was performed. Survival was evaluated by the test of Kaplan-Meier. The male/female ratio was 7.1:1 for the 1950-1970 period, 4.3:1 for the 1961-1968 period; 2.3:1 for the 1972-1984 period; and 1.24:1 in our series (1992-2000). The most frequent tumor site (21 to 35% of the cases) was the tongue. At the time of diagnosis, 60-71% of the patients had advanced TNM clinical stages (III and IV). Our follow-up revealed a five-year survival rate after diagnosis of 39%. The overall analysis of all the cases corresponding to the 1950-2000 period revealed that the prevalence of oral cancer in women has risen alarmingly and that the percentage of patients with advanced stages of tumor development continues to be high.

Analysis of the epidemiological features of oral cancer in the city of Buenos Aires.

Oral cancer comprises 0.6 to 5

of all human malignant tumors. It is accepted in the literature that the clinical evolution of oral cancer has a bad prognosis, i.e. the five year survival rate ranges from 34

to 56

. The aim of the present study was to present a metaanalysis of the most relevant publications on oral cancer in the city of Buenos Aires, including our own series. The publications reviewed herein include the following series: 517 cases (1950-1970), 243 cases (1961-1968), 336 cases (1972-1984), and 274 cases (1992-2000). The clinical end-points evaluated were: age, distribution by sex, tumor site, presence of metastatic adenopathies, and clinical stage. A comparative statistical evaluation of the clinical parameters assessed was performed. Survival was evaluated by the test of Kaplan-Meier. The male/female ratio was 7.1:1 for the 1950-1970 period, 4.3:1 for the 1961-1968 period; 2.3:1 for the 1972-1984 period; and 1.24:1 in our series (1992-2000). The most frequent tumor site (21 to 35

of the cases) was the tongue. At the time of diagnosis, 60-71

of the patients had advanced TNM clinical stages (III and IV). Our follow-up revealed a five-year survival rate after diagnosis of 39

. The overall analysis of all the cases corresponding to the 1950-2000 period revealed that the prevalence of oral cancer in women has risen alarmingly and that the percentage of patients with advanced stages of tumor development continues to be high.

Consideraciones epidemiológicas por el uso del mate: un modelo experimental / Epidemiologic considerations by the use of the mate

Se presentan los datos sobre algunos problemas del empleo de la infusión del Illex Paraguayensis (yerba mate) tal como es habitual en distintas zonas de Sudamérica, mediante el uso del "mate con bombilla" que implica la posibilidad de que volúmenes apreciables de saliva, a veces con contenido sanguíneo, puedan quedar retenidos en la bombilla y ser objeto de transmisión de enfermedades

Consideraciones epidemiológicas por el uso del mate: un modelo experimental / Epidemiologic considerations by the use of the mate

Se presentan los datos sobre algunos problemas del empleo de la infusión del Illex Paraguayensis (yerba mate) tal como es habitual en distintas zonas de Sudamérica, mediante el uso del "mate con bombilla" que implica la posibilidad de que volúmenes apreciables de saliva, a veces con contenido sanguíneo, puedan quedar retenidos en la bombilla y ser objeto de transmisión de enfermedades (AU)

Study of the vascular pattern in oral lichen planus

El liquen plano de la mucosa bucal es una afección relativamente frecuente. Su etiopatogenia permanece aún desconocida, pudiendo en su evolución sufrir transformación carcinomatosa, por ello reviste especial interés el estudio de parámetros que aporten nuevos conocimientos sobre la biología de esta afección. En el presente trabajo se analizó el patrón vascular del liquen plano bucal, empleando una metodología que permitió la utilización de parámetros cuantificables. Una parte del material biopsico tomado para diagnóstico histopatológico de rutina, fue utilizado para la marcación de paredes vasculares, mediante la técnica histoenzimática para demostración de actividad ATPasica. Las preparaciones fueron luego proyectadas y cuantificadas en un analizador de imágenes magnético, semiautomático. Los parámetros estereológicos estudiados indicaron que no existe un aumento vascular en el liquen con respecto a las mucosas normales o a las leucoplasias, dado que el conteo de paredes vasculares no mostró diferencias significativas. En cambio se observó un marcado aumento en el área vascular. La conjunción de estos parámetros indica que el liquen es una lesión más congestiva que las otras dos condiciones estudiadas. Estos hallazgos indican que las modificaciones del patrón vascular podrían jugar un rol en la etiopatogenia del liquen plano bucal y sugieren que la observación de estos cambios podrían ser un elemento útil en el diagnóstico histopatológico (AU)

Study of the vascular pattern in oral lichen planus

El liquen plano de la mucosa bucal es una afección relativamente frecuente. Su etiopatogenia permanece aún desconocida, pudiendo en su evolución sufrir transformación carcinomatosa, por ello reviste especial interés el estudio de parámetros que aporten nuevos conocimientos sobre la biología de esta afección. En el presente trabajo se analizó el patrón vascular del liquen plano bucal, empleando una metodología que permitió la utilización de parámetros cuantificables. Una parte del material biopsico tomado para diagnóstico histopatológico de rutina, fue utilizado para la marcación de paredes vasculares, mediante la técnica histoenzimática para demostración de actividad ATPasica. Las preparaciones fueron luego proyectadas y cuantificadas en un analizador de imágenes magnético, semiautomático. Los parámetros estereológicos estudiados indicaron que no existe un aumento vascular en el liquen con respecto a las mucosas normales o a las leucoplasias, dado que el conteo de paredes vasculares no mostró diferencias significativas. En cambio se observó un marcado aumento en el área vascular. La conjunción de estos parámetros indica que el liquen es una lesión más congestiva que las otras dos condiciones estudiadas. Estos hallazgos indican que las modificaciones del patrón vascular podrían jugar un rol en la etiopatogenia del liquen plano bucal y sugieren que la observación de estos cambios podrían ser un elemento útil en el diagnóstico histopatológico