Impact of infrasound exposure and streptozotocin-induced glucose intolerance on bone composition in Wistar rats.

The elemental composition of chemical elements can vary between healthy and diseased tissues, providing essential insights into metabolic processes in physiological and diseased states. This study aimed to evaluate the calcium (Ca) and phosphorus (P) levels in the bones of rats with/without streptozotocin-induced diabetes and/or exposure to infrasound. X-ray fluorescence spectroscopy was used to determine the concentrations of Ca and P in Wistar rat tibiae samples.The results showed a significant decrease in bone P concentration in streptozotocin-induced diabetic rats compared to untreated animals. Similarly, the Ca/P ratio was higher in the streptozotocin-induced diabetic group. No significant differences were observed in bone Ca concentration between the studied groups or between animals exposed and not exposed to infrasound.Moreover, streptozotocin-induced diabetic rats had lower bone P concentration but unaltered bone Ca concentration compared to untreated rats. Infrasound exposure did not impact bone Ca or P levels. The reduced bone P concentration may be associated with an increased risk of bone fractures in diabetes.

Is There an Over-Indication for Elective Tracheostomy in Patients With Oral Cavity Cancer?

OBJECTIVES: Temporary tracheostomies (TT) are often used in oral oncologic surgery to secure the postoperative airway. Our primary objective was to determine if there was an over-indication for elective tracheostomy in our population. If so, our secondary objective was to ascertain which patients could have possibly avoided TT. MATERIALS AND METHODS: We performed a retrospective study of patients with oral and oropharyngeal squamous cell carcinoma in which resection with curative intent and TT were performed. Variables collected included demographics, comorbidities, and complications. Additionally, we retrospectively applied the Cameron and TRACHY tracheostomy scoring systems to evaluate overall tracheostomy recommendations. RESULTS: A total of 116 elective tracheostomies were performed between January 2019 and December 2020. According to the Cameron and TRACHY scoring systems, recommendations for tracheostomy coincided in only 54.3% and 45.7%, respectively. Tumor anatomy and type of reconstruction were associated with less time until decannulation. Additionally, in patients without TT recommendation determined by both scores with tumor anatomy and location, as well as T and N stages were also associated with less time until decannulation. CONCLUSION: There appears to be an over-indication for elective tracheostomy in our patients with oral cavity and oropharyngeal cancer. The patients that could have potentially avoided elective TT were those with lateral anatomy, without flap or with fasciocutaneous flap, location in the mandibular alveolus or anterior tongue, as well as N0/N1 and T1/T2 patients.

Profiling oral health status, values, and related quality of life in patients with oral cancer: a pilot study.

Patients diagnosed with oral cancer frequently exhibit an increased likelihood of experiencing common dental conditions, lower dental health literacy, and a decline in their overall quality of life. However, there is limited understanding on the impact of oral health values on these patients. This study aims to explore the oral health status and their oral health determinants and reported outcomes in patients with oral squamous cell carcinoma (OSCC) at the Instituto Português de Oncologia de Lisboa Francisco Gentil. This cross-sectional study included patients who were diagnosed with OSCC for the first time. These individuals were administered a questionnaire that collected sociodemographic data, as well as their scores on the oral health value scale (OHVS) and the short-form oral health impact profile. In addition, participants self-reported their experiences with periodontitis and caries using the decayed, missing, filled index. The final sample consisted of 46 OSCC patients, consisting of 34 males and 12 females. The average age of the participants was 70.0 years (±13.2), with most of them being retired (65.2%). There were no differences found between sex regarding age (p = 0.531), employment status (p = 0.114), presence of systemic conditions, smoking habits (p = 0.423), or alcohol consumption (p = 0.404). In the OHVS, there was a statistically significant difference between men and women regarding the retention of natural teeth (p = 0.021). Patients with self-perceived periodontitis exhibited worse functional limitation (p = 0.039) and physical pain (p = 0.049). Regarding dental caries experience, it was observed that a majority of patients had a higher incidence of missing posterior teeth (59.2%). This sample presented a significant decline in oral health, in addition to the diagnosed OSCC. The oral health value and quality of life were severely declined. There is a concerning lack of oral care and health that, consequently, impacts the quality of life of these patients.

Pyramidal lobe-dominant papillary thyroid carcinoma-A rare entity with important clinical implications.

Papillary thyroid carcinoma (PTC) primarily located in the pyramidal lobe of the thyroid gland is extremely rare, therefore the clinical and pathological features are not well understood. The authors describe a case of PTC of the pyramidal lobe, in a 77-year-old woman who underwent en bloc total thyroidectomy with pyramidal lobe, hyoid bone and cervical lymph node excision. In line with the present case, current literature reports a greater presence of worse prognostic factors, namely extrathyroidal extension, advanced T stage or presence of cervical lymph node metastasis. Recently, a new classification has been suggested-Upper Neck Papillary Thyroid Cancer (UPTC)-which encompasses these carcinomas, Delphi ganglion metastases and thyroglossal duct cyst carcinomas, with potential clinical and therapeutic implications, particularly the need for orthotopic thyroidectomy. Also, the complete excision of the pyramidal lobe during thyroidectomy may influence the success of radioactive iodine therapy and the patient's follow-up surveillance.

Preclinical dental students self-assessment of an improved operative dentistry virtual reality simulator with haptic feedback.

To test and evaluate the second installment of DENTIFY, a virtual reality haptic simulator for Operative Dentistry (OD), on preclinical dental students, by focusing on user performance and self-assessment. Twenty voluntary unpaid preclinical dental students, with different background experience, were enrolled for this study. After the completion of an informed consent, a demographic questionnaire, and being introduced to the prototype (on the first testing session), three testing sessions followed (S1, S2, S3). Each session involved the following steps: (I) free experimentation; (II) task execution; S3 also included (III) completion of questionnaires associated with the experiment (total of 8 Self-Assessment Questions (SAQ)); and (IV) guided interview. As expected, drill time decreased steadily for all tasks when increasing prototype use, verified by RM ANOVA. Regarding performance metrics (Comparisons by Student's t-test and ANOVA) recorded at S3, in overall, a higher performance was verified for participants with the following characteristics: female, non-gamer, no previous VR experience and with over 2 semesters of previous experience of working on phantom models. The correlation between the participants' performance (drill time), for the four tasks, and user self-assessment evaluation, verified by Spearman's rho analysis, allowed to conclude that a higher performance was observed in students who responded that DENTIFY improved their self perception of manual force applied. Regarding the questionnaires, Spearman's rho analysis showed a positive correlation between the improvement DENTIFY inputs on conventional teaching sensed by students, also enhancing their interest in learning OD, their desire to have more simulator hours and the improvement sensed on manual dexterity. All participating students adhered well to the DENTIFY experimentation. DENTIFY allows for student self-assessment and contributes to improving student performance. Simulators with VR and haptic pens for teaching in OD should be designed as a consistent and gradual teaching strategy, allowing multiplicity of simulated scenarios, bimanual manipulation, and the possibility of real-time feedback to allow for the student's immediate self-assessment. Additionally, they should create performance reports per student to ensure self-perception/criticism of their evolution over longer periods of learning time.

Multifocal cutaneous angiosarcoma of the scalp-A challenging reconstructive case managed with skin substitutes.

BACKGROUND: Cutaneous angiosarcoma (AS) of the head and neck is a rare highly aggressive tumor, often associated with difficult local control of the disease and poor prognosis. This article describes a case of multifocal cutaneous AS of the scalp, mainly addressing its difficult surgical management and challenging reconstruction and concludes with a review of the literature. METHODS: A 70-year-old Caucasian male was referred to our hospital with a growing scalp lesion initially suspected to be benign, but later diagnosed with AS. RESULTS: The patient had tumor recurrence and a difficult reconstruction for which dermal substitutes proved very useful. CONCLUSION: AS can mimic a benign lesion in its early stages. Skin substitutes, namely dermal templates, can be useful to meet the complex needs of reconstruction and oncological surveillance of patients with AS.

Usability, acceptance, and educational usefulness study of a new haptic operative dentistry virtual reality simulator.

BACKGROUND: Dental preclinical training has been traditionally centered onverbal instructions and subsequent execution on phantom heads and plastic training models. However, these present present limitations. Virtual Reality (VR) and haptic simulators have been proposed with promising results and advantages and have showed usefullness in the preclinical training environment. We designed DENTIFY, a multimodal immersive simulator to assist Operative Dentistry learning, which exposes the user to different virtual clinical scenarios while operating a haptic pen to simulate dental drilling. OBJECTIVE: The main objective is to assess DENTIFY's usability, acceptance, and educational usefulness to dentists, in order to make the proper changes and, subsequently, to test DENTIFY with undergraduate preclinical dental students. METHODS: DENTIFY combines an immersive head mounted VR display, a haptic pen in which the pen itself has been replaced by a 3D printed model of a dental turbine and a controller with buttons to adjust and select the scenario of the simulation, along with 3D sounds of real dental drilling. The user's dominant hand operated the virtual turbine on the VR-created scenario, while the non-dominant hand is used to activate the simulator and case selection. The simulation sessions occurred in a controlled virtual environment. We evaluated DENTIFY's usability and acceptance over the course of 13 training sessions with dental professionals, after the users performed a drilling task in virtual dental tissues. RESULTS: The conducted user acceptance indicates that DENTIFY shows potencial enhancing learning in operative dentistry as it promotes self-evaluation and multimodal immersion on the dental drilling experience. CONCLUSIONS: DENTIFY presented significant usability and acceptance from trained dentists. This tool showed to have teaching and learning (hence, pedagogical) potential in operative dentistry.

Retrospective Study of 114 Free Flaps for Head and Neck Oncological Reconstruction in a Portuguese Tertiary Cancer Center.

INTRODUCTION: The Portuguese experience in microsurgical reconstruction of the head and neck after oncological surgery is scantly described. The primary aim of this study was to characterize the use of microvascular reconstruction after head and neck tumor resection in a Portuguese tertiary oncological centerMaterial and Methods: The authors retrospectively evaluated 114 microvascular free flap procedures performed for head and neck reconstruction after oncological resection in a department of Head and Neck Surgery of a Portuguese tertiary oncological center. Patients were operated on from January 2012 to May 2018. Data on patient demographic features, tumour characteristics, perioperative complications, postoperative aesthetic and functional results, survival time and time to recurrence were extracted. RESULTS: Most tumours mandating microsurgical reconstruction were mucosal squamous cell carcinomas (85%) and were located in the oral region (95.6%). Around 45% of the patients had a T4a tumour and 30% a T2 tumour. Cervical metastases were present in 45.6% of the cases. The radial forearm flap and the fibular flap were the most commonly used microsurgical reconstructive options (58% and 41%, respectively). More than 80% of patients had no post-operative complications. Partial necrosis of the flap occurred in 6.1% of patients, while total flap necrosis occurred in 3.5% of cases. Aesthetic and functional results were considered at least satisfactory in all patients in which the flaps survived. DISCUSSION: This study is by far the largest series of microsurgical head and neck reconstruction after oncological surgery reported by a single tertiary centre in Portugal. Survival and functional benefits are similar to those reported in other large oncological centres in the world. CONCLUSION: Microvascular reconstruction seems like a reliable treatment option in head and neck oncological surgery at our institution.

Introdução: A experiência portuguesa na reconstrução microcirúrgica da cabeça e pescoço após cirurgia oncológica está escassamente descrita. O objectivo deste estudo foi caracterizar a reconstrução microcirúrgica da cabeça e pescoço num centro de referência terciário português. Material e Métodos: Os autores avaliaram retrospetivamente 114 procedimentos de retalhos livres microvasculares realizados para reconstrução de cabeça e pescoço após ressecção oncológica num departamento de Cirurgia de Cabeça e Pescoço de um centro oncológico terciário português. Os doentes foram operados no período de janeiro de 2012 a maio de 2018. Foram registadas as características demográficas dos doentes, as características do tumor, as complicações peri operatórias, os resultados estéticos e funcionais pós-operatórios, bem como o tempo de sobrevida e o tempo de recorrência. Resultados: A maior parte dos tumores estava localizada na região oral (95,6%), sendo o carcinoma de células escamosas o tipo histológico mais frequente. Os retalhos antebraquial radial e fibular foram as opções reconstrutivas mais usadas (58% e 41%, respetivamente). Mais de 80% dos doentes não apresentaram complicações pós-operatórias. A necrose parcial do retalho ocorreu em sete doentes (6,1%), enquanto a necrose total do retalho ocorreu em apenas quatro casos (3,5%). Os resultados estéticos e funcionais foram considerados pelo menos satisfatórios em todos os doentes em que os retalhos sobreviveram. Discussão: Este trabalho, que descreve a maior série de casos de reconstrução microcirúrgica após cirurgia oncológica da cabeça e pescoço, identificou benefícios funcionais e de sobrevivência semelhantes aos descritos em outros centros oncológicos mundiais. Conclusão: A reconstrução microvascular parece ser uma opção fiável e eficaz no âmbito da cirurgia oncológica de cabeça e pescoço na nossa instituição.

Pretreatment Blood Markers in the Prediction of Occult Neck Metastasis: A 10-Year Retrospective Study.

Introduction The purpose of this study was to clarify the role of inflammatory blood markers in the management of early-stage (T1-T2) oral squamous cell carcinoma (OSCC) of the tongue in patients with a clinically negative neck.  Materials and methods We undertook a retrospective chart review of 102 patients with early-stage OSCC of the tongue, subjected to tumor resection and elective neck dissection. Based on postsurgical histopathological examination results, we divided our cohort into pN+ and pN0 groups. Afterwards, we analyzed the role of pretreatment inflammatory blood markers in predicting occult neck metastasis. We also evaluated neutrophil-lymphocyte ratio (NLR) association with the depth of invasion (DOI) of the primary tumor. Results We found a significant association of NLR (p=0.001) and monocyte-lymphocyte ratio (p=0.011) with neck status on univariate analysis. Multivariate analysis showed that only NLR (p=0.02) was an independent risk factor for occult metastasis among inflammatory blood markers. Receiver Operating Characteristic curve analysis and Younden's Index determined the NLR value of 2.96 as the most adequate cut-off value for neck status prediction. NLR values of pretreatment workup also had a significant association with the DOI of the primary tumor (p=0.018). Conclusion Our study supports the role of pretreatment NLR in predicting occult neck metastasis in early-stage OSCC of the tongue. It also sheds some light over the potential of NLR as a predictor of the primary tumor's DOI.

Recurrent renal cell carcinoma presenting as a cutaneous metastasis: A case report and review of the literature.

Renal cell carcinoma (RCC) is a common urological malignancy. Despite early detection and surgical treatment, some lesions recur late at distant sites. The most common dissemination sites are lung, bone, and liver. Skin metastases are not common, and the incidence and clinical manifestations are poorly established in the literature. We report here the case of a male patient with an isolated scalp cutaneous metastase of RCC, 7 years after radical nephrectomy. An excisional biopsy was performed and confirmed metastatic RCC.

Preoperative Voice Characteristics in Thyroid Patients.

INTRODUCTION: Thyroid surgery outcomes have evolved from mortality control strategies to morbidity control measures. Most vocal outcomes research in thyroid surgery are focused on recurrent nerve anatomic and functional preservation. However, there are likely multiple causes of vocal dysfunction in thyroid patients. We prospectively analyzed preoperative patients with thyroid disease to define preoperative vocal characteristics of this population. OBJECTIVE: Quantify vocal and laryngeal baseline conditions in thyroid surgical patients. METHODS: Prospective study of preoperative stroboscopy findings and vocal function assessing the correlation between thyroid disease, compressive symptoms, baseline vocal conditions and laryngoscopy results. RESULTS: Vocal quantitative scores were positive for dysphonia in 36% of patients and the Vocal Handicap Index confirmed either slight or Moderate impairment in most patients. Stroboscopy results were abnormal in 60% of cases with no diagnoses of immobility. Correlation was established for diagnosis of cancer and the absence of symptoms. CONCLUSIONS: These results point to a multifactorial cause for vocal impairment in thyroid surgery patients. Research on vocal impairment in thyroid surgery should not be centered exclusively on recurrent nerve neuromonitoring and functional preservation, but also on other variables that may contribute to vocal change in thyroid disease and surgery.

Quantitative analysis of air pollution and mortality in Portugal: Current trends and links following proposed biological pathways.

A wealth of studies focusing on the relationships between negative health outcomes and short-term and long-term exposures to environmental risk factors have produced estimates of the burden of disease attributable to air pollution, which have led to the implementation of air pollution control strategies. However, the call to expand those studies, in terms of geographical units of analysis to produce more accurate estimates of the burden of disease in the different countries has been made. Studies of the specific environment-health relationship concerning air pollution in Portugal are scarce and rather descriptive. Therefore, this work assesses the trends both in atmospheric levels of pollutants including particulate matter (PM10), ozone (O3), nitrogen dioxide (NO2) and sulphur dioxide (SO2), and in mortality rates for diabetes, malignant neoplasms and diseases of the respiratory, digestive and circulatory systems, and explores the links between exposure to air pollutants and mortality, following proposed biological pathways and using inferential statistics methods, for the period 2010 to 2017 in Portugal. The following major conclusions were drawn: (i) despite a somewhat initial downward trend in PM10 and a peak in O3 levels, fairly constant air pollution levels were mostly observed; (ii) concomitantly, increases in age-adjusted mortality rates were significant for all diseases except diabetes; (iii) lower atmospheric levels of pollutants were observed in rural areas, when compared to urban areas, except for ozone; (iv) age-adjusted mortality rates were higher in rural regions, for diabetes, and in urban regions, for malignant neoplasms; (v) for a 10 µg/m3 increase in atmospheric levels of PM10, regression analysis estimated an increase of 0.30% in the mortality rate for diseases of the respiratory, digestive and circulatory systems, and malignant neoplasms combined.

HDAC Overexpression in a NUT Midline Carcinoma of the Parotid Gland with Exceptional Survival: A Case Report.

NUT midline carcinoma (NMC) is a recently described entity with a predilection for young individuals, characterised by a rearrangement of NUT, most commonly with BRD4. It usually involves midline structures, with a minority of cases presenting outside the midline axis. Given its dismal prognosis, new molecularly targeted therapies (eg, HDAC inhibitors) are gaining ground, but the HDAC expression pattern remains unknown. We describe the exceptional evolution of a NMC arising in the parotid gland. A 34-year-old male presented with a rapidly growing 35 mm left-parotid mass. Parotidectomy and lymphadenectomy were performed. The tumour invaded the surrounding soft tissue and lay adjacent to the surgical margin. No lymph node metastases were identified. Histology revealed blue nests of undifferentiated cells merging with foci of necrosis and occasional abrupt foci of keratinising squamous epithelium. FISH analysis confirmed a rearrangement of NUT, but not of BRD4. A diagnosis of NMC was rendered. Currently, after adjuvant chemoradiotherapy and 47 months after diagnosis, the patient is alive and well. The tumour was found to have increased immunoexpression of HDAC2, 4 and 6 and phospho-HDAC4/5/7. This case emphasises the importance of considering NMC in the differential diagnosis of poorly differentiated carcinomas of the head and neck region in young adults, even away from midline structures. As molecular targets hold the promise of successful therapy for the vast majority of NMC patients, the knowledge of their HDAC expression patterns will probably be relevant.

Systematic Review and Meta-Analysis of Unconventional Perfusion Flaps in Clinical Practice.

BACKGROUND: Although unconventional perfusion flaps have been in clinical use since 1975, many surgeons are still deterred from using them, because of some reports of high necrosis rates. METHODS: The authors performed a systematic review and meta-analysis of all articles written in English, French, German, Spanish, and Portuguese on the clinical use of unconventional perfusion flaps and indexed to PubMed from 1975 until July 15, 2015. RESULTS: A total of 134 studies and 1445 patients were analyzed. The estimated survival rate of unconventional perfusion flaps was 89.5 percent (95 percent CI, 87.3 to 91.3 percent; p < 0.001). Ninety-two percent of unconventional perfusion flaps (95 percent CI, 89.9 to 93.7 percent; p < 0.001) presented complete or nearly complete survival. Most defects mandating unconventional perfusion flap reconstruction were caused by trauma (63.6 percent), especially of the hand and fingers (75.1 percent). The main complication of all types of flaps was a variable degree of necrosis (7.5 percent of all unconventional perfusion flaps presented marginal necrosis; 9.2 percent and 5.5 percent had significant and complete necrosis, respectively). There was a positive correlation between the rate of postoperative infection and the need for a new flap (Pearson coefficient, 0.405; p = 0.001). Flaps used to reconstruct the upper limb showed better survival than those transferred to the head and neck or to the lower limb (p < 0.001). CONCLUSION: Unconventional perfusion flaps show high survival rates and should probably be used more liberally, particularly in the realm of upper limb reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Structure of the rat tracheal mucosa after chronic intermittent hypoxia or chronic hyperbaric oxygen therapy.

OBJECTIVE: This paper is aimed at identifying putative morphological changes induced in the rat's tracheal mucosa by chronic hyperbaric oxygen (HBO) treatment or chronic intermittent hypoxia (CIH). STUDY DESIGN: Tracheal samples were obtained from three groups of 11, 12 and 13 adult Wistar rats. The first group was submitted to 20 sessions of 100 min-long HBO treatment; the second group was submitted to eucapnic CIH for 35 days; and the third group was not submitted to any CIH or HBO therapy. METHODS: Four proximal tracheal rings were collected after sacrifice and neck dissection of the animals. The samples were processed for both light microscopy and morphometric analysis. Inflammatory leukocyte infiltration was evaluated by a semiquantitative method. Unpaired t test and Bernoulli distribution were applied to evaluate statistical differences in the data collected from the three groups. RESULTS: Both CIH and HBO promote an increase in the thickness of the epithelium and of the basement membrane of the rat tracheal mucosa, as well as an increment in the number of infiltrating leukocytes, when compared with results seen in the untreated group. In the HBO group there was a significant lack of seromucous glands, as opposed to the results obtained in the CIH group. CONCLUSIONS: Chronic HBO and CIH exposure causes only minor changes in the architecture of the tracheal mucosa of the rat. The respiratory tract of the rat showed a mild inflammatory response when subject to variations of pressure and oxygen content. Apparently these effects do not constitute a critical issue on prescribing HBO treatments and in the management of sleep apnea patients.

Mandible reconstruction: History, state of the art and persistent problems.

BACKGROUND: Mandibular reconstruction has been experiencing an amazing evolution. Several different approaches are used to reconstruct this bone and therefore have a fundamental role in the recovery of oral functions. OBJECTIVES: This review aims to highlight the persistent problems associated with the approaches identified, whether bone grafts or prosthetic devices are used. A brief summary of the historical evolution of the surgical procedures is presented, as well as an insight into possible future pathways. STUDY DESIGN: A literature review was conducted from September to December 2012 using the PubMed database. The keyword used was "mandible reconstruction." Articles published in the last three years were included as well as the relevant references from those articles and the "historical articles" were referred. This research resulted in a monograph that this article aims to summarize. RESULTS: Titanium plates, bone grafts, pediculate flaps, free osteomyocutaneous flaps, rapid prototyping, and tissue engineering strategies are some of the identified possibilities. The classical approaches present considerable associated morbidity donor-site-related problems. CONCLUSION: Research that results in the development of new prosthetics devices is needed. A new prosthetic approach could minimize the identified problems and offer the patients more predictable, affordable, and comfortable solutions. CLINICAL RELEVANCE: This review, while affirming the evolution and the good results found with the actual approaches, emphasizes the negative aspects that still subsist. Thus, it shows that mandible reconstruction is not a closed issue. On the contrary, it remains as a research field where new findings could have a direct positive impact on patients' life quality. The identification of the persistent problems reveals the characteristics to be considered in a new prosthetic device. This could overcome the current difficulties and result in more comfortable solutions. Medical teams have the responsibility to keep patients informed about the predictable problems related with each elected approach, even understanding that a perfect reconstruction is a secondary goal when compared with maintenance of life.

Changes in bone Pb accumulation: cause and effect of altered bone turnover.

This paper assesses the magnitude of Pb uptake in cortical and trabecular bones in healthy animals and animals with altered balance in bone turnover, and the impact of exposure to Pb on serum markers of bone formation and resorption. The results reported herein provide physiological evidence that Pb distributes differently in central compartments in Pb metabolism, such as cortical and trabecular bones, in healthy animals and animals with altered balance in bone turnover, and that exposure to Pb does have an impact on bone resorption resulting in OC-dependent osteopenia. These findings show that Pb may play a role in the etiology of osteoporosis and that its concentration in bones varies as a result of altered bone turnover characteristic of this disease, a long standing question in the field. In addition, data collected in this study are consistent with previous observations of increased half-life of Pb in bone at higher exposures. This evidence is relevant for the necessary revision of current physiologically based kinetic models for Pb in humans.

Burkitt's Lymphoma in a Pregnant Woman: Case Report and Review of the Literature.

Burkitt's lymphoma (BL) is an aggressive B-cell malignancy with very high proliferation rate, more common in males than females. Here, we describe a case of Burkitt's lymphoma in a 24-week pregnant woman with cervical and abdominal involvement. The common genetic event of virtually all BL is a reciprocal chromosomal translocation involving the proto-oncogene MYC and one of the Ig gene heavy or light chain loci. Supportive treatment was administered until early delivery, after which the patient was treated according to protocol LMB96. Pregnancy and tumorogenesis share some important events such as immunologic tolerance, angiogenesis, and editing the host immune response. Little is known about the relationship between these events in pregnancy and in tumorogenesis.

Structure of the rat nasal mucosa after acute and chronic hyperbaric oxygen therapy.

OBJECTIVE: We aimed at the identification of putative morphologic changes induced in the rat nasal mucosa by acute or chronic hyperbaric oxygen (HBO2) treatment. STUDY DESIGN: Nasal samples were obtained from three groups of eight adult Wistar rats. The first group was submitted to 30 daily sessions of 100-minute-long HBO2 treatments at 2.5 ATA, the second group to a single 485-minute-long HBO2 session following the U.S. Navy Table 6 extended twice at 2.8 and 1.9 ATA, and the third group was composed of rats not submitted to any HBO2 therapy. METHODS: Samples of anterior portion of the lower nasal turbinates (concha nasalis ventralis) were collected after sacrifice and head dissection of the animals. The samples were processed for light and electron microscopy and for morphometric analysis. Inflammatory leukocyte infiltration was evaluated by a semiquantitative method. Non-parametric ANOVA was applied to evaluate statistical differences between leukocyte infiltration, and ANOVA one-way was used to evaluate the thickness of epithelium and basement membrane from samples of HBO2-treated rats and untreated rats. RESULTS: Samples of the turbinate mucosa of the rats submitted to chronic HBO2 treatment showed a significant increase in the thickness of the epithelium and a mild enhancement in the number of infiltrating leukocytes when compared with data from samples from untreated rats or from rats submitted to a single HBO2 treatment. CONCLUSIONS: Chronic HBO2 treatment causes only minor changes in the architecture of the nasal mucosa of the rat; they reflect a mild inflammatory response of the respiratory tract to the increase in pressure and in oxygen content induced by HBO2. No significant morphological changes were observed after a single HBO2 treatment.