Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis.

OBJECTIVE: Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC). MATERIALS AND METHODS: A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model. RESULTS: A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74-0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83-0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54-0.63) CONCLUSIONS: Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC. CLINICAL RELEVANCE: Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination.

Long-term clinical, radiological, and histological follow-up after complex ventral incisional hernia repair using urinary bladder matrix graft reinforcement: a retrospective cohort study.

BACKGROUND: Complex ventral incisional hernia repair represents a challenging clinical condition in which biologically derived graft reinforcement is often utilized, but little long-term data inform that decision. Urinary bladder matrix (UBM) has shown effectiveness in diverse clinical settings as durable reinforcement graft material, but it has not been studied over a long term in ventral incisional hernia repair. This study evaluates the clinical, radiographic, and histological outcome of complex incisional hernia repair using UBM reinforcement with 12-70 months of follow-up. METHODS: A single-arm, retrospective observational study of all ventral incisional hernia repairs utilizing UBM reinforcement over a 6-year time frame by a single surgeon was performed. Patients were assessed in long-term follow-up clinically and with the Carolina Comfort Scale. A subset of patients was assessed with abdominal wall ultrasound or CT scan. Three patients had abdominal wall fascial biopsies years after the incisional hernia repair with UBM graft, and the histology is analyzed. RESULTS: 64 patients underwent repair of complex incisional hernias with UBM graft reinforcement by a single surgeon. 42 patients had concomitant procedures including large or small bowel resection, excision of infected mesh, evacuation of abscess or hematoma, cholecystectomy, or panniculectomy with abdominoplasty. 16 patients had ostomies at the time of repair. Median follow-up time is 36 months, with a range of 12-70 months. Nine patients (14%) have required surgical repair of a recurrent hernia, and a tenth patient has a recurrence that is managed non-surgically, for a total recurrence rate of 15.6% over the entire time frame. Median time to recurrence was 32 months, and a Kaplan-Meier freedom from recurrence curve is depicted. 28 patients have undergone ultrasound or CT assessments of the abdominal wall which demonstrate radiographic fascial integrity 12-70 months after repair. Three patients have been re-explored for unrelated reasons in the years following ventral incisional hernia repair with UBM, and full thickness fascial biopsies demonstrate a robust remodeling response histologically similar to native myofascial tissue. No patients have developed graft infection, fistulization to the graft, or required graft explantation. Carolina Comfort Scale assessment of 45 patients 3 years after the repair averaged 16 out of a possible 115. CONCLUSION: In 64 patients undergoing complex ventral incisional hernia repair with UBM reinforcement, all have experienced successful resolution of complex clinical conditions and 15.6% of these repairs have recurred at a median follow-up of 3 years. Three full-thickness biopsies of the repaired fascia years later shed light on a promising remodeling response which may signal strength and durability comparable to native fascia.

Interaction of avirulent Leishmania species with rat peritoneal macrophages.

Um sistema "in vivo" foi desenvolvido para estudar-se o comportamento do parasito-celula hospedeiro em leshimaniose cutanea e visceral com promastigotos avirulentos de L. brasiliensis e L. donovani (mantidos no meio Davis) e com macrofagos de exsudado peritonial de rato. As especies inicialmente foram isoladas de casos humanos. A confrontacao de Leishmania spp-macrofago se realizou na presenca do meio 199 e a duas temperaturas diferentes, para L. brasiliensis 33 graus C. e para L donovani 37 graus C. Apesar de o rato ser um animal resistente a infeccao de Leishmania spp.; promastigotos das especies por nos estudadas nao so se interiorizaram mas tambem se diferenciaram em amastigotos com posterior multiplicacao, a partir dos 10 minutos depois da infeccao dos macrofagos e ate as 24 horas

Cystoisospora felis: initial penetrative ability into cell cultures from rat peritoneal exudate.

Macrofagos de exudado peritoneal de rata fueron invadidos "in vitro" por esporozoitos y merozoitos de Cystoisospora felis.Bajo la accion de 2-deoxiglucosa, colchicina y/o bajas temperaturas se evidencio penetracion activa. Los esporozoitos y merozoitos mostraram una capacidad invasiva muy limitada en cultivos celulares, aunque los esporozoitos se interiorizaron mas eficientemente