Presence and associated factors of carotid artery calcification detected by digital panoramic radiography in patients with chronic kidney disease undergoing hemodialysis.

OBJECTIVES: The aim of this study was to investigate the presence and associated factors of carotid artery calcification (CAC) in patients with chronic kidney disease (CKD) undergoing hemodialysis. STUDY DESIGN: A total of 309 panoramic radiographs of patients with CKD (180 men and 129 women; mean age 43.7 years) undergoing hemodialysis were evaluated by a single radiologist to determine the frequency of CAC. An analysis of associated factors, such as age, sex, time spent in hemodialysis, arterial hypertension, diabetes mellitus, biochemical parameters, and other systemic diseases, was also performed. RESULTS: The presence of CAC in patients with CKD, as determined on the basis of panoramic radiography, was 15.9%. The χ2 test revealed that there was a statistically significant association between certain factors, such as age, sex, and diabetes mellitus, and the presence of CAC (P < .05). Multivariate analysis demonstrated that time spent in hemodialysis was significantly associated with the occurrence of CAC. CONCLUSIONS: A significant presence of CAC was detected on digital panoramic radiographs in patients with CKD undergoing hemodialysis. Calcification was more frequent in older patients, women, individuals with diabetes mellitus, and patients who had undergone hemodialysis for longer periods.

Oral pigmentations in Laugier-Hunziker syndrome: a case report and review of diagnostic criteria / Pigmentações orais na síndrome de Laugier-Hunziker: relato de caso e revisão dos critérios de diagnóstico

ABSTRACT Laugier-Hunziker syndrome (LHS) is a rare mucocutaneous disorder, of unknown etiology, characterized by multiple hyperpigmented macules, dispersed mostly on the oral mucosa, occasionally associated with longitudinal ridging of the nails. The diagnosis requires exclusion of other conditions, such as Addison's disease and Peutz-Jeghers syndrome. We report a case of a 34-year-old male patient, presenting with hyperpigmented macules on the lips, buccal mucosa and palate, as well as mild dark striations on toenails. After careful clinical and laboratorial investigations, the diagnosis of LHS was established. Given the lack of aesthetic complaints and symptoms, no treatment was necessary.

RESUMO A síndrome de Laugier-Hunziker (SLH) é uma rara desordem mucocutânea, de etiologia indeterminada, caracterizada por múltiplas máculas hiperpigmentadas, dispersas principalmente na mucosa oral, por vezes associadas a estrias longitudinais nas unhas. O diagnóstico requer exclusão de condições como doença de Addison e síndrome de Peutz-Jeghers. Descrevemos o caso de um paciente do sexo masculino, 34 anos, com presença de máculas hiperpigmentadas em lábios, mucosa jugal e palato, além de discretas estrias enegrecidas nas unhas dos pés. Após minuciosa investigação clínica e laboratorial, foi estabelecido o diagnóstico de SLH. Dada a ausência de queixas estéticas e sintomatologia, nenhum tratamento foi necessário.

Unusual presentation of oral actinomycosis in the tongue: case report / Apresentação incomum de actinomicose em língua: relato de caso

ABSTRACT Actinomycosis is a rare infection caused by bacteria of Actinomyces genus that can affect both soft and bone tissues; it may be associated with trauma or previous infections. This paper aims to report a clinical case of actinomycosis on the lateral border of the tongue originating from a previous trauma with the use of sclerosing substance for treatment of vascular malformation. The patient underwent debridement of necrotic tissue in the region, and the material was sent for histopathological analysis, which confirmed the diagnosis of actinomycosis. After two years of follow-up, no recurrence was detected.

RESUMO A actinomicose é uma infecção rara causada pela bactéria do gênero Actinomyces, que pode acometer tanto tecidos moles como ósseo; pode estar associada a traumas ou infecções prévias. O presente trabalho tem o objetivo de relatar um caso clínico de actinomicose na borda lateral de língua originária de um trauma prévio com o uso de substância esclerosante para tratamento de malformação vascular. A paciente foi submetida ao debridamento de tecido necrótico na região, e o material, encaminhado para análise histopatológica, confirmando o diagnóstico de actinomicose. Após dois anos de acompanhamento, não se detectou recidiva.

Lymphoepithelial cyst on the tongue: case report at unusual location / Cisto linfoepitelial em língua: relato de caso em localização incomum

ABSTRACT Oral lymphoepithelial cyst (OLEC) is an uncommon lesion that develops in oral lymphoid tissue. The aim of the present study was to report a clinical case of OLEC in the tongue. A 22-year-old patient presented a nodular lesion, yellowish, with a softened consistency, measuring 0.5 cm in the ventral surface of the tongue. Under the clinical hypotheses of mucocele and OLEC, excisional biopsy was performed. The histopathological examination revealed a cystic lesion covered by a parakeratinized stratified squamous epithelium, which presented in its fibrous capsule a prominent lymphoid tissue. Based on the definitive diagnosis, surgical excision of the lesion was performed.

RESUMO O cisto linfoepitelial oral (CLEO) é uma lesão incomum que se desenvolve no tecido linfoide oral. O objetivo do presente trabalho foi relatar um caso clínico de CLEO na língua. Paciente de 22 anos de idade exibia uma lesão nodular, de coloração amarelada e consistência amolecida, medindo 0,5 cm na região ventral de língua. Sob as hipóteses clínicas de mucocele e CLEO, foi realizada biópsia excisional. O exame histopatológico revelou lesão cística revestida por epitélio escamoso estratificado paraceratinizado, que apresentava em sua cápsula fibrosa tecido linfoide proeminente. Com base no diagnóstico definitivo, foi realizada a excisão cirúrgica da lesão.

Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a relatively common chronic inflammatory disease whose etiopathogenesis is not completely understood. Several factors have been proposed in an attempt to explain the variety of clinical manifestations and periods of exacerbation and remission of symptoms of these lesions. The objective of this study was to associate local factors, systemic diseases, and level of anxiety with clinical characteristics of OLP. METHODS: The following factors were analyzed in 37 patients with OLP: presence of smoking, alcohol consumption, diabetes mellitus, hypertension, and hepatitis C virus infection. Anxiety was measured by the Spielberger State-Trait Anxiety Inventory. These variables were associated with clinical form and symptoms (chi-squared/Fisher's exact test). RESULTS: The erosive form was the most prevalent presentation (57.1%). Symptoms were reported by 45.7% of the patients. Most patients were non-smokers (97.3%), and none of them was an alcoholic. Diabetes and hypertension were present in 10.8% and 16.2% of the patients, respectively. Only one patient was hepatitis C virus seropositive, and 78.4% presented moderate levels of anxiety. No significant association was observed between the variables studied and clinical form or symptoms. CONCLUSIONS: In this study, no association was observed between local and systemic factors or level of anxiety and clinical characteristics of OLP.

Síndrome de Sjõgren: revisão de literatura e acompanhamento de um caso clínico / Sjõgren's syndrome: literature review and clinical case management

A síndrome de Sjõgren é uma doença inflamatória sistêmica, de natureza auto-imune, caracterizada pela infiltração linfocitária progressiva de vários órgãos exócrinos e não exócrinos. Acomete preferencialmente as glândulas salivares e lacrimais determinando prejuízo estrutural e disfunção secretória destes órgãos. A produção de auto-anticorpos e a hipergamaglobulinemia policlonal indicam que anormalidades na imunidade humoral desempenham um papel importante na patogenia desta afecção e o seu diagnóstico é baseado na combinação de vários achados clínicos e laboratoriais. A proposta deste trabalho é apresentar um caso clínico de síndrome de Sjõgren enfatizando a sua importância clínica e a necessidade do diagnóstico precoce na tentativa de melhorar a qualidade de vida dos pacientes acometidos.

Estudo de 54 casos de paracoccidioidomicose diagnosticados no Serviço de Estomatologia do Hospital Säo Lucas da PUCRS / Study of 54 cases of paracoccidioidomycosis diagnosed at the Stomatology Department of Säo Lucas's Hospital, PUCRS

Foi feito um estudo de 54 casos de Paracoccidioidomi cose oral no Serviço de Estomatologia e Prevençäo do Câncer Bucomaxilofacial do Hospital Säo Lucas no período de janeiro de 1976 a junho de 1997. Foram analisados em relaçäo à idade, sexo, profissäo, cidade de origem, hábitos, presença de lesäo pulmonar, tipo de lesäo oral e sítios mais atingidos. Observou-se que os homens säo mais atingidos que as mulheres, com maior incidência na faixa etária dos 30 aos 60 anos. A profissäo de agricultor foi a mais encontrada, sendo a maioria dos pacientes estudados proveniente de cidades localizadas na regiäo norte do Estado, àrea que apresenta clima, solo e umidade favoráveis ao desenvolvimento do fungo. O hábito de fumar foi relatado por dois terços dos pacientes, sendo muitos deles também etilistas. As lesöes orais, presentes em todos os casos, apresentaram-se como ulceraçöes moriformes ou como úlceras vegetantes, as quais foram observadas em vários sítios da boca. Metade dos pacientes avaliados aprsentaram evidências radiográficas de lesöes pulmonares