miRNAs in Neurological Manifestation in Patients Co-Infected with SARS-CoV-2 and Herpesvírus 6 (HHV-6).

Human herpesviruses (HHVs) can establish latency and be reactivated, also are neurotropic viruses that can trigger neurological disorders. HHV-6 is a herpesvirus that is associated with neurological disorders. Studies have reported the detection of HHV-6 in patients with COVID-19 and neurological manifestations. However, specific diagnoses of the neurological disorders caused by these viruses tend to be invasive or difficult to interpret. This study aimed to establish a relationship between miRNA and neurological manifestations in patients co-infected with COVID-19 and HHV-6 and evaluate miRNAs as potential biomarkers. Serum samples from COVID-19 patients in the three cohorts were analyzed. miRNA analysis by real-time polymerase chain reaction (qPCR) revealed miRNAs associated with neuroinflammation were highly expressed in patients with neurological disorders and HHV-6 detection. When compared with the group of patients without detection of HHVs DNA and without neurological alterations, the group with detection of HHV-6 DNA and neurological alteration, displayed significant differences in the expression of mir-21, mir-146a, miR-155 and miR-let-7b (p < 0.01). Our results reinforce the involvement of miRNAs in neurological disorders and provide insights into their use as biomarkers for neurological disorders triggered by HHV-6. Furthermore, understanding the expression of miRNAs may contribute to therapeutic strategies.

Clinical Profile and Risk Factors for Severe COVID-19 in Hospitalized Patients from Rio de Janeiro, Brazil: Comparison between the First and Second Pandemic Waves.

Since COVID-19 was declared a pandemic, Brazil has become one of the countries most affected by this disease. A year into the pandemic, a second wave of COVID-19 emerged, with a rapid spread of a new SARS-CoV-2 lineage of concern. Several vaccines have been granted emergency-use authorization, leading to a decrease in mortality and severe cases in many countries. However, the emergence of SARS-CoV-2 variants raises the alert for potential new waves of transmission and an increase in pathogenicity. We compared the demographic and clinical data of critically ill patients infected with COVID-19 hospitalized in Rio de Janeiro during the first and second waves between July 2020 and October 2021. In total, 106 participants were included in this study; among them, 88% had at least one comorbidity, and 37% developed severe disease. Disease severity was associated with older age, pre-existing neurological comorbidities, higher viral load, and dyspnea. Laboratory biomarkers related to white blood cells, coagulation, cellular injury, inflammation, renal, and liver injuries were significantly associated with severe COVID-19. During the second wave of the pandemic, the necessity of invasive respiratory support was higher, and more individuals with COVID-19 developed acute hepatitis, suggesting that the progression of the second wave resulted in an increase in severe cases. These results can contribute to understanding the behavior of the COVID-19 pandemic in Brazil and may be helpful in predicting disease severity, which is a pivotal for guiding clinical care, improving patient outcomes, and defining public policies.

Herpesvirus and neurological manifestations in patients with severe coronavirus disease.

BACKGROUND: Certain clinical manifestations of coronavirus disease (COVID-19) mimic those associated with human herpesvirus (HHV) infection. In this study, we estimated the prevalence of herpesvirus in patients with COVID-19 and determined if coinfection is associated with poorer outcomes and neurological symptoms. METHODS: We analyzed samples of 53 patients diagnosed with COVID-19. The samples were evaluated for the presence of alphaherpesviruses, betaherpesviruses, and gammaherpesviruses, and the viral loads were quantified using quantitative polymerase chain reaction (qPCR) method. RESULTS: Among the patients, in 79.2% had detection at least one type of herpesvirus. HHV-6 (47.2%), cytomegalovirus (43.3%), and HHV-7 (39.6%) showed the highest detection rates. Patients with a high severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load were more likely to show herpes simplex virus 1 detection (p = 0.037). Among patients coinfected with SARS-CoV-2 and HHVs, 26.4% showed central nervous system-associated neurological symptoms and herpetic manifestations. A statistically significant association was observed between neurological changes and HHV-6 detection (p = 0.034). CONCLUSIONS: The findings showed a high prevalence of herpesvirus in patients with COVID-19. Furthermore, even though SARS-CoV-2 and HHV coinfection was not associated with poorer outcomes, the findings demonstrated the association between neurological symptoms and HHV-6 detection.

Survival and prognostic factors in patients with oral squamous cell carcinoma / Supervivencia y factores pronósticos en pacientes con carcinoma oral de células escamosas

Background: This study aimed to evaluate sociodemographic and clinical factors influencing overall survival(OS) in patients with oral squamous cell carcinoma (OSCC).Material and Methods: Medical charts of 547 patients with OSCC from a public hospital in northeastern Brazilseen between 1999 and 2013 were evaluated. Survival analysis was performed using the Kaplan-Meier method.The influence of age, sex, ethnicity, clinical stage, anatomical location, type of treatment, and comorbidities on thepatients’ prognosis was evaluated. Cox proportional hazards regression model was used to identify independentprognostic factors.Results: The 5-year OS was 39%. Multivariate analysis showed that age < 40 years (HR = 2.20; 95%CI: 1.02-4.72)and a single treatment modality (HR = 1.91; 95%CI: 1.37-2.67) were associated with a poor prognosis, while earlyclinical stage resulted in better outcomes (HR = 0.38; 95%CI: 0.25-0.58).Conclusions: OSCC patients in advanced clinical stages, diagnosed at a younger age, and submitted to a singletherapeutic modality have a poorer prognosis.(AU)

Detection of polyomavirus microRNA-5p expression in saliva shortly after kidney transplantation.

Background: MicroRNAs (miRNAs) of polyomavirus (PyV) are present in several biological fluids and are suggested to be relevant viral factors for monitoring its persistence. Aim: To evaluate the effect of an immunosuppressive regimen on the status of PyV-miRNA-5p in the oral cavity. Materials and Methods: The JCPyV, BKPyV, MCPyV miRNA-5p were investigated in paired saliva and plasma samples obtained from 23 patients before and shortly after renal-transplantation by using real-time RT-PCR. Results: Overall, within a short-time after transplantation, patients exhibited decreased numbers of leukocyte and lymphocyte as well as low levels of creatinine. During the clinical management of the patients, a significant amount of saliva samples were positive for JCPyV and BKPyV miRNA-5p (range: 26%-91%) compared to paired plasma samples (range: 9%-35%). Among the two polyomaviruses showing positive expression of miRNA-5p, BKPyV presented the highest positivity in saliva (91%) and MCPyV-miRNA-5p was constantly negative in both saliva and plasma samples. Compared to the time before transplantation, a significant reduction in the expression of JCPyV-miRNA-5p was observed in saliva samples obtained after transplantation. Conclusions: Altogether, these data suggest that additional investigations of polyomavirus miRNA-5p in saliva should be performed shortly after renal-transplantation to evaluate the potential role in early viral reactivation.

Differentiation of periapical granuloma from radicular cyst using cone beam computed tomography images texture analysis.

OBJECTIVE: This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. METHODS: Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR <0.005). RESULTS: The texture parameters used to differentiate the lesions were assessed by using a receiver operating characteristic analysis. Five texture parameters were predictive of lesion differentiation for eight positions: angular second moment; sum of squares; sum of average; contrast; correlation. CONCLUSION: Texture analysis of CBCT scans distinguishes radicular cysts from periapical granulomas and can be a promising diagnostic tool for periapical lesions. CLINICAL SIGNIFICANCE: Texture analysis can be used in diagnostic and treatment monitoring to provide supplementary information.

Longitudinal study on oral shedding of human betaherpesviruses 6 and 7 in renal transplant recipients reveals active replication.

BACKGROUNG: Roseolovirus latency and persistence in salivary glands that are frequently reactivated after renal transplantation to cause infection have been reported. However, limited information is available on the persistence and excretion of HHV-6 and HHV-7 during and after transplant. METHODS: 32 renal transplant recipients were followed up before (T1) and after transplant (T2 and T3) and viral replication (via assessment of mRNA) in oral fluid samples investigated. Roseolovirus DNA was detected and quantified via multiplex qPCR. For evaluation of mRNA replication, positive samples were subjected to nested RT-PCR. RESULTS: Viral replication of HHV-7 was significantly increased during T3 (72.9%), compared to the pre-transplant period T1 (25%; McNemar Test, p= 0.001). Analysis of the viral replicative to quantitative ratio disclosed ahigher number of DNA copies (>106) in positive cases of replication (p < 0.001). Astrong positive correlation (Spearman correlation coefficient = 0.781; p< 0.001) was evident between viral quantities of Roseoloviruses. CONCLUSION: Our findings consistently suggest that the salivary gland is an important site of active and persistent infection by roseoloviruses. In view of the increasing problem of Roseoloviruses, pre- and post-transplantation, viral surveillance and monitoring of active replication are pivotal steps for effective screening and treatment of renal transplant patients.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis.

Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Poor oral health status and short-term outcome of kidney transplantation.

AIMS: This study aims to know whether poor oral health increases the risk of acute rejection and hospitalization in kidney allograft recipients. METHODS AND RESULTS: This is a prospective cohort study. The same dentist followed participants for 2 months after renal transplant for monitoring oral health (clinical evaluation, DTMF index, and CPITN index), signs of graft rejection, infection, and hospitalization. We compiled rates and reasons for hospital readmission or extended hospital stay. The CPITN had a mean score of 0.38 ± 0.71, increasing to 0.90 ± 0.84, 60 days after transplant (P < .001). No one rejected the graft in the period of study. Patients with older age (P = .009; OR: 1.07; CI 95% 1.01-1.12) were at higher risk of hospitalization at each year of age and patients presenting pretransplant dental focus (P = .001; OR: 7.23; CI 95% 2.13-24.56) had 7.23 times more chance to be hospitalized in the first 2 months after the transplant. One participant was hospitalized due to acute foci of dental infection. CONCLUSION: There was an association between dental focus and hospital readmission/stay. However, our methods do not provide conclusive proof of causality. Hospitalization due to acute dental infection was rare.

Herpesviruses oral shedding and viremia in renal transplant recipients: A longitudinal study.

BACKGROUND: The objective was to assess the oral shedding and viremia of human herpesviruses in renal transplant recipients. METHODS: This is a cohort study in which the participants were examined in three different periods: the first within 24 hours before renal transplantation and the second and third ones 15-20 and 45-60 days after the transplantation. Mouthwash and blood samples were collected in each period and then submitted to screening for the presence of eight types of human herpesviruses by using multiplex PCR. RESULTS: HSV-1 and EBV were more frequent in the saliva after renal transplantation, 15- to 20-day period after the transplant. EBV was found in the saliva of 26 (35.6%) patients before renal transplantation and in 56.2% and 46.6% of them, in the 15- to 20-day and 45- to 60-day periods after the transplant, respectively. High detection rates (75.3%-78.1%) were found for HHV-7 despite the lack of significant variations between the study periods. There was no concordance between herpesviruses oral shedding and viremia. CONCLUSION: We concluded that the pattern of excretion of HSV-1 and EBV in saliva is changed immediately after renal transplantation, increasing in the 15- to 20-day period after the transplant surgery. No concordance between herpesviruses oral shedding and viremia was observed.

Oral manifestations of allograft recipients immediately before and after kidney transplantation.

Objective: To identify the oral lesions of individuals with kidney disease immediately before and shortly after kidney transplantation, taking into account the immunosuppressive regimen, antiviral prophylaxis and type of transplantation.Methods: A prospective observational cohort study was carried from January 2017 to January 2018. Eighty individuals aged 18 years or older who were admitted for kidney transplantation were eligible to participate. Clinical data regarding medical history, immunosuppressive therapy, antiviral prophylaxis, laboratorial data and oral examination were performed by the same trained researcher, in three different moments: 24 hours before transplantation (1st time point), 15-20 days (2nd time point) and 45-60 days (3rd time point) after transplantation.Results: In the first, second and third time points, it was found that 3.7% (3/80), 23.7% (18/76) and 25.7% (19/74) of the participants showed oral soft tissue lesions. Ulcers and candidiasis were the most frequent oral lesions, and they were associated with the use of everolimus (p = .005) and azathioprine (p = .034), respectively. Less patients reported xerostomia after transplantation than before (p < .001).Conclusions: Oral lesions are common in the short term after renal transplantation and are particularly related to both toxicities of immunosuppressive drugs and immunosuppression.

Presence of langerhans cells, regulatory T cells (Treg) and mast cells in asymptomatic apical periodontitis

Abstract Asymptomatic Apical Periodontitis is essentially an inflammatory disease of microbial aetiology. Association and function of the cell components involved, or specific inductive factors and growth mediators associated with development, maintenance and resolution of the periapical lesions are still unknown. The objective of this study was to evaluate the concentration of Regulatory T cells (FoxP3+; Treg), Langerhans cells (CD1a+; LC) and mast cells in asymptomatic apical periodontitis. 73 cases were selected: 30 periapical granulomas, 29 radicular cysts and 14 residual cysts. All groups were submitted to morphological analysis for classification of inflammatory infiltrate and thickness of the epithelial lining as well as to immunohistochemical analysis for detection of LC and Treg cells. Toluidine blue staining was used for detecting mast cells. Analysis showed higher mean numbers of LC (8.2 cells/0.2mm2), and Treg cells in radicular cysts (5.910 cells/0.2mm2). As for mast cells, it was found that radicular cysts had a higher mean number of these cells compared to other periapical lesions (12.68 cells/0.2mm2). The association between thickness of the epithelial lining and inflammatory cells showed that the presence of hypertrophic epithelium in radicular cysts presented higher density of LC. The number of LC and Treg cells play an important role in the control of the inflammatory micro-environment in periapical granulomas and radicular cysts, respectively. The presence of mast cells in radicular cysts may be associated with progression of the lesion. Knowledge regarding the inflammatory cell profile is therefore essential for a better understanding of the pathogenesis of asymptomatic periapical periodontitis.

Avaliação da saúde bucal e padrão da excreção salivar dos herpesvírus em indivíduos transplantados renais / Evaluation of oral health and salivary shedding of herpesviruses in renal transplant recipients

O transplante renal é a terapia mais eficaz para a doença renal em fase terminal, porém sua longevidade depende de várias condutas, dentre elas o uso crônico de fármacos imunossupressores, os quais predispõem infecções oportunistas, como as por herpesvírus, sendo estas uma das principais causas de morbidade e mortalidade para a maioria dos receptores de transplante. A literatura apresenta vários artigos focando o tipo e a frequência de manifestações bucais em pacientes transplantados renais a longo prazo no pós-transplante, mas é escassa em pesquisas que forneçam evidências científicas no curto prazo, principalmente em relação a saúde bucal e seu impacto no transplante renal. Outra área de interesse científico e pouco abordada é o uso da saliva para detecção e monitoramento de infecção por vírus da família herpesviridae. Este volume apresenta um compilado de três capítulos que abordaram o tema saúde bucal, manifestações orais e excreção salivar de herpesvírus em receptores de transplante renal. Os estudos objetivaram: avaliar o impacto da saúde bucal pré-transplante dos pacientes no desfecho a curto prazo do transplante renal e determinar a incidência de hospitalização por causa odontogênica; identificar as lesões orais de indivíduos com doença renal imediatamente antes e logo após o transplante renal; e avaliar a excreção salivar e a viremia dos vírus da família Herpesviridae em doentes renais. Foram desenvolvidos estudos coortes, onde um único dentista treinado coletou dados, durante três períodos consecutivos: dentro de 24 horas antes do transplante; 15 a 20 dias após o transplante; e 45 a 60 dias após o transplante. Os pacientes foram avaliados quando a saúde bucal, presença clínica de lesões/alterações bucais e foram coletados saliva e sangue para detecção dos herpesvírus nessas amostras. Todas as amostras foram submetidas a técnica da detecção da cadeia de polimerase (Panherpes) e subsequente digestão enzimática, para a detecção dos oito herpesvírus humanos. No primeiro estudo observou-se que pacientes transplantados com idade avançada (p = 0,004; OR: 1,10; IC 95% 1,03-1,17) apresentaram maior risco de hospitalização a cada ano de vida; e pacientes com focos de infecção odontogênica no prétransplante (p = 0,009; OR: 8,36; IC 95% 1,68-41,46) apresentaram 8,36 mais chances de serem internados nesse período. Apenas um paciente foi internado por infecção odontogênica aguda; O segundo estudo evidenciou que a candidíase oral foi diagnosticada em 10 dos 80 participantes, sendo associada ao uso de azatioprina (p=0,034) e que 10 participantes tiveram úlceras orais no período pós-transplante, sendo esta associada ao uso de everolimo (p = 0,005), sendo as duas principais lesões encontradas nestes pacientes. Em relação oo terceiro estudo, verificou-se que antes do transplante, o HSV-1 foi excretado por 2 (2.7%) pacientes, 15-20 e 45- 60 dias após o transplante renal, foi excretado, respectivamente, por 13 (17.8%) e 7 (9.6%) pacientes. O EBV foi encontrado na saliva de 26 (35.6%) pacientes antes do transplante e nos dois momentos consecutivos, o percentual de pacientes com excreção salivar do EBV foi, respectivamente, de 56.2% e 46.6%. A viremia dos herpesvírus foi posiviva apenas para o CMV e o HHV-7, não havendo concordância com a excreção salivar (p>0,05). Concluiu-se que: a presença de focos infecciosos odontogênicos no pré-transplante foi associado a readmissão hospitalar/internação hospitalar prolongada, sendo rara a hospitalização por infecção dentária aguda; as lesões orais, principalmente a candidíase e as úlceras orais, são comuns a curto prazo após o transplante renal e estão relacionadas principalmente à imunossupressão e à toxicidade dos imunossupressores; o padrão de excreção salivar dos herpesvírus é alterado após o transplante renal, especialmente o HSV-1 e EBV. Não houve concordância entre a excreção salivar e viremia entre os pacientes transplantados renais.

Epidemiological profile of young patients with squamous cell carcinoma in northeast Brazil.

AIM: The aim of the present study was to delineate the epidemiological profile of young patients with squamous cell carcinoma (SCC) treated at a healthcare service in northeastern Brazil. METHODS: A cross-sectional study was performed involving the quantitative analysis of 51 medical records from patients diagnosed with SCC between 1998 and 2013. All patients aged ≤50 years were included in the study. Statistical analysis involved Pearson's χ2 -test, Fisher's exact test, and the Mann-Whitney U-test, with the level of significance set at 5% (P < .05). RESULTS: The mean age was 46 ± 7.94 years, and males accounted for 80.4% of the sample. The tongue was the most affected site (37.3%). Most tumors were classified as stage III (26.3%) or IV (42.1%). Surgery associated with chemotherapy was the most common therapeutic approach (39.3%). Female patients had a lower mean age (P = .013) and less advanced clinical staging (P = .022). Smoking was more associated with male sex (P = .043). CONCLUSION: SCC in young patients is more common in males aged 46 ± 7.94 years, with the tongue being the most affected anatomic site. Important differences were found in clinical-epidemiological features between young men and women.

BK virus salivary shedding and viremia in renal transplant recipients.

OBJECTIVES: This study aimed to verify the presence of polyomavirus BK (BKPyV) in the saliva of kidney transplant recipients and to correlate it with blood viremia. MATERIAL AND METHODS: We have conducted a cross-sectional study with a sample involving 126 renal transplant recipients. 126 samples of saliva and 52 samples of blood were collected from these patients. Detection and quantification of BKPyV were performed using a real-time PCR. To compare the presence of BKPyV in blood and saliva, the binomial proportion test was used. To verify associations between salivary shedding BKPyV and post-transplant periods (in months), the Mann-Whitney test was used. Spearman's correlation was used to correlate the viral load in the saliva with blood of kidney transplant recipients. RESULTS: The mean age of the study group was 51.11±12.45 years old, and 69 participants (54.8%) were female, with a mean post-transplantation time of 4.80±6.04 months. BKPyV was quantified in several samples of saliva and blood, with medians of 1,108 cp/mL and 1,255 cp/mL, respectively. Only 16/52 (30.8%) participants presented BKPyV in blood, and 59/126 (46.8%) excreted the virus in saliva (p=0.004). BKPyV shedding was found in patients at a shorter post-transplantation period (3.86±5.25, p=0.100). A weak correlation was observed between viral quantification in saliva and blood (Spearman's correlation coefficient=0.193). CONCLUSION: The results of this study suggested that, although saliva excretes more BKPyV than blood, there is no reliable correlation between salivary shedding and blood viremia, showing two independent compartments of viral replication.

Salivary shedding of herpesviruses in renal transplant recipients.

AIM: The aim of the present study was to describe the salivary shedding of human herpesviruses (HHV) in renal transplant recipients and to observe the oral manifestations in this group. METHODS: A prospective case-control study was conducted with a study group of 20 renal transplant recipients and a control group of 20 non-transplanted, immunocompetent individuals. Clinical examination evaluated the presence of drug-induced gingival overgrowth (DIGO), salivary flow, and caries. Stimulated saliva was collected from both groups, with HHV being detected by using real-time polymerase chain reaction. RESULTS: The mean age of the study group was 45.90 ± 9.89 years, with 55% (11/20) being female, 60% (12/20) being Caucasian, 65% (13/20) having a deceased donor, and 70% (14/20) having used tacrolimus as the main immunosuppressive drug. Renal transplant recipients had shedding of more herpesviruses compared to the control group, with the exception of HHV-7. Statistical significance was found for herpes simplex virus-1 (HSV-1) (P = 0.017) and cytomegalovirus (P = 0.035). DIGO was observed in seven patients (35%), with 35% (7/20) presenting with decreased salivary flow and four (20%) reporting xerostomia. CONCLUSION: Renal transplant recipients excreted herpesviruses more often than control individuals, especially HSV-1. Decreased salivary flow and xerostomia were more frequent in patients who used tacrolimus, whereas those who used cyclosporine had more cases of DIGO.

Prevalence of and Factors Associated with Actinic Cheilitis in Extractive Mining Workers.

The objective of the present study was to determine the prevalence of actinic cheilitis among extractive mining workers and factors associated with the condition, especially the relationship between clinical appearance and the length of occupational exposure to sunlight. A cross-sectional study was performed in Dona Inês, Paraíba, Brazil between 2014 and 2015. A clinical examination, clinical photography and a questionnaire were applied to 201 extractive mining workers. The T-student's, ANOVA one-way, Fisher's exact and Pearson chi-squared tests were performed and the significance level was set at 5%. A high prevalence of actinic cheilitis was observed (38.8%). Length of occupational exposure to sunlight in months (169.63±112.68, p=0.002) was associated with actinic cheilitis. Most workers were Caucasian (p<0.001) and aged 37.41±12.15 years (p=0.004). The time of occupational exposure to sunlight was significant in relation to the following clinical features: atrophy (225.75±97.31; p=0.024); blurred demarcation between the vermilion border of the lip and the skin (186.68±113.15; p=0.032); vertical fissures (210.09±123.07; p=0.046); white and red spotting (199.51±91.80; p=0.004); hard consistency of the lip (225.81±122.34; p=0.012). A high prevalence of actinic cheilitis was found. Age and ethnicity were associated with the presence of AC. Severe clinical presentations of actinic cheilitis were found among participants who had worked for at least 185 months (approximately 15 years) exposed to the sun.

Clinical outcome of dental procedures among renal transplant recipients.

AIMS: To compare outcomes of dental procedures among a group of renal transplant recipients who had received antibiotic prophylaxis (AP) before the procedure and another group that had not received AP. METHODS AND RESULTS: The records of all renal transplant patients treated at the Special Care Dentistry Center (SCDC) were assessed. Dental procedures documented in the records were classified as invasive or noninvasive. All dental procedures performed were compiled, and the prescription or nonprescription of prophylactic antibiotics, and the incidence and description of postoperative complications after invasive procedures were recorded. Eighty-seven records were evaluated. Out of 190 invasive procedures all were simple dental extractions, 107 (56.3%) were preceded by AP; out of 242 noninvasive procedures, 14 (5.7%) were preceded by AP. A lack of uniformity on the type and dose of the antibiotic prescribed was observed. Four postoperative complications after invasive procedures (dental extraction) were noted and in 2 cases the procedures were preceded by AP. CONCLUSION: This retrospective study showed no difference in postextraction outcomes between renal transplant recipients who received and who did not receive AP before dental extractions.

Prevalence of and factors associated with actinic cheilitis in extractive mining workers

Abstract The objective of the present study was to determine the prevalence of actinic cheilitis among extractive mining workers and factors associated with the condition, especially the relationship between clinical appearance and the length of occupational exposure to sunlight. A cross-sectional study was performed in Dona Inês, Paraíba, Brazil between 2014 and 2015. A clinical examination, clinical photography and a questionnaire were applied to 201 extractive mining workers. The T-student's, ANOVA one-way, Fisher's exact and Pearson chi-squared tests were performed and the significance level was set at 5%. A high prevalence of actinic cheilitis was observed (38.8%). Length of occupational exposure to sunlight in months (169.63±112.68, p=0.002) was associated with actinic cheilitis. Most workers were Caucasian (p<0.001) and aged 37.41±12.15 years (p=0.004). The time of occupational exposure to sunlight was significant in relation to the following clinical features: atrophy (225.75±97.31; p=0.024); blurred demarcation between the vermilion border of the lip and the skin (186.68±113.15; p=0.032); vertical fissures (210.09±123.07; p=0.046); white and red spotting (199.51±91.80; p=0.004); hard consistency of the lip (225.81±122.34; p=0.012). A high prevalence of actinic cheilitis was found. Age and ethnicity were associated with the presence of AC. Severe clinical presentations of actinic cheilitis were found among participants who had worked for at least 185 months (approximately 15 years) exposed to the sun.

Resumo O objetivo foi determinar a prevalência de queilite actínica entre os trabalhadores extrativistas minerais e os fatores associados a esta lesão, principalmente a relação da aparência clínica da lesão com o tempo de exposição ocupacional à luz solar. Foi realizado um estudo transversal, entre 2014 e 2015, em Dona Inês / PB, localizado no Nordeste do Brasil. Foram aplicados um exame clínico, registro fotográfico e um questionário a 201 trabalhadores extrativistas minerais. Realizaram-se os testes "t" student, ANOVA, Exato de Fisher e Qui-quadrado de Pearson, o nível de significância foi de 5%. Observou-se alta prevalência de queilite actínica (38,8%). A duração da exposição ocupacional à luz solar, em meses, (169,63 ± 112,68, p = 0,002) foi associada à presença de queilite actínica. Estes trabalhadores eram, em sua maioria, brancos (p<0.001) com idade média de 37.41±12.15 anos (p=0.004). O tempo de exposição ocupacional à luz solar foi significativo em relação às seguintes características clínicas: atrofia (225,75 ± 97,31; p = 0,024); perda da demarcação entre o vermelhão do lábio e a borda da pele (186,68 ± 113,15; p = 0,032); Fissuras verticais (210,09 ± 123,07; p = 0,046); Manchas brancas e vermelhas (199,51 ± 91,80; p = 0,004); Consistência dura do lábio (225,81 ± 122,34; p = 0,012). Conclui-se que a prevalência de queilite actínica foi alta. A idade e a etnia foram fatores associados a presença de queilite actinica. Os participantes que haviam trabalhado pelo menos 185 meses (aproximadamente 15 anos) sob exposição ao sol, apresentaram manifestações clínicas graves da queilite actínica.

Oral shedding of HSV-1 and EBV and oral manifestations in paediatric chronic kidney disease patients and renal transplant recipients.

OBJECTIVE: Previous research demonstrated that salivary shedding of HSV-1 and EBV occurs often in adult renal transplant recipients, but there is a lack of studies on the presence of them in the saliva of paediatric population. Therefore, the objective of this study is to describe oral characteristics and to compare the shedding profile of HSV-1 and EBV in the saliva of children with renal transplant to that of chronic kidney disease patients and controls. METHODS: This is a cross-sectional study involving 100 children, being 25 renal transplant recipients, 25 chronic kidney disease patients and 50 healthy children. Demographic and oral clinical characteristics were assessed. Saliva samples were collected and submitted to screening for EBV and HSV-1 by using nested polymerase chain reaction technique. Fisher's exact, Pearson's chi-square and Kruskal-Wallis tests were used for statistical analysis at a significance level of 5%. RESULTS: Oral shedding of HSV-1 (28%) and EBV (60%) were significantly higher in renal transplant recipients compared to the other groups. Single vesicles in the oral mucosa were statistically associated with the presence of HSV-1 (p = .035). In children with chronic kidney disease, there was a higher prevalence of pale oral mucosa (32%) and enamel hypoplasia (40%) compared to paediatric renal transplant recipients and controls. Dental calculus (36%), candidiasis (8%), drug-induced gingival overgrowth (16%), mouth blisters (8%), xerostomia (12%) and salivary gland enlargement (20%) were more common in paediatric renal transplant recipients. CONCLUSIONS: Therefore, it can be concluded that salivary shedding of HSV-1 and EBV in paediatric patients was more often found in renal transplant recipients than in the renal failure and control children. Transplanted recipients showed more oral manifestations than renal failure and control children did.