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1.
Sci Rep ; 11(1): 17552, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475459

RESUMO

Intestinal microbiota (IM) diversity and composition regulates host immunity and affects outcomes after allogeneic stem cell transplantation (allo-HSCT). We evaluated if the oral mucosa microbiota (OM) could impact the outcomes in patients who underwent allo-HSCT. Samples from the oral mucosa of 30 patients were collected at three time points: before the conditioning regimen, at aplasia, and at engraftment. We analyzed the associations of OM diversity and composition with allo-HSCT outcomes. Lower OM diversity at preconditioning was associated with a higher risk of relapse at 3 years (68% versus 33%, respectively; P = 0.04). Dominance (relative abundance ≥ 30%) by a single genus at preconditioning was also associated with a higher risk of relapse (63% versus 36% at 3 years, respectively; P = 0.04), as well as worse progression-free survival (PFS; 19% versus 55%, respectively; P = 0.01), and overall survival (OS) at 3 years (38% versus 81%, respectively; P = 0.02). In our study we observed that OM dysbiosis is associated with a higher risk of relapse and worse survival after allo-HSCT.

2.
Oral Dis ; 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34523191

RESUMO

OBJECTIVES: To characterize the oral shedding of herpes viruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and investigate its relationship with clinical outcomes. MATERIALS AND METHODS: Polymerase chain reaction and enzymatic digestion were performed to identify the oral shedding of the members of the Herpesviridae family in 31 patients. The samples were collected from the oral cavity at five timestamps. RESULTS: The presence of each herpesvirus in the oral cavity was observed in 3.2%, 12.9%, 19.3%, 32.2%, 54.8% and 93.5% patients for human herpesvirus (HHV)-6A, herpes simplex virus-1, HHV-6B, cytomegalovirus (CMV), Epstein-Barr virus (EBV) and HHV-7, respectively. Oral shedding of herpes virus was not uncommon after alloHSCT. There was a statistically significant association between the EBV and CMV oral shedding at C1 and the cumulative incidence of acute graft-versus-host disease (aGVHD). The results suggested that the presence of HSV-1 at C2 was related to a relapse. The HHV-7 oral shedding at C2 suggests a possible link between relapse, progression-free survival and overall survival of the patients. CONCLUSIONS: Patients who developed aGVHD showed higher CMV and EBV shedding in the oral cavity at aplasia, suggesting modifications to the pattern of immune cell response and inflammatory microenvironment.

3.
Int J Paediatr Dent ; 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34115428

RESUMO

BACKGROUND: Oral mucositis (OM) is an important side effect related to allogeneic hematopoietic stem cell transplantation (allo-HSCT), and it has been associated with a significative reduction of quality of life. A negative impact of this toxicity in paediatric patients could result in increased use of parenteral feeding and opioids, longer periods of hospitalization, and a higher risk of systemic infection. AIM: To investigate the clinical features and clinical outcomes associated with OM development and severity in hematological cancer paediatric patients undergoing allo-HSCT who underwent professional dental care (PDC) and photobiomodulation (PBM) as prophylactic treatment. DESIGN: Medical data and OM presentation were retrieved retrospectively from all patients younger than 18 years who were submitted to allo-HSCT between 2013 and 2016. The incidence of OM was assessed and graded by two oral medicine specialists following the WHO guidelines, and it was correlated with clinical parameters. RESULTS: Forty-nine consecutive paediatric patients were included. OM was diagnosed in 73.5% of patients, and in 36.1% of patients, OM was classified as severe. Acute lymphoblastic leukemia as a primary diagnosis and the use of a myeloablative regimen were associated with OM development. The primary diagnosis and use of total body irradiation (TBI) were associated with aggressive OM. Neither the incidence nor the severity of OM affected the overall survival, whereas only the use of a myeloablative regimen and a high body mass index (BMI) were determinants of lower OM-free survival rates. CONCLUSIONS: A myeloablative conditioning and a high BMI were observed to be independent prognostic determinants of a lower OMFS rate. The cluster analysis allowed us to outline patient profiles with greater susceptibility to the development and severity of oral mucositis, which seems to be a useful tool to determine the risk of OM in paediatric patients.

4.
Artigo em Inglês | MEDLINE | ID: mdl-32988809

RESUMO

OBJECTIVE: The aim of this study was to report the clinicopathologic features of 62 cases of central odontogenic fibroma (COdF). STUDY DESIGN: Clinical and radiographic data were collected from the records of 13 oral pathology laboratories. All cases were microscopically reviewed, considering the current World Health Organization classification of tumors and were classified according to histopathologic features. RESULTS: There were 43 females and 19 males (average age 33.9 years; range 8-63 years). Clinically, COdF lesions appeared as asymptomatic swellings, occurring similarly in the maxilla (n = 33) and the mandible (n = 29); 9 cases exhibited palatal depression. Imaging revealed well-defined, interradicular unilocular (n = 27), and multilocular (n = 12) radiolucencies, with displacement of contiguous teeth (55%) and root resorption (46.4%). Microscopically, classic features of epithelial-rich (n = 33), amyloid (n = 10), associated giant cell lesion (n = 7), ossifying (n = 6), epithelial-poor (n = 3), and granular cell (n = 3) variants were seen. Langerhans cells were highlighted by CD1a staining in 17 cases. Most patients underwent conservative surgical treatments, with 1 patient experiencing recurrence. CONCLUSIONS: To the best of our knowledge, this study represents the largest clinicopathologic study of COdF. Most cases appeared as locally aggressive lesions located in tooth-bearing areas in middle-aged women. Inactive-appearing odontogenic epithelium is usually observed within a fibrous/fibromyxoid stroma, occasionally exhibiting amyloid deposits, multinucleated giant cells, or granular cells.


Assuntos
Fibroma , Tumores Odontogênicos , Adolescente , Adulto , Criança , Feminino , Fibroma/diagnóstico por imagem , Fibroma/cirurgia , Humanos , Masculino , Mandíbula , Maxila , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/cirurgia , Adulto Jovem
5.
Autops. Case Rep ; 11: e2020218, 2021. graf
Artigo em Inglês | LILACS | ID: biblio-1142406

RESUMO

The Numb Chin Syndrome (NCS) is defined as facial and oral numbness restricted to the mental nerve's distribution involving the lower lip, skin of the chin, or gingiva of the lower anterior teeth. Hypoesthesia can occur unilaterally or bilaterally. Although this syndrome is rare, its importance is related to the fact that it represents the clinical manifestations of malignant diseases. Breast cancer and non-Hodgkin lymphoma are the most common cause of NCS. The patient, a 58-year-old woman, treated for a Burkitt Lymphoma (BL) nine years ago, described a two-week history of change in sensitivity and pain in the chin region, without relief with the use of analgesics. She had no headache, speech disturbance, dysphagia, visual disturbance, or other neurological symptoms. No surgical intervention has been performed recently. The intraoral examination revealed a healthy oral mucosa and a small area adjacent to the right mental nerve region that was uncomfortable to palpation. No changes were found in the bone trabeculae at cone-beam computed tomography. The contrasted magnetic resonance features made it possible to identify a change in the mandibular body extending to the entire right side, coinciding with the patient's complaint, indicating a probable mandibular medullary invasion. The patient was submitted to a biopsy to rule out a possible recurrence of BL. The microscopic findings were consistent with the diagnosis of BL. The present report described a very unusual presentation of late recurrent BL nine years after the first treatment, which manifested as an NCS.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Mandibulares/patologia , Linfoma de Burkitt/patologia , Recidiva , Linfócitos B , Hipestesia
6.
J Korean Assoc Oral Maxillofac Surg ; 46(4): 282-287, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32855376

RESUMO

Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindlecell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.

7.
J Dent ; 100: 103429, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32673637

RESUMO

OBJECTIVES: The present study investigated the effects of in vitro and in-vivo radiotherapy on endogenous enzymatic activity in dentin using gelatin zymography and in-situ zymography. METHODS: Gelatin zymographic assays were performed on protein extracts obtained from dentin powder of sound non-irradiated (NRT), in vitro irradiated (VTRT) and in vivo irradiated (VIRT) human teeth. Their proteolytic activities were quantified using band densitometric evaluation. For in-situ zymography, dentin specimens from NRT, VIRT and VTRT were covered with fluorescein-conjugated gelatin and examined with confocal laser-scanning microscopy. Fluorescence intensity emitted by the hydrolyzed fluorescein-conjugated gelatin was quantified and statistically analyzed. In-situ zymography data were statistically analyzed using Kruskal-Wallis ANOVA and Dunn's multiple comparison procedures (α = 0.05). RESULTS: No difference between in vitro and in vivo radiotherapy treatment was found. Both VTRT and VIRT groups showed increase in MMP-9 expression when compared to NRT group. Significant increases (p < 0.05) in gelatinolytic activity (26 % for VTRT; 55 % for VIRT) were observed when compared to the NRT group. CONCLUSION: Radiotherapy increase endogenous enzymatic activity in non-restored dentin.


Assuntos
Colagem Dentária , Adesivos Dentinários , Dentina , Humanos , Metaloproteinase 9 da Matriz , Cimentos de Resina
8.
Autops. Case Rep ; 10(2): e2020160, Apr.-June 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1131813

RESUMO

Leukemic cells are rarely present in the oral cavity, and there are very few reports regarding such cases. However, we identified some reports of leukemic cells infiltrating tissues in the oral cavity, including gingival involvement. Recurrent painful oral ulcerations and prominent generalized periodontal destruction are the most common oral features of neutrophil disorders, and they may even be the initial symptoms of the disease. The ulcers may affect any part of the oral mucosa, including the tongue and palate. The objective of this report is to describe and discuss a case of myeloid sarcoma in the oral cavity of a 48-year-old male patient.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Leucemia , Sarcoma Mieloide/patologia , Patologia Bucal
9.
J Korean Assoc Oral Maxillofac Surg ; 46(2): 150-154, 2020 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-32364355

RESUMO

We present a case of osteoradionecrosis treated with leukocyte- and platelet-rich fibrin (LPRF) and surgery and followed up with clinical and tomographic investigations. A 65-year-old woman presented with pain in the posterior region of the right palate. Her medical history included cardiovascular disease and squamous cell carcinoma in the anterior region of the floor of the mouth that had been treated with intensity-modulated radiation therapy. Measurements of isodose curves showed a full dosage of 6,462.6 cGy in the anterior mandibular region, whereas that in the posterior region on the right side of the maxilla reached 5,708.1 cGy. Osteotomy was performed using rotary instruments, and debridement and placement of two LPRF membranes were also carried out. New gum tissue with no bone exposure was noted 14 days postoperatively. Tissue repair was complete, and the patient had no further complaints. During a 39-month follow-up period, the oral mucosa remained intact, and the patient was rehabilitated with a new upper denture. Since there is no consensus regarding the best protocol to treat osteoradionecrosis, LPRF might be an interesting adjuvant to a surgical approach. The use of LPRF is simple and reduces operational costs, time of handling, probability of technical failure, and associated morbidities for patients with osteoradionecrosis.

10.
Support Care Cancer ; 28(11): 5397-5404, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32144584

RESUMO

PURPOSE: To assess the current knowledge regarding medication-related osteonecrosis of the jaw (MRONJ); the adverse effects of anti-resorptive (AR) and anti-angiogenic (AA) drugs; strategies for MRONJ prevention and treatment; and perception of the dentist's role in assisting patients who use these drugs among physicians, dentists, and nurses. METHODS: Using questionnaires, the current knowledge of MRONJ was assessed among dentists, physicians, and nurses, who were divided into group I, which included specialties that directly assist cancer patients, and group II, which included other specialties. The questionnaires assessed the characteristics of the health professionals, training time, and specialties; their knowledge of AR and AA drugs; and their knowledge of MRONJ. RESULTS: A total of 1370 health professionals participated in the study, including 1032 dentists, 239 physicians, and 99 nurses. Among dentists and physicians, the training time (p = 0.036 and p < 0.001, respectively) and specialization in group I domains (p < 0.001 and p < 0.001, respectively) had a significant impact on MRONJ knowledge, while nurses showed no significant impact regardless of the training time and specialty. Less than 10% of the physicians and dentists could correlate the signs and symptoms of all stages of MRONJ. CONCLUSION: The findings indicated a notable lack of knowledge regarding MRONJ among dental surgeons and physicians, and especially among nurses. More experienced professionals and specialists in the areas that assist cancer patients usually have a greater understanding of the dentist's role in MRONJ prevention, diagnosis, treatment, and patient care and will introduce or are already using AR and AA drugs.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Conhecimento , Adulto , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/prevenção & controle , Conservadores da Densidade Óssea/uso terapêutico , Brasil/epidemiologia , Estudos Transversais , Odontólogos/psicologia , Odontólogos/estatística & dados numéricos , Diagnóstico Diferencial , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Médicos/psicologia , Médicos/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários
11.
J Prosthodont ; 29(5): 448-452, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32128953

RESUMO

Oral positioning radiotherapy stents are devices that protect healthy structures adjacent to the target volume of head and neck radiotherapy treatment, leading to reduced acute and chronic side effects. This study describes a digital workflow to produce an oral positioning radiotherapy stent and analyze its efficacy by measuring dosimetric variations with and without this stent. An oral positioning radiotherapy stent was created according to a digital workflow that included intraoral scanning, digital design, and 3D printing for a patient with squamous cell carcinoma of the tongue. The patient underwent computed tomography to evaluate radiotherapy treatment by intensity-modulated radiation therapy with and without the use of the 3D-printed oral stent. The use of a 3D-printed oral positioning radiotherapy stent is a feasible and reproducible technique that reduced the planning target volume and radiation doses delivered to the hard palate, right parotid gland, and left parotid gland by 42%, 21%, and 8.5%, respectively.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Radioterapia de Intensidade Modulada , Humanos , Stents , Fluxo de Trabalho
12.
Clin Oral Investig ; 24(10): 3597-3608, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32036434

RESUMO

OBJECTIVES: This study was performed to characterise oral shedding of herpesviruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and to investigate its relationship with oral mucositis (OM). MATERIALS AND METHODS: PCR and enzymatic digestion were conducted to identify oral shedding of herpesviruses and its correlation with OM development in 31 patients. The samples were collected at three sites in the oral cavity and at 5 times during follow-up; two additional collections were made from patients who developed ulcerative OM. RESULTS: HSV-1, EBV, CMV, HHV-6A, HHV-6B, and HHV-7 were detected in 4.97%, 16.02%, 4.41%, 2.20%, 3.31%, and 68% of the oral mucosal samples, respectively; 4.41%, 16.57%, 5.52%, 2.20%, 5.52%, and 63.53% of supragingival samples, respectively, and 4.41%, 18.23%, 2.76%, 1.65%, 2.75%, and 35.91% of subgingival samples, respectively. OM was diagnosed in 13 patients. The presence of HHV-7 in C1 (oral mucosa: p = 0.032) and C2 (supragingival: p = 0.009; subgingival: p = 0.002) was significantly increased in patients who developed OM, and patients exhibiting HHV-7 shedding in the oral cavity were 3.32-fold more likely to develop OM. CONCLUSIONS: Patients who developed OM showed higher HHV-7 shedding in the oral cavity at nadir (immediately prior to OM development), suggesting modifications to the inflammatory microenvironment. CLINICAL RELEVANCE: HHV-7 may be involved in oral dysbiosis in HSCT-related OM; enhanced understanding of its role in the pathogenesis of OM may lead to the development of strategies for managing and preventing this common side effect of alloHSCT.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Herpesvirus Humano 7 , Infecções por Roseolovirus/etiologia , Estomatite , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Mucosa Bucal
13.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e131-e136, ene. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-196205

RESUMO

BACKGROUND: The aim of the present study was to analyze the clinicopathological and the ultrastructural features of periapical actinomycosis (PA) cases. MATERIAL AND METHODS: Data from the files of an oral pathology laboratory were retrieved and the findings of histopathological analysis were evaluated. Hematoxylin-eosin (HE), a modified Brown & Brenn, and Grocott stains as well as ultrastructural analysis using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were utilized. RESULTS: Six cases were obtained, 4 females and 2 males, with a mean age of 34 year-old. Two cases were symptomatic, lower teeth and the anterior region were more commonly affected, and all cases were characterized by periapical radiolucencies. All cases presented sulfur granules with a ray-fungus or club-shaped pattern of the Splendore-Hoeppli phenomenon in HE-stained sections, with filamentous gram-positive bacteria aggregates highlighted by the modified Brown & Brenn stain. SEM analysis revealed abundant packed rod-like and filamentous bacteria associated with an extracellular amorphous material. EDX analysis showed predominant picks of calcium and sulfur in actinomycotic colonies. CONCLUSIONS: Our findings suggest that PA manifests either clinically and radiologically as a non-specific and heterogeneous condition and that the actinomycotic colonies consist in a calcium- and sulfur-rich matrix. Furthermore, the results highlight the importance of submitting periapical specimens after surgical removal to histopathological análisis


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Idoso , Actinomicose/patologia , Doenças Periapicais/microbiologia , Doenças Periapicais/patologia , Estudos Retrospectivos , Doenças Periapicais/diagnóstico por imagem , Radiografia Dentária , Actinomyces/isolamento & purificação , Microscopia Eletrônica de Varredura
14.
Support Care Cancer ; 28(6): 2977-2984, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31773272

RESUMO

PURPOSE: The objective of this multicentre study was to verify the relationship between the scores of quality of life (QoL) and the decayed, missing and filled teeth (DMFT) and radiation caries (RC) in patients treated with radiation therapy (RT) for head and neck cancer, and through this to determine if RC is capable of causing a significant decrease in the QoL. METHODS: One hundred patients were divided into 2 groups: patients with at least 1 year of RT completion who developed RC (study group, n = 50); and patients with at least 1 year of RT completion who did not develop RC (control group, n = 50). All patients answered the Brazilian-Portuguese version of the University of Washington quality of life (UW-QoL) questionnaire, which was divided into physical and social-emotional functioning domains and evaluated the DMFT index score. RESULTS: The mean score of QoL was 927.2 in the control group and 878.1 in the study group (P = 0.24). The mean score of DMFT was 30.5 in the study group and 20.7 in the control group (P = 0.001). The items recreation and saliva, which belong to the physical function domain, showed a statistically significant difference between the study and control groups (P = 0.031 and P = 0.047, respectively). Saliva was the item with the higher number of patient complaints in both groups. CONCLUSION: RC had a negative impact on the QoL of HNC patients.


Assuntos
Cárie Dentária/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Qualidade de Vida , Lesões por Radiação/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Casos e Controles , Cárie Dentária/epidemiologia , Dor Facial/epidemiologia , Dor Facial/etiologia , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal/estatística & dados numéricos , Lesões por Radiação/psicologia , Inquéritos e Questionários
15.
Int J Implant Dent ; 5(1): 34, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31571065

RESUMO

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is characterized by the development of bone necrosis in the jaws of patients receiving antiresorptive and/or antiangiogenic medications. No scientific reports have been published yet on bevacizumab-related osteonecrosis of the jaw (BeRONJ) when associated with dental implant placement and adjuvant ozone therapy. CASE PRESENTATION: A 54-year-old female patient with a history of metastatic breast cancer and bevacizumab use presented with a dental infection. Dental extraction followed immediately by dental implant placement was planned after suspension of the bevacizumab treatment. The patient presented with pain, drainage of purulent secretion, and bone exposure 5 weeks post-surgery. Complete healing was achieved at postoperative 7 months. CONCLUSIONS: The combination of adjuvant ozone therapy and surgical debridement was effective for the treatment of MRONJ; however, the risk of MRONJ may persist after the suspension of bevacizumab for 28 days.

16.
Support Care Cancer ; 27(10): 3969-3983, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286228

RESUMO

PURPOSE: To systematically review the literature and update the evidence-based clinical practice guidelines for the use of photobiomodulation (PBM), such as laser and other light therapies, for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using PubMed and Web of Science. We followed the MASCC methods for systematic review and guidelines development. The rigorously evaluated evidence for each intervention, in each cancer treatment setting, was assigned a level-of-evidence (LoE). Based on the LoE, one of the following guidelines was determined: Recommendation, Suggestion, or No Guideline Possible. RESULTS: Recommendations are made for the prevention of OM and related pain with PBM therapy in cancer patients treated with one of the following modalities: hematopoietic stem cell transplantation, head and neck (H&N) radiotherapy (without chemotherapy), and H&N radiotherapy with chemotherapy. For each of these modalities, we recommend 1-2 clinically effective protocols; the clinician should adhere to all parameters of the protocol selected. Due to inadequate evidence, currently, No Guideline Possible for treatment of established OM or for management of chemotherapy-related OM. The reported clinical settings were extremely variable, limiting data integration. CONCLUSIONS: The evidence supports the use of specific settings of PBM therapy for the prevention of OM in specific patient populations. Under these circumstances, PBM is recommended for the prevention of OM. The guidelines are subject to continuous update based on new published data.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Mucosite/terapia , Guias de Prática Clínica como Assunto , Estomatite/prevenção & controle , Estomatite/terapia , Protocolos Clínicos , Humanos , Masculino , Neoplasias/terapia
17.
Oral Oncol ; 93: 52-58, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31109696

RESUMO

The presence of lymphovascular invasion is considered a prognostic determinant for different human neoplasms and is frequently taken into account by surgeons and oncologists to determine patients' treatment. However, the exact frequency of this microscopic event and its prognostic impact for patients affected by adenoid cystic carcinoma (AdCC) remains unclear. Therefore, the aim of this study was to carry out a systematic review and meta-analysis to address the prevalence and the prognostic potential of lymphovascular invasion in head and neck AdCC. A literature search on PubMed, Scopus, ClinicalTrials.gov, Web of Science and ProQuest databases was undertaken in January 2019. The primary outcomes of interest were overall survival (OS) and disease-free survival (DFS). The relative frequency of lymphovascular invasion and its possible association with other clinicopathological parameters were addressed. A total of 22 studies and 2117 patients were included in this study. The frequency of lymphovascular invasion ranged from 5.2% to 72.5%. Lymphovascular invasion was associated with an increased likelihood of lymph node metastasis (OR = 2.58; 95% CI 1.61-4.12; p = 0.0001) and death (OR = 3.09; 95% CI 1.82-5.26; p = 0.0001), solid/higher-grade AdCC were more likely to present lymphovascular invasion (OR = 5.51; 95% CI 1.87-16-21; p = 0.002) and patients with this microscopic finding had a significantly lower OS (HR = 8.30; 95% CI 1.68-40.91; p = 0.009) and DFS (HR = 3.76; 95% CI 1.13-12.53; p = 0.03). In conclusion, lymphovascular invasion seems to be a significant predictor of poor prognosis for head and neck AdCC patients.


Assuntos
Vasos Sanguíneos/patologia , Carcinoma Adenoide Cístico/irrigação sanguínea , Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Vasos Linfáticos/patologia , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Terapia Combinada , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Metástase Linfática , Invasividade Neoplásica , Prognóstico , Taxa de Sobrevida
18.
Artigo em Inglês | MEDLINE | ID: mdl-29602688

RESUMO

OBJECTIVE: The aim of this study was to investigate alterations in the EGFR gene and its protein expression for a better understanding of the biologic behavior of ameloblastoma. STUDY DESIGN: Twenty-five samples of ameloblastoma were selected, and dual-color fluorescence in situ hybridization assay was performed. The results of the assay and immunohistochemistry reaction for EGFR and Ki67 were associated with clinicopathologic features and recurrence. RESULTS: All analyzed cases presented disomy without any gene polysomy or amplification. With regard to EGFR immunoexpression, 3 cases (12%) were considered negative, and 22 (88%) were positive, of which 13 (52%) were weak and 9 (36%) were strong. All samples presented low positivity for Ki67. There was no association between EGFR expression and clinicopathologic features or recurrence (P > .05). In some cases, EGFR immunoexpression was observed without gene amplification. CONCLUSIONS: Ameloblastoma development, progression, or recurrence does not appear to be related to EGFR amplification or polysomy.


Assuntos
Ameloblastoma/metabolismo , Receptores ErbB/metabolismo , Neoplasias Mandibulares/metabolismo , Adolescente , Adulto , Idoso , Biomarcadores Tumorais/metabolismo , Criança , Feminino , Amplificação de Genes , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Pathol Res Pract ; 214(6): 907-913, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29559247

RESUMO

Ameloblastoma is a locally aggressive neoplasm with a poorly understood pathogenesis. Therefore, the aim of this study is to investigate whether COX-2 expression is associated with ameloblastoma microvascular density (MVD) and with tumor aggressiveness. Sixty-three cases of primary ameloblastomas arranged in tissue microarray were submitted to immunohistochemistry against cyclooxigenase-2 (COX-2) and CD34. Clinicopathological parameters regarding sex, age, tumour size, tumour duration, tumour location, treatment, recurrences, radiographic features, vestibular/lingual and basal cortical disruption and follow-up data were obtained from patients' medical records and correlated with the proteins expression. The results on BRAF-V600E expression were obtained from our previous study and correlated with COX-2 and CD34 expressions. Log-rank univariate analysis and multivariate Cox regression model were done to investigate the prognostic potential of the molecular markers. Twenty-eight cases (44.4%) exhibited cytoplasmic positivity for COX-2, predominantly in the columnar peripheral cells, with a mean MVD of 2.2 vessels/mm2. COX-2 was significantly associated with recurrences (p < 0.001) and BRAF-V600E expression (p < 0.001), whereas lower MVD was associated with the use of conservative therapy (p = 0.004). Using univariate and multivariate analyses, COX-2 was significantly associated with a lower 5-year disease-free survival (DFS) rate (p < 0.001 and p = 0.012, respectively), but not with a higher MVD (p = 0.68). In conclusion, COX-2 expression in ameloblastomas is not associated with MVD, but it is significantly associated with recurrences and with a lower DFS.


Assuntos
Ameloblastoma/patologia , Biomarcadores Tumorais/análise , Ciclo-Oxigenase 1/biossíntese , Neoplasias Maxilomandibulares/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ameloblastoma/mortalidade , Criança , Ciclo-Oxigenase 1/análise , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Maxilomandibulares/mortalidade , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Adulto Jovem
20.
Med. oral patol. oral cir. bucal (Internet) ; 23(2): e188-e197, mar. 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-171399

RESUMO

Background: To describe the clinicopathological characteristics of a series of head and neck rhabdomyosarcoma (RMS) and to review the literature. Material and Methods: Cases diagnosed as RMS affecting the head and neck region were retrospectively retrieved from the files of two Brazilian institutions from January 2006 to January 2017. Data on clinical features (sex, age and affected site), microscopic subtype, immunohistochemical results, treatment employed and follow-up status were obtained from the patient's medical charts. Results: During the period considered, 10 cases of RMS were identified. Females predominated (4M:6F), the mean age at diagnosis was 16.5 years-old and the orbit was the most affected site (4 cases). Microscopically, most cases were classified as embryonal RMS (6 cases) and the Desmin/Myogenin/Myo-D1 immunohistochemical positivity was useful to confirm the diagnosis. Chemotherapy and radiotherapy were applied to 9 and 8 patients respectively, whereas 2 patients were treated by surgery. Recurrences occurred in 3 patients and distant metastasis in 2 cases. Nine patients were alive in their last follow-up, 3 of them with disease, whereas 1 patient died due to the disease. Conclusions: Head and neck RMS is an aggressive malignant neoplasm which demands especial concern to achieve early diagnosis and successful treatment (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Rabdomiossarcoma/diagnóstico por imagem , Rabdomiossarcoma/terapia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Rabdomiossarcoma/tratamento farmacológico , Rabdomiossarcoma/patologia , Imuno-Histoquímica , Neoplasias de Tecidos Moles/diagnóstico por imagem , Neoplasias de Tecidos Moles/tratamento farmacológico , Neoplasias de Tecidos Moles/patologia
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