Allogenic stem cell transplant-associated acute graft versus host disease: a computational drug discovery text mining approach using oral and gut microbiome signatures.

PURPOSE: Acute graft versus host disease (aGVHD) is a major cause of non-relapse morbidity and mortality post-allogenic hematopoietic stem cell transplant (HSCT). Using conventional literature search and computational approaches, our objective was to identify oral and gut bacterial species associated with aGVHD, potentially affecting drug treatment via lipopolysaccharide (LPS) pathways. METHODS: Medline, PubMed, PubMed Central, and Google Scholar were searched using MeSH terms. The top 100 hits per database were curated, and 25 research articles were selected to examine oral and gut microbiomes associated with health, HSCT, and aGVHD. Literature search validation, aGVHD drug targets, and microbial metabolic pathway identification were completed using BioReader, MACADAM, KEGG, and STRING programs. RESULTS: Our review determined that (1) oral genera Rothia, Solobacterium, and Veillonella were identified in HSCT patients' stool and associated with aGVHD; (2) shifts in gut enterococci profiles were determined in HSCT-associated aGVHD; (3) gut microbiome dysbiosis prior or during HSCT and lower Shannon diversity index at time of HSCT were also associated with increased risk of aGVHD and transplant related death; and (4) Coriobacteriaceae family was negatively correlated with gut aGVHD, whereas Eubacterium limosum was associated with decreased risk of chronic GVHD relapse. Additionally, we identified molecular pathways related to TLR4/ LPS, including candidate aGVHD drug targets, impacted by oral and gut bacterial taxa. CONCLUSION: Reduced microbial diversity reflects higher severity and mortality rate in HSCT patients with aGVHD. Multi-omics approaches to decipher oral and gut microbiome associations will be critical for developing aGVHD preventive therapies.

Una Aproximación Epidemiológica sobre Patologías Orales desde la Perspectiva de la Radiología / An Epidemiological Approach to Oral Pathologies from a Radiology Perspective

RESUMEN: La cavidad de oral es susceptible de alteraciones de diversa índole, que presentan patrones epidemiológicos variables. La caries y la enfermedad periodontal se reconocen como las de mayor prevalencia, pero sobre otras anormalidades que afectan a las estructuras óseas y los dientes se tienen menos datos. El objetivo del trabajo fue determinar la prevalencia de hallazgos radiográficos sugestivos de patología en 10,000 imágenes panorámicas digitales de adultos, obtenidas en diferentes centros de radiología en Bogotá. Se recolectaron radiografías de pacientes mayores de 18 años, de bajo grado de distorsión, con estructuras completas, y adecuado contraste y densidad que permitieran la lectura de las variables a estudiar. La mayoría de las radiografías pertenecen a pacientes de género femenino, y su promedio de edad es de 39 años. El edentulismo parcial es el hallazgo de mayor prevalencia afectando a un 61 % del grupo, seguido de la presencia de tratamientos de endodoncia con un 45 % y en tercer lugar las inclusiones dentales 24,1 %. Otros hallazgos corroboran que las lesiones apicales son las lesiones quísticas de mayor prevalencia y un aumento en la rehabilitación con prótesis fija e implantes. Este estudio refleja los efectos de la caries y la enfermedad periodontal que afectan a la población estudiada y su principal consecuencia el edentulismo parcial que afecta a todos los grupos de edad examinados. La endodoncia, sugerente de patología pulpar, también es de alta prevalencia y en gran porcentaje asociada a lesiones apicales, pero en general el estudio sugiere la necesidad de programas de prevención para el adulto, para cumplir con las metas de la Organización Mundial de la Salud con miras a disminuir la perdida de dientes.

ABSTRACT: The oral cavity is susceptible to alterations of diverse nature that present variable epidemiological patterns. Caries and periodontal disease are recognized as having the highest prevalence, but thereare less data on other abnormalities that affect bone structures and teeth. The objective of the study was to determine the prevalence of radiographic findings suggestive of pathology in 10,000 digital panoramic images of adults, obtained at different radiology centers in Bogotá. Radiographs were collected from patients over 18 years of age, with a low degree of distortion, with complete structures, and adequate contrast and density to allow the reading of the variables to be studied. Most of the radiographs belong to female patients, and their average age is 39 years. Partial edentulism is the most prevalent finding affecting 61 % of the group, followed by the presence of endodontic treatments with 45 % and thirdly the dental inclusions 24.1 %. Other findings corroborate that the apical lesions are the cystic lesions with a higher prevalence and an increase in rehabilitation with fixed prostheses and implants. This study reflects the effects of caries and periodontal disease that affect the population studied and its main consequence is the partial edentulism that affects all age groups examined. Endodontics, suggestive of pulpal pathology, is also of high prevalence and a large percentage associated with apical lesions, but in general the study suggests the need for adult prevention programs to meet the goals of the World Health Organization with a view to reducing tooth loss.

Frecuencia de Lesiones y Condiciones Orales en Pacientes Mayores de 18 Años en una Clínica de Atención Primaria en México / Frequency of Lesions and Oral Conditions in Patients Older than 18 Years in a Primary Care Clinic in Mexico

RESUMEN: La patología oral es el área de la odontología que se especializa en el diagnóstico y tratamiento de enfermedades orales. Se realizó un estudio transversal, en el cual fueron incluidos pacientes mayores de 18 años que acudieron a una clínica de atención primaria del departamento de estomatología de la universidad Autónoma de Ciudad Juárez, en México y a los cuales independientemente del motivo de consulta se les realizo historia clínica y exploración intraoral detallada. Fueron examinados 650 pacientes (424 mujeres y 226 hombres) con un rango de edad de 18 a 89 años (media=42.27). Las lesiones más frecuentes fueron la queratosis friccional (30,46 %) e hiperplasia fibrosa (6,92 %), la melanosis fisiológica (42,92 %) y los gránulos de Fordyce (36,46 %) fueron las condiciones más identificadas. En las lesiones de la mucosa oral que identificamos estuvo presente el factor traumático de manera crónica, es importante que el odontólogo este familiarizado con las lesiones más frecuentes, con su etiología, características clínicas y tratamiento de cada una de ellas.

ABSTRACT: Oral pathology it's the branch of medicine that focuses on the diagnosis and treatment of oral diseases. A cross-sectional study was carried out in which patients older than 18 years was included, that were attended in the primary care clinic at the stomatology department of the Autonomous University of Ciudad Juárez, in Mexico, and regardless of the reason for consultation the clinical history and intraoral examination was done We examined 650 patients (424 women and 226 men) with an age range of 18 to 89 years (mean=42.27). The most frequent oral lesion was the frictional keratosis (30.46 %), fibrous hyperplasia (6.92 %), physiological melanosis (42.92 %), and fordyce granules (36.46 %). In the oral mucosal lesions identified was present a chronic traumatic factor, it is important that the dental staff knows about the most frequent injuries, their etiology, clinical characteristics and treatment of each one.

The Gorlin-Goltz Syndrome: diagnosis of a case associated with heart disease and type 2 diabetes mellitus / Síndrome de Gorlin-Goltz: diagnóstico de um caso associado à cardiopatia e diabetes mellitus 2

The Gorlin-Goltz syndrome (GGS) is a hereditary, autosomal dominant condition, with high penetrance and variable expressivity, resulting from mutations in the genes PTCH1, PTCH2, or SUFU. The diagnosis is based on the presence of 2 major criteria or a major criterion associated with 2 minor criteria, including multiple basal cell carcinomas, keratocystic odontogenic tumor (KOT), and bifid rib. Other endocrine, neurological, ophthalmologic, genital, respiratory, and cardiovascular alterations are found in the literature, but with variable manifestations. This study reports the case of a patient diagnosed with GGS associated with diastolic congestive heart failure and type 2 diabetes mellitus, who underwent multiple treatments for components of the syndrome. More recently, the patient underwent decompression followed by cystic enucleation of two KOTs in the jaw, oral rehabilitation with removable prosthodontics, cardiological evaluation, and attempted clinical control of endocrine and cardiac problems.

A síndrome de Gorlin-Goltz (SGG) é uma condição hereditária, autossômica dominante, com alta penetrância e expressividade variável, decorrente de mutações nos genes PTCH1, PTCH2 ou SUFU. O diagnóstico é baseado na presença de dois critérios maiores ou um critério maior associado a dois critérios menores, dentre eles múltiplos carcinomas basocelulares, tumor odontogênico ceratocístico (TOC) e costela bífida. Outras alterações endócrinas, neurológicas, oftalmológicas, genitais, respiratórias e cardiovasculares são encontradas na literatura, porém com manifestações variáveis. O objetivo deste trabalho é relatar um caso clínico de uma paciente sistematicamente diagnosticada com SGG associada à insuficiência cardíaca congestiva diastólica e diabetes mellitus 2 submetida a tratamentos seriados das respectivas manifestações sindrômicas. Mais recentemente, à descompressão cística seguida da enucleação de dois TOC em mandíbula, reabilitação oral com prótese total removível, avaliação cardiológica e tentativa de controle clínico das alterações endócrinas e cardíacas.

Nested PCR for detection of HSV-1 in oral mucosa

BACKGROUND: It has been estimated that 15%-20% of human tumours are driven by infection and inflammation, and viral infections play an important role in malignant transformation. The evidence that herpes simplex virus type 1 (HSV-1) could be involved in the aetiology of oral cancer varies from weak to persuasive. This study aimed to investigate by nested PCR (NPCR) the prevalence of HSV-1 in samples from normal oral mucosa, oral leukoplakia, and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: We investigated the prevalence of HSV-1 in biopsies obtained from 26 fresh, normal oral mucosa from healthy volunteers as well as 53 oral leukoplakia and 27 OSCC paraffin-embedded samples. DNA was extracted from the specimens and investigated for the presence of HSV-1 by nested polymerase chain reaction (NPCR) and DNA sequencing. RESULTS: HSV-1 was detected in 14 (54%) of the healthy samples, in 19 (36%) of the oral leukoplakia samples, and in 14 (52%) of the OSCC samples. The differences were not statistically significant. CONCLUSIONS: We observed a high incidence of HSV-1 in healthy oral mucosa, oral leukoplakia, and OSCC tissues. Thus, no connection between OSCC development and presence of HSV-1 was detected

Estudo epidemiológico sobre as condições de saúde bucal de crianças menores de cinco anos de idade no município de Diadema, São Paulo - 2012 / Epidemiological survey of oral health status of children under five years-old in Diadema, São Paulo - 2012

O presente estudo teve como objetivos avaliar a prevalência, gravidade e fatores associados à Cárie Dentária (CD), Lesão Dentária Traumática (LDT) e Desgaste Dentário Erosivo (DDEr) em crianças menores de 5 anos de idade no Município de Diadema, São Paulo. Em posse de esses dados, também foram objetivos investigar a tendência da prevalência desses problemas de saúde bucal e avaliar o impacto que esses problemas causam na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) das crianças examinadas e de seus pais. Cirurgiões dentistas treinados e calibrados examinaram 1215 crianças de 1, 2, 3 e 4 anos de idade para CD e LDT e 839 crianças de 3 e 4 anos de idade para DDEr nas 19 Unidades Básicas de Saúde (UBS) do Município de Diadema durante o dia da Campanha de Multivacinação Infantil em 2012. Para a avaliação dos problemas de saúde foram utilizados os índices de Knutson, ceo-d e ceo-s para CD, os critérios modificados de Andreasen para LDT e o índice de O´Brien modificado para DDEr. A ocorrência de fatores associados foi investigada por meio de um questionário elaborado especificamente para esta pesquisa, com base na literatura. Para avaliar a QVRSB os pais ou responsáveis responderam à versão brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS). Os dados foram analisados estatisticamente utilizando a regressão de Poisson (IC 95%) para determinar os fatores associados e a QVRSB dos problemas de saúde bucal estudados. Para determinar a tendência da prevalência foi utilizado o Teste de Qui-quadrado para tendência com um nível de significância de 5%. Na população estudada foi encontrada uma prevalência de CD, LDT e DDEr de 20,3%, 20,1% e 51,3% respectivamente.

O ceo-d e ceo-s do total da amostra foi de 0,7 e 1,2 respectivamente. A fratura de esmalte (72,7%) foi a LDT mais prevalente. As lesões de DDEr foram mais prevalentes em incisivos superiores sendo a maioria das lesões encontradas em esmalte (83,3%). Os fatores associados para CD foram a idade da criança e ter 2 ou mais filhos na família; LDT foram a idade e a presença de mordida aberta anterior e/ou sobressaliência acentuada; DDEr foram consumir refrigerante e suco mais de 3 vezes ao dia, deixar a bebida na boca ou beber na mamadeira, relato de refluxo gastroesofágico e morar só com o pai. Observou-se tendências de diminuição, aumento e estacionária nas prevalências de CD, LDT e DDEr respectivamente. Ao avaliar o impacto na QVRSB foi observado que, a CD (RP:3,09; p<0,001) assim como as LDT complicadas (RP:2,10; p=0,048) têm um impacto negativo na QVRSB e o DDEr (RP:0,79; p=0,163) não mostrou ter um impacto na QVRSB. Por tanto, na população estudada, existe uma tendência de declínio da prevalência da CD, de aumento de LDT e uma alta e constante prevalência de DDEr. As lesões de CD e LDT complicadas têm um impacto negativo na QVRSB das crianças e de seus pais ou cuidadores.

The objective of this study was to assess the prevalence, severity and factors associated of Dental Caries (DC), Traumatic Dental Injury (TDI) and Erosive Tooth Wear (ETW) in children the age of five in the municipality of Diadema, São Paulo. Given these data, an additional objective of this study was to investigate the trend of prevalence of these oral health problems and assess the impact that these problems cause on the Oral Health-Related Quality of Life (OHRQoL) in preschool children and their parents. Trained and calibrated dentists examined 1215 children aged 1-4 years for DC and TDI, and 839 children aged 3 and 4 years for ETW in 19 Basic Health Units (BHU) of the municipality of Diadema during the first stage of the National Children's Vaccination in 2012. For the assessment of DC the Knutson, dmf-t and dmf-s index were used, a modified Andreasen criteria was used for TDI and a modified version of the O'Brien index for ETW. Furthermore, the occurrence of associated factors was investigated using a structured questionnaire prepared after reviewing the literature. In order to assess OHRQoL, parents or caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Data were statistically analyzed using Poisson regression (CI 95%) which was necessary to evaluate the associated factors and the OHRQoL of the oral health problems studied. In order to determine the trend of prevalence the Chi-square for trend test was used for a significance level of 5%. In the population studied, it was found that the prevalence of DC, TDI, ETW was 20.3%, 20.1% and 51.3% respectively. Enamel fracture (72.7%) was the most prevalent TDI.

ETW lesions were most prevalent in the upper incisors being the most lesions in enamel only (83.3%). The Factors associated with DC were age and having 2 or more children in the family, for TDI the factors were age and presence of anterior open bite and/or increased overjet and for ETW the factors were drinking soft drink or juice more than 3 times a day, keeping the drink in the mouth without swallowing or using baby's bottle, report of gastroesophageal reflux and living with the father only. Findings show decreasing, increasing and stationary trends in the prevalence of DC, TDI and ETW respectively. When evaluating the impact on the OHRQoL, it was observed that DC (PR: 3.09; p <0.001) as well the presence of complicated TDI (PR: 2.10; p=0.048) had a negative impact on the OHRQoL. As a result, in the population studied, there is a decreasing in the prevalence of DC, an increasing trend in the prevalence of TDI and a high and stable prevalence of ETW. DC and the presence of complicated TDI were associated with worse OHRQoL of preschool children and their parents or caregivers.

Estudo epidemiológico sobre as condições de saúde bucal de crianças menores de cinco anos de idade no município de Diadema, São Paulo - 2012 / Epidemiological survey of oral health status of children under five years-old in Diadema, São Paulo - 2012

O presente estudo teve como objetivos avaliar a prevalência, gravidade e fatores associados à Cárie Dentária (CD), Lesão Dentária Traumática (LDT) e Desgaste Dentário Erosivo (DDEr) em crianças menores de 5 anos de idade no Município de Diadema, São Paulo. Em posse de esses dados, também foram objetivos investigar a tendência da prevalência desses problemas de saúde bucal e avaliar o impacto que esses problemas causam na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) das crianças examinadas e de seus pais. Cirurgiões dentistas treinados e calibrados examinaram 1215 crianças de 1, 2, 3 e 4 anos de idade para CD e LDT e 839 crianças de 3 e 4 anos de idade para DDEr nas 19 Unidades Básicas de Saúde (UBS) do Município de Diadema durante o dia da Campanha de Multivacinação Infantil em 2012. Para a avaliação dos problemas de saúde foram utilizados os índices de Knutson, ceo-d e ceo-s para CD, os critérios modificados de Andreasen para LDT e o índice de O´Brien modificado para DDEr. A ocorrência de fatores associados foi investigada por meio de um questionário elaborado especificamente para esta pesquisa, com base na literatura. Para avaliar a QVRSB os pais ou responsáveis responderam à versão brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS). Os dados foram analisados estatisticamente utilizando a regressão de Poisson (IC 95%) para determinar os fatores associados e a QVRSB dos problemas de saúde bucal estudados. Para determinar a tendência da prevalência foi utilizado o Teste de Qui-quadrado para tendência com um nível de significância de 5%. Na população estudada foi encontrada uma prevalência de CD, LDT e DDEr de 20,3%, 20,1% e 51,3% respectivamente.O ceo-d e ceo-s do total da amostra foi de 0,7 e 1,2 respectivamente. A fratura de esmalte (72,7%) foi a LDT mais prevalente. As lesões de DDEr foram mais prevalentes em incisivos superiores sendo a maioria das lesões encontradas em esmalte (83,3%). Os fatores associados para CD foram a idade da criança e ter 2 ou mais filhos na família; LDT foram a idade e a presença de mordida aberta anterior e/ou sobressaliência acentuada; DDEr foram consumir refrigerante e suco mais de 3 vezes ao dia, deixar a bebida na boca ou beber na mamadeira, relato de refluxo gastroesofágico e morar só com o pai. Observou-se tendências de diminuição, aumento e estacionária nas prevalências de CD, LDT e DDEr respectivamente. Ao avaliar o impacto na QVRSB foi observado que, a CD (RP:3,09; p<0,001) assim como as LDT complicadas (RP:2,10; p=0,048) têm um impacto negativo na QVRSB e o DDEr (RP:0,79; p=0,163) não mostrou ter um impacto na QVRSB. Por tanto, na população estudada, existe uma tendência de declínio da prevalência da CD, de aumento de LDT e uma alta e constante prevalência de DDEr. As lesões de CD e LDT complicadas têm um impacto negativo na QVRSB das crianças e de seus pais ou cuidadores.

The objective of this study was to assess the prevalence, severity and factors associated of Dental Caries (DC), Traumatic Dental Injury (TDI) and Erosive Tooth Wear (ETW) in children the age of five in the municipality of Diadema, São Paulo. Given these data, an additional objective of this study was to investigate the trend of prevalence of these oral health problems and assess the impact that these problems cause on the Oral Health-Related Quality of Life (OHRQoL) in preschool children and their parents. Trained and calibrated dentists examined 1215 children aged 1-4 years for DC and TDI, and 839 children aged 3 and 4 years for ETW in 19 Basic Health Units (BHU) of the municipality of Diadema during the first stage of the National Children's Vaccination in 2012. For the assessment of DC the Knutson, dmf-t and dmf-s index were used, a modified Andreasen criteria was used for TDI and a modified version of the O'Brien index for ETW. Furthermore, the occurrence of associated factors was investigated using a structured questionnaire prepared after reviewing the literature. In order to assess OHRQoL, parents or caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Data were statistically analyzed using Poisson regression (CI 95%) which was necessary to evaluate the associated factors and the OHRQoL of the oral health problems studied. In order to determine the trend of prevalence the Chi-square for trend test was used for a significance level of 5%. In the population studied, it was found that the prevalence of DC, TDI, ETW was 20.3%, 20.1% and 51.3% respectively. Enamel fracture (72.7%) was the most prevalent TDI. ETW lesions were most prevalent in the upper incisors being the most lesions in enamel only (83.3%). The Factors associated with DC were age and having 2 or more children in the family, for TDI the factors were age and presence of anterior open bite and/or increased overjet and for ETW the factors were drinking soft drink or juice more than 3 times a day, keeping the drink in the mouth without swallowing or using baby's bottle, report of gastroesophageal reflux and living with the father only. Findings show decreasing, increasing and stationary trends in the prevalence of DC, TDI and ETW respectively. When evaluating the impact on the OHRQoL, it was observed that DC (PR: 3.09; p <0.001) as well the presence of complicated TDI (PR: 2.10; p=0.048) had a negative impact on the OHRQoL. As a result, in the population studied, there is a decreasing in the prevalence of DC, an increasing trend in the prevalence of TDI and a high and stable prevalence of ETW. DC and the presence of complicated TDI were associated with worse OHRQoL of preschool children and their parents or caregivers.

The dentist's role within the multi-disciplinary team maintaining quality of life for oral cancer patients in light of recent advances in radiotherapy.

Every year in Ireland over 400 people are diagnosed with head and neck cancer. Oral cancer, a specific type of head and neck cancer, is usually treated with surgery and often requires radiotherapy (RT). However, side effects of RT treatment, which include mucositis, xerostomia, radiation caries, trismus and osteoradionecrosis, can seriously compromise a patient's quality of life. Treatment for oral cancer patients is managed in a multidisciplinary team. General dental practitioners (GDPs), consultant/specialist dentists and oral-maxillofacial surgeons play an important role in these patients' care. Recent advances in the delivery of RT have not only improved locoregional control and survival rates, but have also reduced the incidence and severity of RT-associated side effects; however, no mode of RT delivery has successfully eliminated side effects. The role of dentists is essential in maintaining oral health and all patients should be dentally screened prior to commencing RT. Recent reports have attempted to standardise the quality of care for the oral cancer patient and have highlighted the significance of the role of the GDP. Despite the advancements in RT delivery, the dental team is still faced with a number of challenges, including the high number of patients lost to follow-up dental care, lack of an effective treatment for xerostomia, poor patient compliance, and a lack of standardised guidelines and funding. Addressing these challenges will involve increased communication between all members of the multidisciplinary team and increased involvement of the GDP, thereby ensuring that dental care continues to evolve concurrently with new methods of RT delivery.

Diagnóstico de sífilis em lesões orais: estudo comparativo utilizando-se as técnicas histoquímica e imuno-histoquímica / Diagnosis of syphilis in oral lesions: a comparative study using techniques of histochemistry and immunohistochemistry

A sífilis é uma doença infecciosa, cujo agente etiológico é o Treponema pallidum. Pode ser transmitida sexualmente ou verticalmente, via placenta. Seus estágios variam entre sífilis primária, sífilis secundária, sífilis latente e sífilis congênita. Dentre os diagnósticos mais eficazes, encontram-se os testes sorológicos, porém os falsos positivos e falsos negativos no estágio primário levam à procura de uma forma mais eficaz de se determinar, precocemente, a doença. Além disso, por várias razões, nem sempre o profissional clínico suspeita das lesões presentes na mucosa oral, cogitando de outras hipóteses diagnósticas. O objetivo deste trabalho foi avaliar imuno-histoquimicamente e histoquimicamente lesões bucais biopsiadas cujo aspecto histológico levou à suspeita de sífilis, buscando identificar os microorganismos, bem como correlacionar o quadro sorológico quando positivo. Para o estudo foram incluídas 34 lesões suspeitas de sífilis, que foram submetidas à reação imuno-histoquímica com o anticorpo anti-treponema e técnica histoquímica de coloração pela prata. Dos 34 casos avaliados 13 foram positivos para o anticorpo anti-treponema, todos posteriormente diagnosticados como sífilis secundária, com positividade sorológica, exceto por um caso em que a sorologia não foi realizada. Quando se comparou os métodos de diagnóstico, a técnica de coloração por prata obteve sensibilidade de 46,15% e a de imuno-histoquímica foi de 92,3%. Os aspectos histológicos variaram em um grande número de achados, dentre eles: intensa exocitose, infiltrado inflamatório predominantemente plasmocitário (justaepitelial e perivascular), áreas de ulceração, epitélio paraqueratinizado, edema, espongiose e hiperplasia epitelial. A marcação imuno-histoquímica dos treponemas foi, principalmente, epitelial (61,5%) e esse método se mostrou um meio de diagnóstico rápido, simples e eficiente no diagnóstico de lesões orais de Sífilis.

Syphilis is an infectious disease, whose etiologic agent is Treponema pallidum. It can be transmitted sexually or vertically via the placenta. Its stages include primary syphilis, secondary syphilis, latent syphilis and congenital syphilis. Among the diagnoses most effective are the serological tests, but false positives and false negatives in the primary stage lead to demand for a more effective way to determine the disease earlier. In addition, for various reasons, not always the professional clinical suspicion of lesions present in the oral mucosa, thinking in other possible diagnoses. The objective of this study was to identify microorganisms and set the best way forward to a diagnostic framework confirmed positive serology. The results for syphilis lesions in the oral mucosa corresponded to 13 cases, all of secondary iinjuries,with positive serology for syphilis and in only one of them serology had not been held. In a comparison of diagnostic methods, the technique of silver staining achieved sensitivity of 46.15% and immunohistochemistry was 92.3%. The histological features varied in a large number of findings, including: intense exocytosis, inflammatory infiltrate, predominantly plasmacytic (banda-like and infiltrate perivascular), areas of ulceration, parakeratinized epithelium, edema, spongiosis and epithelial hyperplasia. The immunohistochemical staining of treponemes was mainly epithelial (61.5%) and this method was a rapid, simple and efficient means in the diagnosis of oral lesions of syphilis.

An image processing software applied to oral pathology.

This study presents the development and evaluation of an image processing software for computer-assisted cellular structure counting. The proposed software consists of a set of processing and analytical tools which allows its use in several applications of cell and cellular structure counting. A particular application in AgNOR quantitative analysis is presented. The knowledge obtained from experienced pathologists has been codified in a sequence of processing steps in order to allow automatic estimation of the mean number of AgNORs per cell in ameloblastomas. The performance of the presented software in such application was verified by comparing the data provided by visual analysis, by two observers previously calibrated and under supervision of two experienced specialists (Group 1) and by the computer program (Group 2). No statistical difference was observed (p<0.05) between the two groups. The use of the proposed method in AgNOR applications permitted attainment of accurate and precise data without the difficulties frequently found in the traditional visual analysis method (time, training and subjectivity). The developed software is an interesting tool as an aid in the study (estimation of the number of cells and cellular structures) of malignant and benign neoplasms.

Frecuencia de diagnósticos histopatológicos en un periodo de 20 años (1989-2008) / Histopathological diagnosis frequency during 20 years (1989-2008)

Presentar datos sobre el diagnóstico histopatológico que se realizó en el Departamento de Patología Oral de la Facultad de Odontología de la Universidad Autónoma de Nuevo León, Monterrey, México, durante el periodo 1989 a 2008. De 2 183 biopsias, las lesiones de tejido óseo comprendieron 637 casos (29,2 por ciento) y las de tejido blando sumaron 1 529 (70,0 por ciento), de tejido dental se procesaron 17 muestras (0,8 por ciento). Los diagnósticos más frecuentes para tejido óseo fueron: granuloma periapical, quiste periapical, quiste dentígero y queratoquiste odontogénico (tumor odontogénico queratoquístico). Los diagnósticos más frecuentes de tejido blando fueron: fibroma, granuloma piógeno, mucocele, carcinoma epidermoide y papiloma. En el maxilar se presentaron 292 casos, en la mandíbula 258 y en 87 muestras no se especificó el maxilar de donde se obtuvo la biopsia. En el tejido blando, de encía se obtuvieron 505 biopsias; labio inferior 164, tejido blando sin especificar 157, lengua 147, mucosa alveolar 146, paladar duro 89 y otras áreas presentaron 321 muestras. De pacientes femeninos fueron 1 370 muestras (62,8 por ciento) y los masculinos con 796 biopsias (36,4 por ciento). Hubo coincidencia entre el diagnóstico clínico con el histopatológico de 1 482 casos (67,9 por ciento), los casos no coincidentes fueron 172 (7,9 por ciento) y 529 casos (24,2 por ciento) donde no se proporcionó diagnóstico clínico, lo cual es aceptable de acuerdo a estudios similares, pero puede ser mejorado substancialmente a través de educación continua(AU)

To submit data on the histopathological diagnosis made in the Oral Pathology Department of Stomatology of Autonomous University in Nuevo León, Monterrey, Mexico during from 1989 to 2008. From 2 183 biopsies, bone tissue lesions accounted for 637 cases (29.2 percent) and those that soft tissue summarized 1 529 (70 percent), from dental tissue 17 samples (0.8 percent) were processed. For bone tissue the more frequent diagnoses were: periapical granulomas, periapical cyst, dentigerous cyst and odontogenic keratocyst (keratogenic odontogenic tumor). The more frequent diagnoses for the soft tissue are: fibroma, pyogenic granulomas, mucocele, epidermoid carcinoma and papiloma. In maxillary there were 292 cases, in maxilla 258 and in 87 samples there was no specification from which maxillary was obtained the biopsy. In soft tissue, from gum 505 biopsies were obtained, from inferior lip 164, from soft tissue 157 were not specified, tongue 147, alveolar mucosa 146, hard palate 89 and other areas underwent 321 biopsies. From female patients 1 370 biopsies were obtained (62.8 percent) and from male patients 796 biopsies (36.4 percent). There was a coincidence of 1 482 cases (67.9 percent) between the clinical diagnosis and the histopathological one, the no coincident ones summarized 172 (7.9 percent) and 529 cases (24.2 percent) where there wasn't clinical diagnosis being acceptable according to similar studies, but could be significantly improved by a continuous education(AU)

Análise da expressão de receptores hormonais (androgênio, estrogênio alfa e beta) e da aromatase em carcinomas epidermóides de boca (CE) / Analysis of the expression of hormonal receptors (androgen, estrogen alpha and beta) and aromatase enzime in oral squamous cell carcinoma (OSCC)

Das diversas neoplasias denominadas câncer de boca, mais de 95% tem o diagnóstico de carcinoma epidermóide (CE). O carcinoma epidermóide apresenta etiologia e patogênese complexas e não totalmente compreendidas determinando altos índices de morbidade e mortalidade. Por isso crescentes esforços têm sido empregados para a melhor compreensão dos eventos celulares, da susceptibilidade genética e dos fatores de risco que atuando em conjunto dão origem e atuam na progressão do carcinoma epidermóide de boca. Buscando novas facetas da carcinogênese oral e baseando-se no papel pró-carcinogênico que os hormônios esteróides desempenham nas neoplasias dos órgãos reprodutivos, alguns estudos passaram a avaliar o papel desses hormônios na patogênese e progressão do CE. O propósito deste trabalho foi avaliar a presença dos receptores de androgênio, estrogênio (alfa e beta) e da enzima aromatase em carcinomas epidermóides de boca (CE), através das técnicas de imuno-histoquímica, western-blotting e imunofluorescência, e comparar, com base no gênero (masculino e feminino), os resultados encontrados. Da amostra de CE utilizada, 30 eram pertencentes a pacientes do gênero feminino e 30 do masculino...

Oral squamous cell carcinoma (OSCC) is the main type of oral cancer presenting complex and not completely understood pathogenesis. OSCC implies quite significant mortality and morbidity rates and in spite of the vast amount of research and the advances in the field of oncology and surgery, the overall survival remains largely unchanged. Therefore, the identification of new pathways involved in the mechanisms of carcinogenesis can bring knowledge to the control and advent of new treatments. The role of androgens and estrogens in several endocrine-related malignancies is well known. The successful use of these hormones antagonists in the treatment of these neoplasms has prompted researches to investigate the presence of hormones receptors in other tissues and tumor types. The aim of this study was to asses through immunohistochemistry, western blot and immunoflorescence assays the expression, genderrelated, of androgen, estrogen alpha and beta receptors and aromatase enzyme in cases of OSSC. A total of 60 cases of OSCC (30 from males and 30 from females) were retrieved and submitted to immunohistochemical assay. Two OSCC cell lines were used for western blot and immunoflurescence techniques...

Avaliação da hipermetilação em biomarcadores na progressão do câncer de boca / Evaluation of biomarkers hypermethylation in oral cancer progression

A hipermatilação aberrante de regiões gênicas promotoras foi recentemente sugerida como meio de detecção do carcinoma epidermóide de cabeça e pescoço. Neste estudo nós avaliamos o status de metilação de um painel de 7 genes já relatados na literatura e sua correlação com lesões orais malignas e cancerizáveis de boca. Inicialmente, nós utilizamos amostras de enxágues salivares de pacientes com lesões benignas, displásicas e malignas para determinar a hipermetilação em regiões gênicas promotoras em pacientes de alto risco. Uma avaliação clínica de risco foi realizada e correlacionada com o diagnóstico histológico e status dos biomarcadores. A partir dos resultados analisados nas lesões intraorais, o gene DCC, que obteve a melhor performance entre os 7 genes, foi testado em lesões de queilite actínica e carcinoma epidermoide de lábio. Foram realizadas reações de PCR específica para metilação, quantitativa (Q-MSP) para os 7 genes (CCNA1, MGMT, MINT31, TIMP3, P16, DAPK, DCC) em enxágues salivares de 191 pacientes com lesões intraorais, e do gene DCC em 39 lesões de lábio. Análises de regressão logística e curva ROC foram utilizadas para avaliar a associação do status de metilação com o diagnóstico histológico e para estimar a acurácia da classificação respectivamente, nas amostras de enxágue salivar. Na análise multivariada, o diagnóstico displasia/ câncer foi associado com a idade (OR=1.3, 95% CI= (1.01-1.6, p=0.014) e a metilação do painel de 7 genes (OR=2.2, 95% CI=(1.34.0), p=0.006); a metilação do DCC também foi fortemente associada (OR=3.3, 95% CI=(1.7-6.6), p=0.004). Na análise multivariada, o diagnóstico histológico foi independentemente associado com a metilação do painel de 7 genes (OR=2.0, 95% CI=(1.1-3.6), p=0.027) ou do DCC (OR=2.8, 95% CI=(1.4-5.7), p=0.004)...

Aberrant promoter hypermethylation has been recently proposed as a means for detection of HNSCC in salivary rinses. Here we evaluate the ability of a previously reported 7-gene methylation panel status to correlate with premalignant and malignant oral lesions. We used a large prospective cohort of salivary rinses obtained from patients with benign, dysplastic, and cancer diagnoses to determine promoter hypermethylation in high-risk patients. Clinical risk assessment was performed and correlated with histological diagnosis and biomarker status. Also, a cohort of lip lesions was selected and methylation status of DCC gene was correlated with histology. Quantitative methylation-specific PCR (Q-MSP) was performed analyzing methylation status of 7 genes (CCNA1, MGMT, MINT31, TIMP3, P16, DAPK, DCC) in salivary rinses of 191 patients with oral lesion and 39 lip lesions. Logistic regression and receiver operating characteristic (ROC) analyses were used to examine the association of methylation status with histologic diagnosis and to estimate classification accuracy, respectively. On univariate analysis, diagnosis of dysplasia/cancer was associated with age (OR=1.3, 95% CI= (1.01-1.6, p=0.014) and 7-gene panel methylation (OR=2.2, 95% CI=(1.34.0), p=0.006); DCC methylation was also strongly associated (OR=3.3, 95% CI=(1.7-6.6), p=0.004). On multivariable modeling, histologic diagnosis was independently associated with 7 gene panel (OR=2.0, 95% CI=(1.1-3.6), p=0.027) or DCC (OR=2.8, 95% CI=(1.4- 5.7), p=0.004) methylation...

Análise da via do Akt em neoplasias benignas e malignas de glândulas salivares / Analisys of Akt pathway in benign and malignant salivary galnd tumours

A proteína Akt modula a função de numerosos substratos envolvidos na regulação da sobrevivência celular, progressão do ciclo celular e crescimento celular. Estudos prévios realizados em nosso laboratório demonstraram a superexpressão de Akt em adenoma pleomórfico, mioepitelioma e carcinoma adenóide cístico. O objetivo deste estudo foi analisar a via da proteína Akt através da avaliação da expressão das proteínas NFkB e PTEN em neoplasias benignas e malignas de glândulas salivares através das técnicas de imunohistoquímica, western blotting e imunofluorescência, e a possível interação protéica direta entre p-Akt/Mdm2 e p-Akt/PTEN em linhagem de carcinoma adenóide cístico. A superexpressão nuclear na proteína PTEN foi encontrada nas duas neoplasias malignas estudadas. Além disso, não foi observada interação direta entre as proteínas p-Akt/Mdm2 e p-Akt/PTEN, as quais apresentam localização nuclear em neoplasias de glândulas salivares.

The Akt protein modulates the function of numerous substrates involved in the regulation of cell survival, cell cycle progression and cell growth. Previous studies from our laboratories showed overexpression of Akt and Mdm2 followed by the lack of p53 expression in pleomorphic adenoma, myoepithelioma and adenoid cystic carcinoma. The aim of this study was to analyze the Akt pathway through evaluation of expression of NFkB and PTEN proteins in pleomorphic adenoma, carcinoma ex pleomophic adenoma and adenoid cystic carcinoma by western blotting, immunofluorescence and immunohistochemical techniques, and we have intended to analyse a possible direct interaction between p-Akt/Mdm2 and p-Akt/ PTEN protein in salivary gland tumours. Overexpression of nuclear PTEN was present in both carcinomas studied. In addition, there was no direct interaction between p-Akt/Mdm2 and p-Akt/ PTEN protein, which presents a nuclear localization in salivary gland tumours.

Manifestações bucais em pacientes com hipogamaglobulinemia / Oral manifestations in patients with hypogammaglobulinemia

A hipogamaglobulinemia é uma alteração da imunidade humoral caracterizada por baixos níveis séricos de anticorpos podendo ter causas primárias e secundárias. Estes pacientes apresentam uma susceptibilidade a infecções bacterianas de repetição ou crônicas, principalmente do trato respiratório. Além disso, há alta prevalência de doenças gastrointestinais infecciosas e inflamatórias, hepatite C, doenças auto-imunes, doenças linfoproliferativas e granulomatosas. Ainda que a doença seja conhecida desde 1954 há poucos trabalhos na literatura sobre manifestações bucais nestes pacientes. Alguns estudos sugerem uma maior prevalência de lesões liquenóides, doença periodontal, candidíase pseudomembranosa, úlcera aftosa recorrente e hipoplasia de esmalte. Desta forma, o objetivo deste trabalho foi avaliar a prevalência das manifestações e alterações bucais, e caracterizar a saúde bucal de pacientes com hipogamaglobulinemias e correlacioná-las com o estado imunológico do paciente, comparativamente a um grupo de pacientes saudáveis. Para tanto avaliamos 100 pacientes com hipogamaglobulinemias atendidos no Ambulatório de Imunologia e Alergia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e 93 pacientes normorreativos da Clínica Odontológica da Faculdade de Odontologia da Universidade de São Paulo, sendo realizado exame clínico bucal, anamnese e compilação de exames laboratoriais recentes

Do total de pacientes com hipogamaglobulinemias, 59 pacientes apresentaram alguma alteração bucal, sendo as mais frequentes lesões de cárie (21), hipoplasia de esmalte (21), gengivite (18), periodontite (8), boca seca (6), língua geográfica (5) e úlcera aftosa recorrente (2). Vinte e sete pacientes apresentaram queixas de úlcera aftosa recorrente com frequência. Dos 93 pacientes do grupo controle, 84 (90,3%) apresentaram alguma alteração bucal, sendo as mais frequentes lesões de cárie (66), gengivite (31), periodontite (44) e candidíase (3). Dezoito pacientes apresentaram queixas de úlcera aftosa recorrente com freqüência. Concluímos que os pacientes com hipogamaglobulinemias, apesar de apresentarem diminuição das imunoglobulinas do sangue, e alguns pacientes apresentarem uma diminuição de células da imunidade celular, não se encontrou relação positiva entre a incidência de cárie e IgA, doença periodontal e IgA e doença periodontal e CD4

The hypogammaglobulinemia is an alteration in humoral immunity characterized by low levels of antibodies may have primary and secondary causes. These patients have a susceptibility to recurrent bacterial infections or chronic diseases, mainly respiratory tract. Moreover, there is a high prevalence of infectious and inflammatory gastrointestinal diseases, hepatitis C, autoimmune diseases, lymphoproliferative diseases and granulomatous disease. Although the disease is known since 1954 there are few available studies on oral manifestations in these patients. Some studies suggest a higher prevalence of lichenoid lesions, periodontal disease, pseudomembranous candidiasis, recurrent aphthous ulcer and enamel hypoplasia. Thus, the objective was to assess the prevalence of manifestations diseases and to characterize the oral health of patients with hypogammaglobulinemia and correlate with the immune status, compared with healthy patients. For that evaluated 100 patients with hypogammaglobulinemia in the Outpatient Immunology and Allergy Hospital of the Faculty of Medicine, University of São Paulo and 93 healthy patients of School of Dentistry, University of São Paulo, and was conducted oral clinical examination, medical history and compilation of recent laboratory tests. Of all patients with hypogammaglobulinemia, 59 patients showed abnormalities of the mouth, with 21 patients exhibited caries, 21 enamel hypoplasia, 18 gingivitis, 8 periodontitis, 6 dry mouth, 5 geographic tongue and 2 recurrent aphthous ulcer

Twenty-seven patients complained of frequent recurrent aphthous ulcer. Of the 93 control group patients, 84 (90.3%) showed abnormalities, being the most frequent caries (66), gingivitis (31), periodontitis (44) and candidiasis (3). Eighteen patients complained of recurrent aphthous ulcers frequently. We conclude that patients with hypogammaglobulinemia, despite showing decreased blood immunoglobulins, and some patients had a decrease of cells in cellular immunity, we did not find a positive relationship between the incidence of caries and IgA, IgA and periodontal disease and periodontal disease and CD4

Manifestaciones orales en la diabetes mellitus tipo 2 / No disponible

No disponible

Análise quantitativa das células CD4 e sua importância no diagnóstico de lesões orais em pacientes HIV positivos / Quantitative analysis of the cells CD4 and its importance in the diagnosis of verbal injuries in positive patients HIV

As manifestações bucais da infecção pelo HIV são, muitas vezes, os primeiros sinais clínicos da doença. Estas lesões também podem funcionar como sinalizadores e sentinelas do curso e progressão da infecção pelo HIV e AIDS. O objetivo desse trabalho foi avaliar a prevalência das lesões orais em pacientes HIV positivos, relacionando-as com a contagem de células CD4+ e a carga viral em pacientes do Hospital de Doenças Infectocontagiosas Gizelda Trigueiro em Natal-RN. Foram avaliados 121 pacientes, onde após exame clínico da cavidade oral, estes eram conduzidos à coleta de sangue periférico para contagem dos linfócitos CD4+. Observamos uma prevalência de 25,6%, de lesões orais, totalizando 31 casos. A candidíase foi a lesão mais comum, seguida da leucoplasia pilosa, eritema gengival linear, herpes labial, periodontite ulcero-necrosante e gengivite ulcero-necrosante. A contagem média das células CD4+ dos pacientes portadores de lesão foi de 250 células/mm3. Não observamos relação entre a presença de lesões e a carga viral dos indivíduos (AU).

The oral manifestations due to HIV infection are, a lot of times, the first clinical signs of the disease. These injuries may also function as beepers and sentries of the curse and progression of the HIV infection and AIDS. The objective of this work was to evaluate the prevalence of the oral injuries in HIV positive patients, relating them with the CD4+ cells counting and the viral load in patients from the Hospital of Infected contagious Gizelda Trigueiro in Natal-RN. One hundred and one patients were evaluated, where after the clinical exam of the oral cavity, these ones were conducted to the peripheral blood collection for the counting of CD4+ lymphocytes. We observed a prevalence of 25,6%, that is, 31 cases. The Oral Candidiasis was the most commum injure, followed by Oral Hairy Leukoplakia, linear gingival erytema, lips herpes, gingivitis and periodontitis - HIV. The average counting of cells CD4+ of the injury carrying patients was of 250 cells/mm3. We did not observe relation between the presence of injuries and the viral load of the individuals (AU).