Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.671
Filtrar
1.
J Laryngol Otol ; 135(10): 869-873, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34348805

RESUMO

BACKGROUND: The two-week-wait head and neck cancer referral pathway was introduced by the Department of Health, and refined through National Institute for Health and Care Excellence guidelines which were updated in 2015. METHODS: A retrospective study was conducted of two-week-wait referrals to out-patient ENT from January to June 2018. The analysis included demographics, referral symptoms according to National Institute for Health and Care Excellence 2015 guidelines, cancer pick-up rates and positive predictive values. RESULTS: A total of 1107 patients were referred for suspected head and neck cancer over six months, with 6 per cent diagnosed with cancer. Neck lump, persistent hoarseness and throat pain were the most common presenting symptoms. Neck lump had the highest positive predictive value, followed by oral swelling. Oral bleeding and persistent unilateral sore throat showed significant positive predictive values. Investigation for metastatic head and neck cancer of an unknown primary or the involvement of other multidisciplinary teams could hinder the achievement of a 62-day treatment target. CONCLUSION: The cancer pick-up rate from two-week-wait referrals is only 1.5 times higher than routine referrals. The 'red flag' symptoms given in the 2015 National Institute for Health and Care Excellence update would benefit from further review.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Rouquidão/diagnóstico , Neoplasias Primárias Desconhecidas/diagnóstico , Faringite/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer/normas , Edema/diagnóstico , Edema/etiologia , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/patologia , Hemorragia/diagnóstico , Hemorragia/etiologia , Rouquidão/epidemiologia , Humanos , Comunicação Interdisciplinar , Masculino , Pessoa de Meia-Idade , Boca/patologia , Neoplasias Primárias Desconhecidas/epidemiologia , Otolaringologia/normas , Otolaringologia/estatística & dados numéricos , Faringite/epidemiologia , Valor Preditivo dos Testes , Encaminhamento e Consulta , Estudos Retrospectivos , Centros de Atenção Terciária , Fatores de Tempo , Listas de Espera
2.
Cochrane Database Syst Rev ; 7: CD010276, 2021 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-34282854

RESUMO

BACKGROUND: Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES: Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE: to estimate the relative accuracy of the different index tests. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA: We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS: This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Bucais/diagnóstico , Viés , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/patologia , Corantes , Detecção Precoce de Câncer , Humanos , Luz , Neoplasias Labiais/diagnóstico , Neoplasias Labiais/patologia , Boca/patologia , Neoplasias Bucais/patologia , Saliva/química , Sensibilidade e Especificidade
4.
Int J Mol Sci ; 22(11)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071720

RESUMO

The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. In contrast to facial skin, however, the oral mucosa rarely exhibits itch responses. Like the gut, the oral cavity performs mechanical and chemical digestion. Therefore, the oral mucosa needs to be insensitive, to some degree, in order to endure noxious irritation. Persistent pain from the oral mucosa is often due to ulcers, involving both tissue injury and infection. Trigeminal nerve injury and trigeminal neuralgia produce intractable pain in the orofacial skin and the oral mucosa, through mechanisms distinct from those seen in the spinal area, which is particularly difficult to predict or treat. The diagnosis and treatment of idiopathic chronic pain, such as atypical odontalgia (idiopathic painful trigeminal neuropathy or post-traumatic trigeminal neuropathy) and burning mouth syndrome, remain especially challenging. The central integration of gustatory inputs might modulate chronic oral and facial pain. A lack of pain in chronic inflammation inside the oral cavity, such as chronic periodontitis, involves the specialized functioning of oral bacteria. A more detailed understanding of the unique neurobiology of pain from the orofacial skin and the oral mucosa should help us develop novel methods for better treating persistent orofacial pain.


Assuntos
Dor Crônica , Mucosa Bucal , Boca , Animais , Face/fisiologia , Dor Facial , Humanos , Camundongos , Boca/patologia , Boca/fisiologia , Mucosa Bucal/patologia , Mucosa Bucal/fisiologia , Neuralgia , Periodontite , Pele , Fenômenos Fisiológicos da Pele , Traumatismos do Nervo Trigêmeo , Neuralgia do Trigêmeo
5.
Transl Res ; 236: 72-86, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33992825

RESUMO

There is significant interest in understanding the cellular mechanisms responsible for expedited healing response in various oral tissues and how they are impacted by systemic diseases. Depending upon the types of oral tissue, wound healing may occur by predominantly re-eptihelialization, by re-epithelialization with substantial new connective tissue formation, or by a a combination of both plus new bone formation. As a result, the cells involved differ and are impacted by systemic diaseses in various ways. Diabetes mellitus is a prevalent metabolic disorder that impairs barrier function and healing responses throughout the human body. In the oral cavity, diabetes is a known risk factor for exacerbated periodontal disease and delayed wound healing, which includes both soft and hard tissue components. Here, we review the mechanisms of diabetic oral wound healing, particularly on impaired keratinocyte proliferation and migration, altered level of inflammation, and reduced formation of new connective tissue and bone. In particular, diabetes inhibits the expression of mitogenic growth factors whereas that of pro-inflammatory cytokines is elevated through epigenetic mechanisms. Moreover, hyperglycemia and oxidative stress induced by diabetes prevents the expansion of mesengenic cells that are involved in both soft and hard tissue oral wounds. A better understanding of how diabetes influences the healing processes is crucial for the prevention and treatment of diabetes-associated oral complications.


Assuntos
Diabetes Mellitus/patologia , Boca/patologia , Cicatrização , Animais , Comorbidade , Humanos , Reepitelização , Extração Dentária , Cicatrização/genética
6.
J Laryngol Otol ; 135(6): 473-485, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33988100

RESUMO

OBJECTIVE: This review assesses regenerative medicine of the upper aerodigestive tract during the first two decades of the twenty-first century, focusing on end-stage fibrosis and tissue loss in the upper airways, salivary system, oropharynx and tongue. METHOD: PubMed, Embase, Google Scholar, Cochrane Library, Medline and clinicaltrials.org were searched from 2000 to 2019. The keywords used were: bioengineering, regenerative medicine, tissue engineering, cell therapy, regenerative surgery, upper aerodigestive tract, pharynx, oropharynx, larynx, trachea, vocal cord, tongue and salivary glands. Original studies were subcategorised by anatomical region. Original human reports were further analysed. Articles on periodontology, ear, nose and maxillofacial disorders, and cancer immunotherapy were excluded. RESULTS: Of 716 relevant publications, 471 were original studies. There were 18 human studies included, within which 8 reported airway replacements, 5 concerned vocal fold regeneration and 3 concerned salivary gland regeneration. Techniques included cell transplantation, injection of biofactors, bioscaffolding and bioengineered laryngeal structures. CONCLUSION: Moderate experimental success was identified in the restoration of upper airway, vocal fold and salivary gland function. This review suggests that a shift in regenerative medicine research focus is required toward pathology with a higher disease burden.


Assuntos
Laringe/patologia , Boca/patologia , Nariz/patologia , Faringe/patologia , Medicina Regenerativa , Engenharia Tecidual , Traqueia/patologia , Fibrose/terapia , Humanos , Índice de Gravidade de Doença
7.
Viruses ; 13(4)2021 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-33920978

RESUMO

The oral cavity is often the first site where viruses interact with the human body. The oral epithelium is a major site of viral entry, replication and spread to other cell types, where chronic infection can be established. In addition, saliva has been shown as a primary route of person-to-person transmission for many viruses. From a clinical perspective, viral infection can lead to several oral manifestations, ranging from common intraoral lesions to tumors. Despite the clinical and biological relevance of initial oral infection, little is known about the mechanism of regulation of the viral life cycle in the oral cavity. Several viruses utilize host epigenetic machinery to promote their own life cycle. Importantly, viral hijacking of host chromatin-modifying enzymes can also lead to the dysregulation of host factors and in the case of oncogenic viruses may ultimately play a role in promoting tumorigenesis. Given the known roles of epigenetic regulation of viral infection, epigenetic-targeted antiviral therapy has been recently explored as a therapeutic option for chronic viral infection. In this review, we highlight three herpesviruses with known roles in oral infection, including herpes simplex virus type 1, Epstein-Barr virus and Kaposi's sarcoma-associated herpesvirus. We focus on the respective oral clinical manifestations of these viruses and their epigenetic regulation, with a specific emphasis on the viral life cycle in the oral epithelium.


Assuntos
Epigênese Genética , Regulação Viral da Expressão Gênica , Herpesviridae/genética , Doenças da Boca/virologia , Saliva/virologia , Replicação Viral/genética , Linhagem Celular , Herpesviridae/classificação , Herpesviridae/patogenicidade , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/patogenicidade , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/patogenicidade , Herpesvirus Humano 8/genética , Herpesvirus Humano 8/patogenicidade , Humanos , Boca/patologia , Boca/virologia , Internalização do Vírus
8.
Viruses ; 13(4)2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33810374

RESUMO

This study is focused on the epidemiological characteristics and biomolecular mechanisms that lead to the development of precancerous and cancerous conditions of oral lesions related to Human Papilloma Virus (HPV) infections. Current evidence from the literature demonstrates the role of HPV in potentially malignant oral disorders. Therefore, the underlying biomolecular processes can give arise, or contribute to, benign lesions as well as to oral carcinogenesis.


Assuntos
Carcinogênese/genética , Neoplasias Bucais/virologia , Papillomaviridae/genética , Papillomaviridae/patogenicidade , Infecções por Papillomavirus/complicações , Humanos , Microbiota , Boca/patologia , Boca/virologia , Neoplasias Bucais/genética
9.
Head Neck ; 43(7): 2193-2201, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33835633

RESUMO

BACKGROUND: Levels of circulating hybrid cells (CHCs), a newly identified circulating tumor cell (CTC), correlate with disease stage and progression in cancer. We investigated their utility to risk-stratify patients with clinically N0 (cN0) oral cavity squamous cell carcinoma (OCSCC), and to identify patients with occult cervical lymph node metastases (pN+). METHODS: We analyzed peripheral blood samples for CHCs with co-expression of cytokeratin (tumor) and CD45 (leukocyte) from 22 patients with cN0 OCSCC using immunofluorescence microscopy, then correlated levels with pathologic lymph node status. RESULTS: CHC levels exceeded CTCs and correlated with the presence of both clinically overt (p = 0.002) and occult nodal metastases (p = 0.006). CONCLUSIONS: For evaluated cN0 OCSCC patients, those with cN0 → pN+ status harbored elevated CHC levels compared to patients without occult disease. Our findings highlight a promising blood-based biologic assay with potential utility to determine the necessity of surgical neck dissection for staging and treatment.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Humanos , Células Híbridas/patologia , Linfonodos/patologia , Linfonodos/cirurgia , Boca/patologia , Esvaziamento Cervical , Estadiamento de Neoplasias , Estudos Retrospectivos
10.
Laryngoscope ; 131(10): 2254-2261, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33797083

RESUMO

OBJECTIVE: To assess the oncological outcome and prognostic factors for primary Oral Squamous Cell Cancer (OSCC) staged as per AJCC 8th pTNM, and treated by the contemporary standard of primary surgery and pathology directed adjuvant radiation-chemoradiation. METHODS: A single institution cohort from a tertiary care academic institution in North India. Case inclusion 2013 to 2016; n = 218, median follow-up 35 months. All patients were restaged as per the AJCC 8th pTNM classification. Analysis for Overall Survival (OS), Disease-free Survival(DFS), and factors impacting outcome (Cox proportionate model Multivariate analysis). RESULTS: AJCC pTNM 7th to 8th edition conversion led to upstaging in 16.5%. Stage-II demonstrated greatest stage migration and apparent improvement in OS and DFS (P < .09). Discordance was noted between the presurgical (clinico-radiologic) and postsurgical (pathological) nodal status in 40.3% (88/218; 54 pathologically upstaged;34 downstaged). Pathological downstaging was particularly significant with advanced stage Gingivo-Buccal Cancers (25/73-34.7%). Stage-I-II early cancers had 3 years. OS-86.7% and DFS-78.8%; Stage-III-IV advanced cancers had 3 years. OS-56.7% and DFS-46.6%. Multivariate analysis identified poorer OS and DFS for age < 40 years (HR-1.8; 2.0), skin involvement (HR-2.1; 2.6) and pN+ status (HR-2.4; 3.5). Bone involvement did not compromise survival in this surgically treated set of patients. CONCLUSION: Age < 45 is newly identified as significantly compromising DFS and OS in Oral Cancer. Established factors of skin involvement and pN+ are confirmed as impacting DFS-OS. An apparent improvement in survival in Stage II Cancers is noted as consequent to adoption of AJCC 8th edition staging. LEVEL OF EVIDENCE: 2 (OCEBM 2011-Inception Cohort Study for Prognosis) Laryngoscope, 131:2254-2261, 2021.


Assuntos
Neoplasias Bucais/mortalidade , Recidiva Local de Neoplasia/epidemiologia , Procedimentos Cirúrgicos Bucais/estatística & dados numéricos , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Boca/patologia , Boca/cirurgia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Centros de Atenção Terciária/estatística & dados numéricos , Adulto Jovem
11.
Top Magn Reson Imaging ; 30(2): 79-83, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33828059

RESUMO

ABSTRACT: Understanding oral cavity and oropharyngeal anatomy is important to identify various pathologies that may afflict them. This article reviews normal magnetic resonance imaging anatomy of these vital spaces and structures, with special attention to the complex musculature, mucosal surfaces, relevant osseous structures, salivary glands, and nerves. Anatomic awareness of these spaces and critical potential pathways for perineural tumoral spread are important to recognize to improve diagnostic evaluation and treatment.


Assuntos
Imageamento por Ressonância Magnética/métodos , Boca/diagnóstico por imagem , Orofaringe/diagnóstico por imagem , Humanos , Boca/patologia , Orofaringe/patologia
12.
J Clin Pathol ; 74(8): 483-490, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33858937

RESUMO

Giant cell granulomas are enigmatic lesions of the oral cavity characterised by a peculiar combined proliferation of mononuclear and multinucleated giant cells in a mesenchymal stromal background. Central and peripheral giant cell granulomas may have similar pathogenesis and histology but differ in their location and biological behaviour. It is important to differentiate them from other giant cell lesions that can occur in the oral cavity, such as giant cell tumour of the bone, aneurysmal bone cyst, brown tumour of hyperparathyroidism, and giant cell lesions of Ramon syndrome, Noonan syndrome, neurofibromatosis and Jaffe-Campanacci syndrome. A recent insight into their molecular genetics and pathogenesis, with identification of KRAS, FGFR1 and TRPV4 mutations, allows for better diagnostic differentiation and opens the door to the use of pathway inhibitors in the treatment of recurrent or dysmorphic lesions. In this review, we provide an updated summary of the clinical and pathological features of oral cavity giant cell granulomas that help with their precise diagnosis and management.


Assuntos
Proliferação de Células , Células Gigantes/patologia , Granuloma de Células Gigantes/patologia , Doenças da Boca/patologia , Boca/patologia , Adolescente , Adulto , Idoso , Biópsia , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Predisposição Genética para Doença , Células Gigantes/imunologia , Granuloma de Células Gigantes/genética , Granuloma de Células Gigantes/imunologia , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , Boca/imunologia , Doenças da Boca/genética , Doenças da Boca/imunologia , Mutação , Fenótipo , Valor Preditivo dos Testes , Adulto Jovem
13.
mBio ; 12(2)2021 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-33688011

RESUMO

"METH mouth" is a common consequence of chronic methamphetamine (METH) use, resulting in tooth decay and painful oral tissue inflammation that can progress to complete tooth loss. METH reduces the amount of saliva in the mouth, promoting bacterial growth, tooth decay, and oral tissue damage. This oral condition is worsened by METH users' compulsive behavior, including high rates of consumption of sugary drinks, recurrent tooth grinding, and a lack of frequent oral hygiene. Streptococcus mutans is a Gram-positive bacterium found in the oral cavity and associated with caries in humans. Hence, we developed a murine model of METH administration, sugar intake, and S. mutans infection to mimic METH mouth in humans and to investigate the impact of this drug on tooth colonization. We demonstrated that the combination of METH and sucrose stimulates S. mutans tooth adhesion, growth, and biofilm formation in vivo METH and sucrose increased the expression of S. mutans glycosyltransferases and lactic acid production. Moreover, METH contributes to the low environmental pH and S. mutans sucrose metabolism, providing a plausible mechanism for bacterium-mediated tooth decay. Daily oral rinse treatment with chlorhexidine significantly reduces tooth colonization in METH- and sucrose-treated mice. Furthermore, human saliva inhibits S. mutans colonization and biofilm formation after exposure to either sucrose or the combination of METH and sucrose. These findings suggest that METH might increase the risk of microbial dental disease in users, information that may help in the development of effective public health strategies to deal with this scourge in our society.IMPORTANCE "METH mouth" is characterized by severe tooth decay and gum disease, which often causes teeth to break or fall out. METH users are also prone to colonization by cariogenic bacteria such as Streptococcus mutans In addition, this oral condition is aggravated by METH users' compulsive behavior, including the consumption of beverages with high sugar content, recurrent tooth grinding, and a lack of frequent oral hygiene. We investigated the effects of METH and sugar consumption on S. mutans biofilm formation and tooth colonization. Using a murine model of METH administration, sucrose ingestion, and oral infection, we found that the combination of METH and sucrose increases S. mutans adhesion and biofilm formation on the teeth of C57BL/6 mice. However, daily chlorhexidine-based oral rinse treatment reduces S. mutans tooth colonization. Similarly, METH has been associated with dry mouth or hyposalivation in users. Hence, we assessed the impact of human saliva on biofilm formation and demonstrated that surface preconditioning with saliva substantially reduces S. mutans biofilm formation. Our results are significant because to our knowledge, this is the first basic science study focused on elucidating the fundamentals of METH mouth using a rodent model of prolonged drug injection and S. mutans oral infection. Our findings may have important translational implications for the development of treatments for the management of METH mouth and more effective preventive public health strategies that can be applied to provide effective dental care for METH users in prisons, drug treatment centers, and health clinics.


Assuntos
Açúcares da Dieta/administração & dosagem , Metanfetamina/farmacologia , Boca/efeitos dos fármacos , Boca/patologia , Streptococcus mutans/metabolismo , Animais , Aderência Bacteriana/efeitos dos fármacos , Biofilmes , Cárie Dentária , Modelos Animais de Doenças , Feminino , Infecções por Bactérias Gram-Positivas/microbiologia , Masculino , Metanfetamina/administração & dosagem , Camundongos , Camundongos Endogâmicos C57BL , Boca/microbiologia , Streptococcus mutans/efeitos dos fármacos , Streptococcus mutans/crescimento & desenvolvimento , Dente/efeitos dos fármacos , Dente/microbiologia
14.
Int. j. med. surg. sci. (Print) ; 8(1): 1-13, mar. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1151580

RESUMO

Objectives: Evaluate the agreement between the clinical and histopathological diagnosis of oral lesions in patients submitted to biopsies. Identify the most frequent oral lesions and their correlation with age, gender, and anatomical location. Methods: A retrospective study of 368 pathological examinations collected between 2008 and 2018, corresponding to biopsies performed at the Clínica Universitária Egas Moniz. A detailed analysis of the histopathological reports attached to the patients' files was made and the variables gender, age, anatomical site, clinical diagnosis, and histopathological diagnosis was evaluated. Results: The most affected gender was female (55%); the most common age group was 61-70 years old; The most biopsied anatomical location was the gum (23.9%); the five most common pathological entities were fibroma(26.4%),root cyst(8.7%),oral lichen planus(7.6%), hemangioma (6.3%) and oral leukoplakia (6.0%). On agreement, 74.5% of the cases were concordant and 25.5% discordant. The most concordant lesions were Radicular Cyst (90.6%), Traumatic Injury (87.5%), Hemangioma (82.6%), Fibroma (82.5%) and Mucocele (82.5%). Conclusion: this study proves a significant level of agreement between clinical and histopathological diagnosis in this particular area, consistently obtained in a ten years period of time.


Objetivos: Evaluar el nivel de acuerdo entre el diagnóstico clínico e histopatológico de lesiones orales en pacientes sometidos a biopsias. Identificar las lesiones orales más frecuentes y su correlación con la edad, el sexo y la ubicación anatómica. Métodos: Estudio retrospectivo de 368 exámenes patológicos recogidos entre 2008 y 2018, correspondientes a biopsias realizadas en la Clínica Universitária Egas Moniz. Se realizó un análisis detallado de los informes histopatológicos adjuntos a los archivos de los pacientes y se evaluaron las variables de género, edad, sitio anatómico, diagnóstico clínico y diagnóstico histopatológico. Resultados: El género más afectado fue femenino (55%); el grupo de edad más común fue de 61-70 años; La ubicación anatómica más biopsiada fue la encía (23,9%); las cinco entidades patológicas más comunes fueron fibroma (26,4%), quiste radicular (8,7%), liquen plano oral (7,6%), hemangioma (6,3%) y leucoplasia oral (6,0%). Según el grado de acuerdo, el 74,5% de los casos fueron concordantes y el 25,5% discordantes. Las lesiones más concordantes fueron Quiste Radicular (90,6%), Lesión Traumática (87,5%), Hemangioma (82,6%), Fibroma (82,5%) y Mucocele (82,5%). Conclusión: este estudio demuestra un nivel significativo de acuerdo entre el diagnóstico clínico e histopatológico en esta área en particular, obtenido consistentemente en un período de diez años de tiempo


Assuntos
Humanos , Masculino , Feminino , Biópsia , Diagnóstico Clínico , Boca/lesões , Boca/patologia , Estudos Retrospectivos , Distribuição por Sexo , Distribuição por Idade
15.
Biomed Res Int ; 2021: 6631757, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33623784

RESUMO

The human papilloma virus (HPV) is responsible for different pathological manifestations in humans. This agent gives rise to lesions of different types and in different areas of the organism, including the oral cavity. The aim of this study is to show which are the main diseases for which HPV is responsible and to bring to light some of the interceptive and therapeutic strategies. The analysis was conducted by consulting the major scientific databases with the aim of obtaining information on the characteristics of oral HPV and its management; furthermore, the literature was supported by some clinical cases proposed by the authors. The role of dentistry is essential in the early diagnosis of this type of pathologies and above all in knowing how to direct patients towards a path that can lead to patient management, especially in the event that these lesions have a malignant potential. Enhancing the knowledge and role of dentistry can lead to early diagnosis of this type of injury, intercepting a pathology that could have multiorgan implications.


Assuntos
Alphapapillomavirus , Neoplasias Bucais , Saúde Bucal , Infecções por Papillomavirus , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/patologia , Boca/virologia
16.
Acta otorrinolaringol. esp ; 72(1): 27-36, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200346

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Con el objetivo de conseguir la preservación funcional, una de las estrategias de tratamiento para los pacientes con carcinomas localmente avanzados de cabeza y cuello consiste en iniciar el tratamiento con quimioterapia (QT) de inducción y decidir la segunda maniobra terapéutica en función de la respuesta. El objetivo del presente estudio es evaluar la capacidad de preservación de órgano basada en esta estrategia terapéutica en pacientes con tumores de cavidad oral y orofaringe. MÉTODOS: Estudio retrospectivo de 246 pacientes con carcinomas de cavidad oral u orofaringe localmente avanzados (cT3-T4) tratados inicialmente con QT de inducción. RESULTADOS: Tras la QT de inducción el 28% de los pacientes consiguieron una respuesta completa de la localización primaria del tumor, el 43,1% una respuesta parcial superior al 50% y el 28,9% una reducción inferior al 50% o persistencia. Tras el tratamiento de QT de inducción 70 pacientes (28,5%) recibieron tratamiento quirúrgico y 176 (71,5%) radioterapia (RT) o quimiorradioterapia (QRT). Considerando a los pacientes tratados de forma no quirúrgica (n = 176), la preservación de órgano para los pacientes con una respuesta completa (n = 66) fue del 65,2%, para los pacientes con una respuesta parcial superior al 50% (n = 75) fue del 30,7% y para los pacientes con una respuesta inferior al 50% o persistencia (n = 35) fue del 14,3%. CONCLUSIÓN: La respuesta al tratamiento con QT de inducción cuenta con capacidad pronóstica en los pacientes con carcinomas localmente avanzados de cavidad oral y orofaringe. Los pacientes candidatos a tratamiento conservador con RT o QRT serían aquellos que consiguen una respuesta completa tras la administración del tratamiento de inducción


INTRODUCTION AND OBJECTIVES: With the goal of achieving functional preservation, one of the treatment strategies for patients with locally advanced squamous cell carcinomas of the head and neck is to initiate treatment with induction chemotherapy (CT) and decide the second therapeutic manoeuvre depending on the response. The objective of this study is to evaluate organ preservation capacity based on this therapeutic approach in patients with tumours of the oral cavity and oropharynx. METHODS: A retrospective study of 246 patients with locally advanced carcinomas of the oral cavity or oropharynx (cT3-T4) initially treated with induction CT. RESULTS: After induction CT 28% of patients achieved a complete response of the primary location of the tumour, 43.1% a partial response greater than 50%, and 28.9% a reduction less than 50% or persistence. After the induction CT treatment 70 patients (28.5%) underwent surgical treatment, and 176 (71.5%) radiotherapy (RT) or chemoradiotherapy (CRT). Considering the patients treated non-surgically (n = 176), organ preservation for patients with a complete response (n = 66) was 65.2%, for those patients with a partial response greater than 50% (n = 75) it was 30.7%, and for patients with a partial response less than 50% or persistence (n = 35) it was 14.3%. CONCLUSION: The response to treatment with induction CT has prognostic value in patients with locally advanced carcinomas of the oral cavity and oropharynx. Patients who are candidates for conservative treatment with RT or CRT would be those who achieve a complete response after induction treatment


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Preservação de Órgãos/métodos , Neoplasias Orofaríngeas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Quimioterapia de Indução/métodos , Neoplasias Hipofaríngeas/patologia , Neoplasias Orofaríngeas/cirurgia , Estudos Retrospectivos , Boca/patologia , Quimiorradioterapia , Imuno-Histoquímica , Fluoruracila/administração & dosagem , Progressão da Doença
17.
J Cutan Pathol ; 48(1): 24-33, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33410541

RESUMO

BACKGROUND: Oral focal mucinosis (OFM) is a rare benign condition of unknown etiology, considered the oral counterpart of cutaneous focal mucinosis. We report the clinicopathologic features of 21 cases of OFM in conjunction with a review of the literature. METHODS: Clinical data were collected from the records of five oral and maxillofacial pathology services. All cases were evaluated by hematoxylin and eosin staining, histochemistry, and immunohistochemistry (vimentin, S-100, α-SMA, CD34, and mast cell). RESULTS: The series comprised 14 females (66.7%) and seven males (33.3%), with a mean age of 48.2 ± 20.7 years (range: 8-77 years) and a 2:1 female-to-male ratio. Most of the lesions affected the gingiva (n = 6, 28.6%) and presented clinically as asymptomatic sessile or pedunculated nodules with fibrous or hyperplasic appearance. All cases were negative for S-100 protein, CD34, and α-SMA and positive for Alcian blue staining. Conservative surgical excision was the treatment in all cases, and there was only one recurrence. CONCLUSION: OFM is a rare benign disorder that is often clinically misdiagnosed as reactive lesions or benign proliferative processes. Dermatologists and pathologists should consider OFM in the differential diagnosis of soft tissue lesions in the oral cavity, mainly located in the gingiva.


Assuntos
Boca/patologia , Mucinoses/diagnóstico , Mucinoses/cirurgia , Neoplasias de Tecidos Moles/patologia , Actinas/metabolismo , Adulto , Idoso , Azul Alciano , Antígenos CD34/metabolismo , Conscientização , Estudos de Casos e Controles , Dermatologistas , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Humanos , Imuno-Histoquímica/métodos , Masculino , Pessoa de Meia-Idade , Mucinoses/etiologia , Mucinoses/metabolismo , Patologistas , Fotomicrografia/métodos , Recidiva , Proteínas S100/metabolismo , Coloração e Rotulagem/métodos
18.
Laryngoscope ; 131(7): E2266-E2274, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33459389

RESUMO

OBJECTIVE/HYPOTHESIS: With non-surgical treatment, T4b oral squamous cell carcinoma (OSCC) have an unacceptably poor prognosis. A subset of patients if selected wisely for surgery, can have significantly improved survival. The present study aims to explore the feasibility of radical resection and neoadjuvant chemotherapy (NACT) in the T4b OSCC and their impact on survival, along with the factors affecting it. STUDY DESIGN: This is a retrospective analysis of 302 consecutive patients with T4b OSCC presented at our institute between July 2015 and January 2016. METHODS: Three different treatment protocols were decided depending on the extent of the disease-upfront resection, NACT (followed by surgery or chemo/radiation depending on the response), or upfront non-surgical treatment (chemotherapy and/or radiotherapy). RESULTS: Upfront surgery was done in 67 (22.19%) patients and 155 (51.32%) patients received NACT. The rest of the patients received upfront non-surgical treatment. The overall response rate of NACT was 23.23% and the resectability rate was 36.13%. The median OS for the whole population was 12 months (30 months for the surgical group and 9 months for the non-surgical group). There was no survival difference between supra versus infra-notch tumors (P value = .552) or post-NACT versus upfront surgery (P value = .932). Nodal involvement was the most important poor prognostic factor affecting both DFS (P = .006) and OS (P = .002). CONCLUSIONS: With proper patient selection after thorough clinico-radiological assessment, a subset of T4b OSCC can be operated with curative intention; either upfront or after downstaging with NACT, which ultimately translates into improved survival. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2266-E2274, 2021.


Assuntos
Neoplasias Bucais/terapia , Boca/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Cuidados Paliativos/estatística & dados numéricos , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Adulto , Idoso , Quimiorradioterapia Adjuvante/métodos , Quimiorradioterapia Adjuvante/estatística & dados numéricos , Quimioterapia Adjuvante/métodos , Quimioterapia Adjuvante/estatística & dados numéricos , Intervalo Livre de Doença , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Boca/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Terapia Neoadjuvante/métodos , Terapia Neoadjuvante/estatística & dados numéricos , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Cuidados Paliativos/métodos , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto Jovem
20.
J Vet Diagn Invest ; 33(2): 345-347, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33446090

RESUMO

A 1-mo-old reticulated giraffe had progressive anorexia and died at the Ordos Zoo. Autopsy revealed necrotic stomatitis with severe bilateral necroulcerative lesions at the base of the tongue and of the cheeks near the commissures of the mouth. There was also severe bilateral confluent bronchopneumonia with a pronounced bronchial pattern and multifocal fibrinous pleuritis. Histologically, there was serofibrinous-suppurative bronchopneumonia with necrosuppurative bronchiolitis and necrotic arteritis. Filamentous bacteria with morphology consistent with Fusobacterium necrophorum were observed at the advancing edge of the necrotic tissue in the tongue and cheeks, as well as in the affected alveolar spaces and bronchioles. Aggregates of slender, gram-negative, rod-like or filamentous bacteria were identified in the lung impression smear. PCR results of 16S rDNA of the tongue and lung lesions had 100% homology to the F. necrophorum subsp. funduliforme B35 sequence (EF447425.1). The gross, histologic, Gram stain, and PCR product sequencing features in our case were consistent with oral and pulmonary necrobacillosis in ruminants, a rare disease of giraffes.


Assuntos
Infecções por Fusobacterium/veterinária , Fusobacterium necrophorum/isolamento & purificação , Girafas , Pneumopatias/veterinária , Doenças da Boca/veterinária , Animais , Animais de Zoológico , China , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/microbiologia , Fusobacterium necrophorum/genética , Pulmão/patologia , Pneumopatias/diagnóstico , Pneumopatias/microbiologia , Boca/patologia , Doenças da Boca/diagnóstico , Doenças da Boca/microbiologia , Reação em Cadeia da Polimerase/veterinária , RNA Bacteriano/análise , RNA Ribossômico 16S/análise
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...