The SSB-positive/SSA-negative antibody profile is not associated with key phenotypic features of Sjögren's syndrome.

OBJECTIVE: To determine whether the Sjögren's syndrome B (SSB)-positive/Sjögren's syndrome A (SSA)-negative antibody profile is associated with key phenotypic features of SS. METHODS: Among registrants in the Sjögren's International Collaborative Clinical Alliance (SICCA) with possible or established SS, we compared anti-SSA/anti-SSB reactivity profiles against concurrent phenotypic features. We fitted logistic regression models to explore the association between anti-SSA/anti-SSB reactivity profile and each key SS phenotypic feature, controlling for potential confounders. RESULTS: Among 3297 participants, 2061 (63%) had negative anti-SSA/anti-SSB, 1162 (35%) had anti-SSA with or without anti-SSB, and 74 (2%) anti-SSB alone. Key SS phenotypic features were more prevalent and had measures indicative of greater disease activity in those participants with anti-SSA, either alone or with anti-SSB, than in those with anti-SSB alone or negative SSA/SSB serology. These between-group differences were highly significant and not explained by confounding by age, race/ethnicity or gender. Participants with anti-SSB alone were comparable to those with negative SSA/SSB serology in their association with these key phenotypic features. Among SICCA participants classified with SS on the basis of the American-European Consensus Group or American College of Rheumatology criteria, only 2% required the anti-SSB-alone test result to meet these criteria. CONCLUSIONS: The presence of anti-SSB, without anti-SSA antibodies, had no significant association with SS phenotypic features, relative to seronegative participants. The solitary presence of anti-SSB antibodies does not provide any more support than negative serology for the diagnosis of SS. This serological profile should thus be interpreted cautiously in clinical practice and potentially eliminated from future classification criteria.

Topical treatment of oral lichen planus with anthocyanins.

BACKGROUND: Oxidative stress is involved in oral lichen planus (OLP) pathogenesis; meanwhile anthocyanins are natural antioxidants present in grapes skin. OBJECTIVES: The aim of this research was to verify the utility of anthocyanins, extracted from grapes skin, for the local treatment of oral lichen planus and to compare it with clobetasol propionate- neomycin -nystatin cream (CP-NN). STUDY DESIGN: Prospective, non-randomized study, with control group. Fifty-two patients with OLP were included. We divided patients into two categories: erosive oral lichen planus (EOLP) and non erosive oral lichen planus (NEOLP). 38 had EOLP (17 cases and 21 controls) and 14 presented NEOLP types (9 cases and 5 controls).Cases received local treatment with anthocyanins from grapes and controls, were treated with CP-NN. The clinical evolution of patients was followed up during six months. RESULTS: The patients had a therapeutic response with anthocyanins. This was better than CP-NN treatment for patients with EOLP, in improving the involvement score of the oral mucosa and in the morphometric study of the affected areas. In EOLP there were no statistically significant differences in: therapeutic response time, the evolution of pain, or the relapse rate between the two groups. With respect to the treatment of NEOLP there was improved pain relief in the group treated with anthocyanins. This was not observed with CP-NN. The resting analized variables showed no significant difference with both treatments. CONCLUSIONS: OLP has a favorable response to local treatment with anthocyanins from grapes. We found an equal to or better response than with CP-NN treatment. Many of our patients have systemic diseases, which may contraindicate the use of steroids. With regard to this particular group, the use of this natural antioxidant present in the diet is considered advantageous.

Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants.

OBJECTIVE: To examine associations between labial salivary gland (LSG) histopathology and other phenotypic features of Sjögren's syndrome (SS). METHODS: The database of the Sjögren's International Collaborative Clinical Alliance (SICCA), a registry of patients with symptoms of possible SS as well as those with obvious disease, was used for the present study. LSG biopsy specimens from SICCA participants were subjected to protocol-directed histopathologic assessments. Among the 1,726 LSG specimens exhibiting any pattern of sialadenitis, we compared biopsy diagnoses against concurrent salivary, ocular, and serologic features. RESULTS: LSG specimens included 61% with focal lymphocytic sialadenitis (FLS; 69% of which had focus scores of ≥1 per 4 mm²) and 37% with nonspecific or sclerosing chronic sialadenitis (NS/SCS). Focus scores of ≥1 were strongly associated with serum anti-SSA/SSB positivity, rheumatoid factor, and the ocular component of SS, but not with symptoms of dry mouth or dry eyes. Those with positive anti-SSA/SSB were 9 times (95% confidence interval [95% CI] 7.4-11.9) more likely to have a focus score of ≥1 than were those without anti-SSA/SSB, and those with an unstimulated whole salivary flow rate of <0.1 ml/minute were 2 times (95% CI 1.7-2.8) more likely to have a focus score of ≥1 than were those with a higher flow rate, after controlling for other phenotypic features of SS. CONCLUSION: Distinguishing FLS from NS/SCS is essential in assessing LSG biopsies, before determining focus score. A diagnosis of FLS with a focus score of ≥1 per 4 mm², as compared to FLS with a focus score of <1 or NS/SCS, is strongly associated with the ocular and serologic components of SS and reflects SS autoimmunity.

Clinical features and evolution of oral cancer: A study of 274 cases in Buenos Aires, Argentina.

UNLABELLED: Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial diagnosis, due to late diagnosis. OBJECTIVES: The aim of the present study was to examine the clinical features and evolution of oral cancer in the University of Buenos Aires. STUDY DESIGN: 274 patients with primary oral carcinoma, over the 1992-2000 period were included in the study. RESULTS: The survival rate of this population was 80% at 12 months, 60% at 24 months, 46% at 36 months, 40% at 48 months, and 39% at 60 months (5 years). The tumor localizations with worse prognosis were floor of mouth and tongue, with survival rates of 19% and 27% respectively. Sixty-five percent of the oral carcinomas evaluated were diagnosed at advanced stages (III and IV). CONCLUSIONS: The patients under study exhibited the lowest survival rate described for oral cancer (34% five-year survival after initial diagnosis). The population included in this study can be considered representative of the Argentine population. This bad prognosis would be mainly due to the large number of oral cancer cases that were diagnosed at advanced stages.

Oral mucosal lesions in Anorexia Nervosa, Bulimia Nervosa and EDNOS.

OBJECTIVES: The aim of this study is to describe oral lesions in patients with eating disorders (ED), including Anorexia Nervosa (AN), Bulimia Nervosa (BN) and eating disorders not otherwise specified (EDNOS). MATERIAL AND METHODS: A prospective case-control study was carried out from April 2003 to May 2004. Inclusion criteria for the study group were individuals with a diagnosis of ED; age and sex-matched individuals without ED were included as controls. Clinical data regarding ED, medical complications and oral examination were performed by previously calibrated professionals. RESULTS: Study group (n = 65) presented 46 cases of BN (71%), 13 of EDNOS (20%) and 6 of AN (9%); also, 94% (n = 61) showed oral lesions. The most common were: labial erythema, exfoliative cheilitis, orange-yellow palate, hemorrhagic lesions, lip-cheek biting and non-specific oral atrophies. Only two patients of the study group had dental erosions, and no case of major salivary gland swelling was found. CONCLUSIONS: ED display a wide array of oral mucosal lesions that can be regarded as their early manifestations. The dentist could be the first professional to detect symptoms of eating disorders, potentially improving early detection and treatment of ED.

Natural History and Predictors of Progression to Sjögren's Syndrome Among Participants of the Sjögren's International Collaborative Clinical Alliance Registry.

OBJECTIVE: To explore changes in the phenotypic features of Sjögren's syndrome (SS), and in SS status among participants in the Sjögren's International Collaborative Clinical Alliance (SICCA) registry over a 2-3-year interval. METHODS: All participants in the SICCA registry who were found to have any objective measures of salivary hypofunction, dry eye, focal lymphocytic sialadenitis in minor salivary gland biopsy, or anti-SSA/SSB antibodies were recalled over a window of 2 to 3 years after their baseline examinations to repeat all clinical examinations and specimen collections to determine whether there was any change in phenotypic features and in SS status. RESULTS: As of September 15, 2013, a total of 3,514 participants had enrolled in SICCA, and among 3,310 eligible, 771 presented for a followup visit. Among participants found to have SS using the 2012 American College of Rheumatology (ACR) classification criteria, 93% again met the criteria after 2 to 3 years, and this proportion was 89% when using the 2016 ACR/European League Against Rheumatism (EULAR) criteria. Among those who did not meet ACR or ACR/EULAR criteria at baseline, 9% and 8%, respectively, had progressed and met them at followup. Those with hypergammaglobulinemia and hypocomplementemia at study entry were, respectively, 4 and 6 times more likely to progress to SS by ACR criteria than those without these characteristics (95% confidence interval 1.5-10.1 and 1.8-20.4, respectively). CONCLUSION: While there was stability over a 2-3-year period of both individual phenotypic features of SS and of SS status, hypergammaglobulinemia and hypocomplementemia at study entry were predictive of progression to SS.

Characterization of Chronic Mechanical Irritation in Oral Cancer.

Objective. Oral mucosa could host many lesions originated by chronic mechanical irritation (CMI) from teeth or dentures, and it has been proposed as risk factor for oral cancer. Nevertheless, the features of CMI factors in oral cancer and other lesions are not assessed. The aim of this study is to describe CMI features regarding type (dental, prosthetic, and/or functional), localization, and time span. Materials and Methods. Three groups were studied in this cross-sectional study: Oral Cancer (OC); Chronic Traumatic Ulcer (CTU); and Benign Irritative Mechanical Lesions (BIML). All sources of mechanical irritation were included: dental, prosthetic, and functional. Results. 285 patients (176 females, 109 males) were studied: OC = 38, CTU = 44, and BIML = 203. The most frequent CMI factor was dental, followed by functional and prosthetic in all groups; 76.5% (n = 218) presented functional factors. Buccal mucosa (45%) and tongue (42%) were the most affected sites. Time of action of CMI displayed statistically significant differences between BIML, CTU, and OC groups, with a mean of 21, 33, and 49 months, respectively. Conclusions. CMI should be properly recorded with as much detail as alcohol and tobacco consumption. CMI associated lesions are produced by dental or prosthetic factors, usually in relation to functional factors, involving mainly tongue and buccal mucosa.

Genome-Wide Association Analysis Reveals Genetic Heterogeneity of Sjögren's Syndrome According to Ancestry.

OBJECTIVE: The Sjögren's International Collaborative Clinical Alliance (SICCA) is an international data registry and biorepository derived from a multisite observational study of participants in whom genotyping was performed on the Omni2.5M platform and who had undergone deep phenotyping using common protocol-directed methods. The aim of this study was to examine the genetic etiology of Sjögren's syndrome (SS) across ancestry and disease subsets. METHODS: We performed genome-wide association study analyses using SICCA subjects and external controls obtained from dbGaP data sets, one using all participants (1,405 cases, 1,622 SICCA controls, and 3,125 external controls), one using European participants (585, 966, and 580, respectively), and one using Asian participants (460, 224, and 901, respectively) with ancestry adjustments via principal components analyses. We also investigated whether subphenotype distributions differ by ethnicity, and whether this contributes to the heterogeneity of genetic associations. RESULTS: We observed significant associations in established regions of the major histocompatibility complex (MHC), IRF5, and STAT4 (P = 3 × 10-42 , P = 3 × 10-14 , and P = 9 × 10-10 , respectively), and several novel suggestive regions (those with 2 or more associations at P < 1 × 10-5 ). Two regions have been previously implicated in autoimmune disease: KLRG1 (P = 6 × 10-7 [Asian cluster]) and SH2D2A (P = 2 × 10-6 [all participants]). We observed striking differences between the associations in Europeans and Asians, with high heterogeneity especially in the MHC; representative single-nucleotide polymorphisms from established and suggestive regions had highly significant differences in the allele frequencies in the study populations. We showed that SSA/SSB autoantibody production and the labial salivary gland focus score criteria were associated with the first worldwide principal component, indicative of higher non-European ancestry (P = 4 × 10-15 and P = 4 × 10-5 , respectively), but that subphenotype differences did not explain most of the ancestry differences in genetic associations. CONCLUSION: Genetic associations with SS differ markedly according to ancestry; however, this is not explained by differences in subphenotypes.

Analysis of the epidemiological features of oral cancer in the city of Buenos Aires.

Oral cancer comprises 0.6 to 5% of all human malignant tumors. It is accepted in the literature that the clinical evolution of oral cancer has a bad prognosis, i.e. the five year survival rate ranges from 34% to 56%. The aim of the present study was to present a metaanalysis of the most relevant publications on oral cancer in the city of Buenos Aires, including our own series. The publications reviewed herein include the following series: 517 cases (1950-1970), 243 cases (1961-1968), 336 cases (1972-1984), and 274 cases (1992-2000). The clinical end-points evaluated were: age, distribution by sex, tumor site, presence of metastatic adenopathies, and clinical stage. A comparative statistical evaluation of the clinical parameters assessed was performed. Survival was evaluated by the test of Kaplan-Meier. The male/female ratio was 7.1:1 for the 1950-1970 period, 4.3:1 for the 1961-1968 period; 2.3:1 for the 1972-1984 period; and 1.24:1 in our series (1992-2000). The most frequent tumor site (21 to 35% of the cases) was the tongue. At the time of diagnosis, 60-71% of the patients had advanced TNM clinical stages (III and IV). Our follow-up revealed a five-year survival rate after diagnosis of 39%. The overall analysis of all the cases corresponding to the 1950-2000 period revealed that the prevalence of oral cancer in women has risen alarmingly and that the percentage of patients with advanced stages of tumor development continues to be high.

RED MEAT, MICRONUTRIENTS AND ORAL SQUAMOUS CELL CARCINOMA OF ARGENTINE ADULT PATIENTS.

INTRODUCTION: the identification of risk group of oral cancer allows reducing the typical morbidity and mortality rates of this pathology. OBJETIVE: it was analyzed the role of red meat, macronutrients and micronutrients on Oral Squamous Cell carcinoma (OSCC) in a case-control study carried out in Cordoba, Argentina. METHODS: case-control study 3:1, both genders, aged 24-80 years. Dietary information was collected using a quali-quantitative food frequency questionnaire. The logistic regression was applied for assessing the association among case/control status and daily red meat/macronutrient/ micronutrients/energy intake. RESULTS: micronutrients and minerals in the diet that showed high significant median values of common consumption in cases relative to controls were iron, phosphorus, vitamins B1, B5, B6, E and K and selenium. The association measurement estimated by logistic regression was showed that a significant association between red meat, fat, daily energy, phosphorous, vitamin B5, vitamin E, and selenium intake and OSCC presence. CONCLUSIONS: a high intake of fats, phosphorus, vitamin B5, vitamin E, and selenium intake and red meat appears to be related to the presence OSCC in Cordoba, Argentina. In relation to red meat consumption and risk of OSCC, the future research should center of attention on reducing the complexity of diet and disease relationships and reducing variability in intake data by standardizing of criteria in order to implement simple strategies in public health for recognizing risk groups of OSCC.

Introducción: la detección de grupos de riesgo de cáncer oral permite reducir las tasas de morbilidad y mortalidad típicas de esta patología. Objetivo: se analizó el rol de carnes rojas, macronutrientes y micronutrientes en pacientes con carcinoma oral de células escamosas (COCE) en un estudio de casos y controles llevado a cabo en Córdoba, Argentina. Métodos: estudio de casos y controles 3:1, ambos sexos, con edades comprendidas entre 24-80 años. La información sobre la dieta fue recogida mediante un cuestionario de frecuencia de alimentos cuali-cuantitativo. La regresión logística se aplicó para evaluar la asociación entre el estado caso/control y la ingesta diaria de carne roja/ macronutrientes/micronutrientes/energía. Resultados: los micronutrientes y minerales de la dieta que mostraron valores medios significativos de consumo común en los casos relativos a los controles eran hierro, fósforo, vitaminas B1, B5, B6, E y K y selenio. La medición de la asociación estimada por regresión logística mostró una asociación significativa entre carne roja, grasas, energía diaria, fósforo, vitamina B5, vitamina E, ingesta de selenio y presencia de COCE. Conclusión: un alto consumo de grasas, fósforo, vitamina B5, vitamina E, selenio y carne roja parece estar relacionado con la presencia de COCE en Córdoba, Argentina. En relación con el consumo de carne roja y el riesgo de COCE, la investigación futura debería centrar su atención en la reducción de la complejidad de las relaciones de la dieta y la enfermedad, así como en reducir la variabilidad de los datos de ingesta mediante la estandarización de los criterios de admisión a fin de aplicar estrategias sencillas en salud pública para el reconocimiento de grupos de riesgo de COCE.

Increased subepithelial vascularization and VEGF expression reveal potentially malignant changes in human oral mucosa lesions.

OBJECTIVE: The objective of this study was to provide evidence that the magnitude of angiogenesis induced by oral mucosa epithelium with potentially malignant lesions is related to the degree of epithelial aggressiveness. METHODS AND RESULTS: We evaluated 96 biopsies that included: (1) leukoplakia with and without dysplasia, (2) nontumoral borders adjacent to squamous cell carcinomas with and without dysplasia, and (3) normal oral mucosa. Number, size, and localization of vessels labeled immunohistochemically for the antigen CD34 were assessed by image analysis using a software developed "ad hoc." All vascular sections and those localized immediately below the epithelium (sub-basal vessels) were separately evaluated in areas 30-µm deep. Vascular endothelial growth factor (VEGF) expression was labeled immunohistochemically and evaluated semiquantitatively against a standard. Leukoplakia and nontumoral borders adjacent to carcinomas exhibited an increase in VEGF expression and in subepithelial vascularization. This increase was significantly greater in leukoplakia with dysplastic changes than in leukoplakia without dysplasia. Conversely, no differences were observed between epithelia with and without dysplasia adjacent to carcinomas. CONCLUSIONS: Demonstration of expression of epithelial VEGF and sub-basal vascularization could be an additional aid for evaluation of the severity of potentially malignant lesions in oral mucosa routine biopsies.

Red meat, micronutrients and oral squamous cell carcinoma of Argentine adult patients / Carne roja, micronutrientes y carcinoma oral de células escamosas en pacientes adultos argentinos

Introduction: the identification of risk group of oral cancer allows reducing the typical morbidity and mortality rates of this pathology. Objetive: it was analyzed the role of red meat, macronutrients and micronutrients on Oral Squamous Cell carcinoma (OSCC) in a case-control study carried out in Cordoba, Argentina. Methods: case-control study 3:1, both genders, aged 24-80 years. Dietary information was collected using a quali-quantitative food frequency questionnaire. The logistic regression was applied for assessing the association among case/control status and daily red meat/macronutrient/micronutrients/energy intake. Results: micronutrients and minerals in the diet that showed high significant median values of common consumption in cases relative to controls were iron, phosphorus, vitamins B1, B5, B6, E and K and selenium. The association measurement estimated by logistic regression was showed that a significant association between red meat, fat, daily energy, phosphorous, vitamin B5, vitamin E, and selenium intake and OSCC presence. Conclusions: a high intake of fats, phosphorus, vitamin B5, vitamin E, and selenium intake and red meat appears to be related to the presence OSCC in Cordoba, Argentina. In relation to red meat consumption and risk of OSCC, the future research should center of attention on reducing the complexity of diet and disease relationships and reducing variability in intake data by standardizing of criteria in order to implement simple strategies in public health for recognizing risk groups of OSCC (AU)

Introducción: la detección de grupos de riesgo de cáncer oral permite reducir las tasas de morbilidad y mortalidad típicas de esta patología. Objetivo: se analizó el rol de carnes rojas, macronutrientes y micronutrientes en pacientes con carcinoma oral de células escamosas (COCE) en un estudio de casos y controles llevado a cabo en Córdoba, Argentina. Métodos: estudio de casos y controles 3:1, ambos sexos, con edades comprendidas entre 24-80 años. La información sobre la dieta fue recogida mediante un cuestionario de frecuencia de alimentos cuali-cuantitativo. La regresión logística se aplicó para evaluar la asociación entre el estado caso/control y la ingesta diaria de carne roja/ macronutrientes/micronutrientes/energía. Resultados: los micronutrientes y minerales de la dieta que mostraron valores medios significativos de consumo común en los casos relativos a los controles eran hierro, fósforo, vitaminas B1, B5, B6, E y K y selenio. La medición de la asociación estimada por regresión logística mostró una asociación significativa entre carne roja, grasas, energía diaria, fósforo, vitamina B5, vitamina E, ingesta de selenio y presencia de COCE. Conclusión: un alto consumo de grasas, fósforo, vitamina B5, vitamina E, selenio y carne roja parece estar relacionado con la presencia de COCE en Córdoba, Argentina. En relación con el consumo de carne roja y el riesgo de COCE, la investigación futura debería centrar su atención en la reducción de la complejidad de las relaciones de la dieta y la enfermedad, así como en reducir la variabilidad de los datos de ingesta mediante la estandarización de los criterios de admisión a fin de aplicar estrategias sencillas en salud pública para el reconocimiento de grupos de riesgo de COCE (AU)

Ploidy study in oral carcinomas: use of improved methodology to assess its clinical prognostic value.

OBJECTIVE: This study reports a ploidy analysis in oral squamous cell carcinomas (SCC) using methodologic adjustments to improve the accuracy of the measurements and derive numeric indices of aggressiveness of prognostic value. STUDY DESIGN: Sixty-seven SCC were assessed by DNA image cytometry in the areas of the histologic sections with most atypia. Five indices of aggressiveness were analyzed in relation to the clinical-pathologic data and evolution of the patients. RESULTS: The mean value of the index of deviation from the diploid value (2cDi) and malignancy index (Mi), taken as a cut-off value, defined 2 populations with statistically significant differences in survival. In patients with tumors in clinical stages III and IV (TNM classification), the Mi also exhibited prognostic value. CONCLUSIONS: The 2cDi and Mi can be used, under certain methodologic conditions, as an objective indicator of prognostic value of the degree of aggressiveness of oral SCC.

Topical treatment of oral lichen planus with anthocyanins

BACKGROUND: Oxidative stress is involved in oral lichen planus (OLP) pathogenesis; meanwhile anthocyanins are natural antioxidants present in grapes skin. OBJECTIVES:T he aim of this research was to verify the utility of anthocyanins, extracted from grapes skin, for the local treatment of oral lichen planus and to compare it with clobetasol propionate- neomycin -nystatin cream (CP-NN).STUDY DESIGN: Prospective, non-randomized study, with control group. Fifty-two patients with OLP were included. We divided patients into two categories: erosive oral lichen planus (EOLP) and non erosive oral lichen planus (NEOLP). 38 had EOLP (17 cases and 21 controls) and 14 presented NEOLP types (9 cases and 5 controls).Cases received local treatment with anthocyanins from grapes and controls, were treated with CP-NN. The clinical evolution of patients was followed up during six months. RESULTS: The patients had a therapeutic response with anthocyanins. This was better than CP-NN treatment for patients with EOLP, in improving the involvement score of the oral mucosa and in the morphometric study of the affected areas. In EOLP there were no statistically significant differences in: therapeutic response time, the evolution of pain, or the relapse rate between the two groups. With respect to the treatment of NEOLP there was improved pain relief in the group treated with anthocyanins. This was not observed with CP-NN. The resting analized variables showed no significant difference with both treatments. CONCLUSIONS: OLP has a favorable response to local treatment with anthocyanins from grapes. We found an equal to or better response than with CP-NN treatment. Many of our patients have systemic diseases, which may contraindicate the use of steroids. With regard to this particular group, the use of this natural antioxidant present in the diet is considered advantageous

Clinical features and evolution of oral cancer: A study of 274 cases in Buenos Aires, Argentina

No disponible

Oral Squamous Cell Carcinoma has a low survival rate, 34 to 66% five-year survival after initial diagnosis, due tolate diagnosis. Objetives: The aim of the present study was to examine the clinical features and evolution of oral cancer in the University of Buenos Aires. Study design: 274 patients with primary oral carcinoma, over the 1992-2000 period were included in the study. Results: The survival rate of this population was 80% at 12 months, 60% at 24 months, 46% at 36 months, 40% at 48 months, and 39 % at 60 months (5 years). The tumor localizations with worse prognosis were floor of mouth and tongue, with survival rates of 19% and 27% respectively. Sixty-five percent of the oral carcinomas evaluated were diagnosed at advanced stages (III and IV). Conclusions: The patients under study exhibited the lowest survival rate described for oral cancer (34% five-year survival after initial diagnosis). The population included in this study can be considered representative of the Argentine population. This bad prognosiswould be mainly due to the large number of oral cancer cases that were diagnosed at advanced stages (AU)

Analysis of the epidemiological features of oral cancer in the city of Buenos Aires.

Oral cancer comprises 0.6 to 5

of all human malignant tumors. It is accepted in the literature that the clinical evolution of oral cancer has a bad prognosis, i.e. the five year survival rate ranges from 34

to 56

. The aim of the present study was to present a metaanalysis of the most relevant publications on oral cancer in the city of Buenos Aires, including our own series. The publications reviewed herein include the following series: 517 cases (1950-1970), 243 cases (1961-1968), 336 cases (1972-1984), and 274 cases (1992-2000). The clinical end-points evaluated were: age, distribution by sex, tumor site, presence of metastatic adenopathies, and clinical stage. A comparative statistical evaluation of the clinical parameters assessed was performed. Survival was evaluated by the test of Kaplan-Meier. The male/female ratio was 7.1:1 for the 1950-1970 period, 4.3:1 for the 1961-1968 period; 2.3:1 for the 1972-1984 period; and 1.24:1 in our series (1992-2000). The most frequent tumor site (21 to 35

of the cases) was the tongue. At the time of diagnosis, 60-71

of the patients had advanced TNM clinical stages (III and IV). Our follow-up revealed a five-year survival rate after diagnosis of 39

. The overall analysis of all the cases corresponding to the 1950-2000 period revealed that the prevalence of oral cancer in women has risen alarmingly and that the percentage of patients with advanced stages of tumor development continues to be high.

Hallazgos ultraestructurales en el síndrome de Werner / Ultrastructural findings in Werner's syndrome

El síndrome de Werner es una entidad rara, de herencia autosómica recesiva, que se caracteriza por ciertos rasgos de envejecimiento prematuro. El estudio con microscopía electrónica nos permitió comprobar ateraciones morfológicas de los fibroblastos y de sus zonas circundantes. Estas alteraciones se caracterizan por marcada vacuolización citoplasmática, alteraciones nucleares con cromatina condensada y dispuesta en forma periférica, y aumento del plegamiento de la membrana nuclear. Es destacable la abundante cantidad de colágeno normal que ocupa grandes areas de la dermis, alterando con zonas de aspecto amorfo. La membrana basal presentaba aspecto normal, así como las células basales y espinosas de la epidermis; ocasionalmente se observaron vacuolas claras de localización perinuclear. Creemos que estos hallazgos pueden contribuir de alguna manera a esclarecer la fisiopatogenia de esta entidad, así como la del envejecimiento en general, pues se vincularían con las anormalidades en el crecimiento de los fibroblastos demostrada "in vitro"

Consideraciones epidemiológicas por el uso del mate: un modelo experimental / Epidemiologic considerations by the use of the mate

Se presentan los datos sobre algunos problemas del empleo de la infusión del Illex Paraguayensis (yerba mate) tal como es habitual en distintas zonas de Sudamérica, mediante el uso del "mate con bombilla" que implica la posibilidad de que volúmenes apreciables de saliva, a veces con contenido sanguíneo, puedan quedar retenidos en la bombilla y ser objeto de transmisión de enfermedades

Study of the vascular pattern in oral lichen planus

El liquen plano de la mucosa bucal es una afección relativamente frecuente. Su etiopatogenia permanece aún desconocida, pudiendo en su evolución sufrir transformación carcinomatosa, por ello reviste especial interés el estudio de parámetros que aporten nuevos conocimientos sobre la biología de esta afección. En el presente trabajo se analizó el patrón vascular del liquen plano bucal, empleando una metodología que permitió la utilización de parámetros cuantificables. Una parte del material biopsico tomado para diagnóstico histopatológico de rutina, fue utilizado para la marcación de paredes vasculares, mediante la técnica histoenzimática para demostración de actividad ATPasica. Las preparaciones fueron luego proyectadas y cuantificadas en un analizador de imágenes magnético, semiautomático. Los parámetros estereológicos estudiados indicaron que no existe un aumento vascular en el liquen con respecto a las mucosas normales o a las leucoplasias, dado que el conteo de paredes vasculares no mostró diferencias significativas. En cambio se observó un marcado aumento en el área vascular. La conjunción de estos parámetros indica que el liquen es una lesión más congestiva que las otras dos condiciones estudiadas. Estos hallazgos indican que las modificaciones del patrón vascular podrían jugar un rol en la etiopatogenia del liquen plano bucal y sugieren que la observación de estos cambios podrían ser un elemento útil en el diagnóstico histopatológico