Hookah Smoking among Brazilian University Students: An Exploratory Survey on the Prevalence and Perceptions of Addiction and its Harmfulness.

Background: This study aimed to determine the prevalence, beliefs, attitudes, and perceptions of hookah use in a population of undergraduate students at a large public university in Brazil. Methods: The sample consisted of 1348 undergraduate students aged over 18-year-old. They completed structured questionnaires on demographic information and close-ended questions on the past and current experiences of smoking hookah. The data underwent descriptive analysis and binary logistic regression. Findings: Finally, 1298 valid survey forms were obtained from printed and digital questionnaires. More than half (53.9%) of participants reported having tried hookah at least once, however, only 10.8% reported they had experienced it within the last 30 days. The majority of the studied population presented acceptable beliefs about the harmfulness and addictive capacity of hookah smoking. However, when comparing the perceptions of those who had smoked and those who had never smoked hookah, and also, the perceptions of users and non-users, significant differences were observed. Students who were users or had already tried hookah showed a tendency to underestimate the deleterious effects of this type of smoking. Conclusion: It could be concluded that hookah smoking was common among Brazilian university students. In addition, preoccupying misperceptions of hookah's harmfulness and addictive capacity were found. The results showed that the epidemic of hookah smoking, especially among young people, has spread far beyond the Arab world and the Persians. Accordingly, preventive measures must be taken if this population is to be protected from addiction and other serious health problems.

Epithelial inclusion cyst after free gingival graft: a case report.

There have been few case reports of cystic lesions occurring after gingival grafting. There are three reports of this type of sequela after connective tissue grafting, but this is the first known case of a cystlike lesion developing secondarily to a free gingival graft procedure. The bulky tissue, which had developed under the previously grafted area, was properly excised under local anesthesia. The small specimen removed was sent for histologic analysis. A new gingival graft was performed immediately after the lesion enucleation, as the cystic lesion had dislocated the earlier graft. The surgical wound healed uneventfully, and no recurrence was seen 18 months later The microscopic sections showed a cystic cavity lined with an orthokeratinized, hyperplastic, stratified squamous epithelium covered with fibrous connective tissue. The development of a cystlike lesion following a free gingival graft is, to date, an unpublished event. The fact that most cystic lesions appear in the mandibular lateral incisor-canine-first premolar area deserves further consideration.

Focal Epithelial Hyperplasia (Heck's Disease) in a 57-Year-Old Brazilian Patient: A Case Report and Literature Review.

Focal epithelial hyperplasia (FEH), or Heck's disease, is a rare disease of the oral mucosa associated with infection by some subtypes of human papilloma virus, especially subtypes 13 or 32. The disease is predominantly found in children and adolescents with indigenous heritage, but other ethnic groups can be affected worldwide. To the best of the authors' knowledge, it has not been reported in Brazil's elderly population. This article describes a case of FEH in a 57-year-old Brazilian patient presenting since childhood, with multiple lesions in the lips, buccal mucosa and tongue. The solitary tongue lesion underwent excisional biopsy and the histopathological analysis showed parakeratosis, acanthosis, rete pegs with a club-shaped appearance, koilocytosis and the presence of mitosoid cells. These microscopic findings in conjunction with clinical presentation were sufficient to establish the accurate diagnosis of FEH. Polymerase chain reaction (PCR) was performed, but no one human papillomavirus (HPV) subtype could be identified. Clinicians must be aware of this rare oral disease, which can even affect elderly patients, as we described here. Treatment may be indicated in selected cases due to esthetic and/or functional problems.