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Introduction: Metastasis of hepatocellular carcinoma (HCC) to the mandible is an extre-mely rare condition with less than a hundred cases reported worldwide. Such lesions do not have any pathognomonic clinical, radiologic, or histologic features, and they can mimic many other conditions or diseases with orofacial involvement. Case report: We present an interesting but intriguing case of metastasis of HCC to the mandible, which presented as an orofacial swelling accompanied by intense pain and spontaneous bleeding following tooth removal. Conclusion: This paper highlights the importance of integration of the in-depth medical history of the patient, clinical findings, and microscopic examinations in cases of uncommon oral lesions of challenging diagnosis. (AU)
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Humanos , Masculino , Persona de Mediana Edad , Neoplasias Maxilomandibulares , Carcinoma Hepatocelular , Neoplasias Hepáticas , Metástasis de la NeoplasiaRESUMEN
Basal cell carcinoma is the most frequent skin cancer, generally located in hair-bearing, sunlight-exposed areas. Basal cell carcinoma usually occurs on the head and neck, but very rarely on extra-facial locations. We report a case of a 65-year-old woman presenting with a solitary non-healing ulcer on the sole of the right foot for two years. Histopathological examination showed a typical nodular basal cell carcinoma, confirmed by positivity to Ber-EP4 on immunohistochemistry. There was no history of trauma, exposure to noxious agents, basal cell nevus syndrome, or xeroderma pigmentosum.
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Carcinoma Basocelular/patología , Úlcera del Pie/patología , Neoplasias Cutáneas/patología , Anciano , Femenino , Humanos , InmunohistoquímicaRESUMEN
Abstract: Basal cell carcinoma is the most frequent skin cancer, generally located in hair-bearing, sunlight-exposed areas. Basal cell carcinoma usually occurs on the head and neck, but very rarely on extra-facial locations. We report a case of a 65-year-old woman presenting with a solitary non-healing ulcer on the sole of the right foot for two years. Histopathological examination showed a typical nodular basal cell carcinoma, confirmed by positivity to Ber-EP4 on immunohistochemistry. There was no history of trauma, exposure to noxious agents, basal cell nevus syndrome, or xeroderma pigmentosum.
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Humanos , Femenino , Anciano , Neoplasias Cutáneas/patología , Carcinoma Basocelular/patología , Úlcera del Pie/patología , InmunohistoquímicaRESUMEN
Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis. During the laboratorial investigation, the patient had confirmed HIV infection, with a low CD4+ peripheral T-cell count (74 cells/µL). During hospitalization, the patient presented drug-induced hepatitis due to trimethoprim/sulfamethoxazole in a prophylactic dose, requiring interruption of this medication. On the 55th day of hospitalization, the patient developed refractory shock and died. At the autopsy, disseminated toxoplasmosis with encephalitis and severe necrotizing pneumonia were diagnosed, with numerous tachyzoites in the areas of pulmonary necrosis.
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Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis. During the laboratorial investigation, the patient had confirmed HIV infection, with a low CD4+ peripheral T-cell count (74 cells/µL). During hospitalization, the patient presented drug-induced hepatitis due to trimethoprim/sulfamethoxazole in a prophylactic dose, requiring interruption of this medication. On the 55th day of hospitalization, the patient developed refractory shock and died. At the autopsy, disseminated toxoplasmosis with encephalitis and severe necrotizing pneumonia were diagnosed, with numerous tachyzoites in the areas of pulmonary necrosis.
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Humanos , Masculino , Persona de Mediana Edad , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Encefalitis Infecciosa/complicaciones , Neumonía/complicaciones , Choque/complicaciones , Toxoplasmosis Cerebral/complicaciones , Autopsia , Diagnóstico Diferencial , Resultado Fatal , Toxoplasma , Toxoplasmosis/patologíaRESUMEN
Abstract Leiomyomas are smooth muscle tumors and may occur in places where these fibers are present, while the anorectal location is rare. They are commonly incidental imaging findings and in most cases, patients are asymptomatic. The therapeutic recommendation is tumor resection and postoperative follow-up. Case report: a 38-year-old Black woman had, one year ago, a swelling in perianal right region, which showed slow and progressive growth. She denied bowel habit alterations, local pain, hematochezia, or tenesmus. Proctologic examination showed a fibroelastic, regular, mobile, painless nodule measuring 10 cm at its largest diameter in the right perianal region, next to the anal verge. The soft tissue ultrasound image identified a solid, hypoechoic, and discreetly vascularized nodule in the perianal, superficial right gluteal region that did not reach the adjacent muscles. A complete resection of perineal tumor was carried out in the ventral position. Histological and immunohistochemical analyses disclosed a leiomyoma with a positive finding for actin smooth muscle and negative for desmin. She is currently asymptomatic and undergoing outpatient follow-up.
Resumo Os leiomiomas são tumores da musculatura lisa podendo ocorrer nos locais onde essas fibras estão presentes, sendo rara a localização anorretal. Na maioria dos casos os pacientes são assintomáticos, sendo comumente achados de exame de imagem. A recomendação terapêutica é a ressecção tumoral e o seguimento pós-operatório. Relato do caso: mulher, 38 anos, negra. Há um ano, apresentou abaulamento em região perianal direita, de crescimento lento e progressivo. Negava alteração do hábito intestinal, dor local, hematoquezia, puxo ou tenesmo. Ao exame proctológico, apresentava nodulação fibroelástica, regular, móvel, indolor, com 10 cm de diâmetro em região perianal à direita, próxima à borda anal. Realizou ultrassonografia de partes moles que identificou imagem nodular, sólida, hipoecogênica e discreta vascularização em parte superficial perianal e glútea direita, não envolvendo musculatura adjacente. Foi submetida à ressecção completa do tumor via perineal, em posição ventral. O laudo histológico e imuno-histoquímico revelou leiomioma, com achado positivo para actina de músculo liso e negativo para desmina. Atualmente está assintomática, em seguimento ambulatorial.
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Humanos , Femenino , Adulto , Canal Anal/cirugía , Perineo/cirugía , Leiomioma/diagnóstico , Canal Anal/patología , Leiomioma/cirugía , Leiomioma/clasificaciónRESUMEN
Left ventricular involvement in the advanced stage of arrhythmogenic cardiomyopathy (AC) is an evolution of this desmosomopathy. Mutation in intercalated discs explains the phenotypic variability. Abnormal trafficking of the intercalated discs at the site of end-to-end contacts between cardiomyocytes and the canonical Wnt/ß-catenin and Hippo signaling pathways have been implicated. In AC, T-wave inversion in lateral leads is the hallmark of left ventricular (LV) involvement. We herein report a case of isolated LV AC in which the initial ECG has typical features: fragmented QRS (fQRS), Twave inversion (TWI) in lateral leads, and ventricular tachycardia from inferobasal LV wall.
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Cardiomiopatías/complicaciones , Cardiomiopatías/diagnóstico , Electrocardiografía/métodos , Taquicardia Ventricular/complicaciones , Taquicardia Ventricular/diagnóstico , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Introdução: O uso de substâncias psicoativas é um acontecimento mundial,preocupante e o Governo Brasileiro tem buscado implantar políticas públicas objetivando controlar o uso e oferecer tratamento aos pacientes dependentes químicos. Objetivos: O presente estudo analisa o perfil sociodemográfico, assim como o...
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Terapéutica , Trastornos Relacionados con SustanciasRESUMEN
Durante anos o grande desafio da odontologia tem sido a busca por métodos que reabilitem os pacientes de forma menos traumática e eficaz do ponto de vista funcional e estético. Nessa interface, os implantes dentários surgiram e estão em pleno desenvolvimento tecnológico para garantir a satisfação dos pacientes. Dessa forma, o objetivo deste trabalho foi revisar a literatura sobre as superfícies de implantes de titânio e sua capacidade de estimulo na formação óssea, enfocando evidências científicas acerca das alterações químicas e topográficas no contexto da osseointegração.
For years the big challenge of dentistry has been the search for methods that rehabilitates patients less traumatic, and more effective functionally and aesthetically. In this interface, dental implants have emerged and are being increasingly perfected to ensure the complete satisfaction of rehabilitated patients. Thus, the aim of this study was to develop a theoretical review on the surfaces of titanium implants and their ability to stimulate bone formation focusing on scientific evidence of chemical and topographical changes in the context of osseointegration.
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O estágio curricular supervisionado é objeto de lei e de avaliação dos cursos de graduação em Odontologia pelo Ministério da Educação do país. A regulamentação deste componente curricular é amparada por diferentes segmentos de regulação da formação profissional do cirurgião dentista. A Associação Brasileira de Ensino Odontológico (ABENO) por meio da sua Comissão de Ensino divulgou as primeiras diretrizes acerca do assunto em 2002 e apresenta a revisão destas diretrizes à luz da legislação vigente e das melhores práticas educacionais para atendimento ao perfil do egresso preconizado pelas Diretrizes Curriculares Nacionais (DCN) para o curso de graduação em Odontologia. Assim, são apresentadas 12 diretrizes da ABENO para a definição do estágio curricular supervisionado nos cursos de graduação em Odontologia (AU).
The supervised traineeship is a law object in the evaluation of Dental undergraduate courses in Brazil, by the country's Ministry of Education. The regulation of this curricular component exists in several documents provided by different segments of regulating the training of dentists. The Brazilian Association of Dental Education (Associação Brasileira de Ensino Odontológico - ABENO), through its Education Commission, issued the first guidelines on this subject in 2002, and presents a review of these guidelines in the light of current legislation and best educational practices to meet the profile of the recommended egress by the Guidelines National curriculum for undergraduate Dental course. Thus, they present 12 ABENO guidelines for the definition of curricular supervised training in undergraduate courses in dentistry (AU).
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Educación en Salud/métodos , Curriculum/normas , Educación en OdontologíaRESUMEN
O adenoma pleomórfico, que é uma neoplasia mista de glândula salivar, é uma morbidade relativamente comum. Apresenta prevalência dominante como neoplasia em glândula parótida, podendo acometer também glândulas salivares menores. É derivado de uma mistura de elementos ductais e mioepiteliais. O tumor geralmente é solitário e apresenta umcrescimento lento e indolor, como massa nodular única, independentedo sítio de origem. Quando intraoral é mais comum em palato duro e lábio superior, sendo relativamente incomum em mucosa jugal. Nesse trabalho, relata-se um caso clínico de adenoma pleomórfico em mucosa jugal, apresentando sete anos de evolução, com completa resolução após o tratamento cirúrgico conservador.
The pleomorphic adenoma, which is a mixed salivary gland neoplasm, is a relatively common disease. It has dominant prevalence such as neoplasm on parotid gland may also affect the minor salivary glands. It is derived from a mixture of ductal and myoepithelial elements. The tumor is usually solitary and presents a slow and pain less growth, being a single mass, independent of site of origin. When intraoral, it is more common onthe hard palate and upper lip. It is relatively uncommon on the buccal mucosa. In this paper, we report a case of pleomorphic adenoma in the buccal mucosa, with seven years of evolution, with complete resolution after conservatory surgical treatment.
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There is controversy concerning the effect of pilocarpine in the reversal of radio-induced xerostomia; however, the tests are usually performed at the end of radiotherapy. The present study evaluated the radioprotective effects of pilocarpine when ingested during radiation treatment. Eleven patients (recently diagnosed with head and neck cancer who were not undergoing radiotherapy) were divided into two groups: the control group (saline solution intake n=6) and the pilocarpine-treated (5 mg pilocarpine three times daily, n=5) group, in a prospective and double-blinded study. For five weeks, oral conditions, unstimulated salivary flow and stimulated saliva flow were collected weekly, with the first collection occurring prior to radiation therapy. As early as the second week, the control group exhibited oral complications and greater reduction in salivary flow rate. At the end of the study, the pilocarpine-treated group presented mean values of salivary flow greater than those of the control group. Pilocarpine intake applied simultaneously with radiotherapy demonstrated encouraging results with regard to lowering salivary flow reduction and incidence of xerostomia, as well as of oral complications.
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Pilocarpina/administración & dosificación , Protectores contra Radiación/administración & dosificación , Radioterapia/efectos adversos , Glándulas Salivales/efectos de los fármacos , Glándulas Salivales/efectos de la radiación , Administración Oral , Neoplasias de Cabeza y Cuello/complicaciones , Neoplasias de Cabeza y Cuello/radioterapia , Humanos , Pilocarpina/uso terapéutico , Protectores contra Radiación/uso terapéutico , Resultado del Tratamiento , Xerostomía/etiologíaRESUMEN
Since the 19th century, neuroendocrine neoplasms (NEN) have been identified. Right up to the present day, the nomenclature is still under debate reflecting the heterogeneity of these tumors. Although some of them are slow growing, some can be fearfully aggressive and may develop in almost any organ of the abdomen, thorax, neck, skin, and gonads. The most commonly observed sites of NEN are the lung and the gastroenteropancreatic system (GEP), where more than 50 entities have been observed. In case of a NEN of unknown primary tumor, the histopathological diagnostic workup includes immunohistochemistry for chromogranin A and synaptophysin, followed by specific tissue markers. Clinical presentation is very diverse, depending on the primary site and functionality of the tumor. In the case of the GEP-NEN, the main symptoms are abdominal pain, diarrhea, weight loss, gastrointestinal bleeding, or bowel obstruction. The presence of neuropsychiatric symptoms is not insignificant in this group of tumors. The authors report a case of a 51-year-old man who sought medical attention because of a three-month history of a consumptive disease. The diagnostic workup disclosed a diffuse nodular infiltration of the lungs, hypokalemia, and hypercalcemia in a cachectic patient. The clinical investigation could not proceed because of an infectious intercurrence, which led to the fatal outcome. Autopsy findings showed a diffuse metastatic NEN. The primary tumoral site could not be demonstrated with the available immunohistochemical panel.
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A radioterapia em região de cabeça e pescoço provoca inúmeras sequelas ao paciente irradiado, afetando o sistema estomatognático e com repercussões sistêmicas importantes. As sequelas da radiação ionizante podem ser extensas e, algumas vezes, permanentes, em especial nas glândulas salivares e no tecido ósseo. É relevante que o cirurgião dentista tenha conhecimento das reações adversas e das formas adequadas de prevenção e tratamento para amenizar o desconforto e melhorar a condição de vida do paciente irradiado. Portanto, a conscientização e motivação deste paciente, com a promoção de saúde oral através da adequação do meio bucal e orientações sobre ações preventivas, são essenciais para se obter o melhor prognóstico.
Head and neck radiotherapy causes countless sequelae in irradiated patients, affecting the stomatognathic system, with significant systemic implications. Sequelae of exposure to ionizing radiation may be extensive and sometimes permanent, particularly in the salivary glands and bone tissue. It is of utmost importance that the surgeon dentist be aware of adverse reactions and appropriate forms of treatment to alleviate discomfort and improve the quality of life of the irradiated patient. Therefore, awareness and motivation of the patient, with promotion of oral health through the adaptation of the oral environment and guidance on preventive measures are essential to get a better prognosis.
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Humanos , Neoplasias de Cabeza y Cuello , Radiobiología , Radioterapia , Radioterapia/efectos adversos , Ageusia , Disgeusia , Infecciones Oportunistas , Osteorradionecrosis , Enfermedades Periodontales , Estomatitis , Trismo , XerostomíaRESUMEN
Objeti vo: Avaliar o conhecimento de acadêmicos do curso de Odontologia sobre hepati tes virais. Método: A amostra foi constituída por 109 acadêmicos dos 157 acadêmicos do Curso de Odontologia da Universidade Estadual da Paraíba (UEPB), do terceiro ao quinto anos, selecionadosaleatoriamente, os quais estão mais expostos aos fatores de risco inerentes ao não conhecimento das hepatites virais. Os dados foram coletados através de um questionário com questões de múltipla escolha que abordavam o conhecimento sobre hepatites virais. As variáveis do estudo incluíam questõescomo: tipo de Equipamento de Proteção Individual usado durante os procedimentos, opinião sobre a exposição ao vírus da hepatite, quais seriam as vias de transmissão da hepatite, se o acadêmico já havia sofrido acidente com instrumental pérfuro-cortante. Os dados foram analisados de forma descritiva. Resultados: Todos os alunos (100%) afirmaram que usavamluvas, máscara e gorro, porém, apenas 92% deles achavam estar expostos aos vírus da hepati te. Em relação às vias de exposição, 95% dos acadêmicos afirmaram ser o sangue contaminadouma das principais vias de transmissão da hepatite, porém, 36% apenas afirmaram que as mucosas poderiam ser uma via de transmissão. De todos os acadêmicos pesquisados, 28% jáhaviam sofrido algum acidente pérfuro-cortante. Os resultados da investigação com base no questi onário mostraram que apenas 75% dos acadêmicos eram vacinados, 63% responderam que para a hepati te ti po B. Conclusão: Os estudantes de Odontologia têm consciência dos riscos de contaminação em relação às hepatites virais, mas osconhecimentos adquiridos sobre os mesmos não estão sendo aplicados na práti ca clínica.
Objective: To evaluate the knowledge of undergraduate dental students about viral hepatites. Methods: The sample was composed of 109 out of 157 3rd-5th undergraduate dental students from the State University of Para¡ba (UEPB), Brazil, selected at random, who are more exposed to the risk factors inherent to the unawareness of viral hepatites. Data were collected using a questionnaire with multiple-choice questions arguing about the knowledge of viral hepatites. The study variables included questions regarding individual protection equipment used during the procedures, opinion about exposure to hepatitis virus, which would be the transmission routes, and whether the student had already suffered any accident with perforating/cutting instruments. Data were subjected to descriptive analysis. Results: All (100%) students affirmed to use gloves, mask and cap, but only 92% of them believed to be exposed to the hepatitis virus. Regarding the forms of exposure, 95% of the undergraduate students affirmed that contaminated blood is one of the main transmission routes of hepatitis, but only 36% of them believed that the mucosas could be a transmission route. From all undergraduate students interviewed for the study, 28% had already experienced some kind of perforating/cutting accident. The results of this questionnaire-based investigation revealed that only 75% of the undergraduate students were vaccinated, 63% of them for type B hepatitis. Conclusion: The dental students are aware of the risks of contamination by viral hepatites, but the acquired knowledge about the risks are not being applied in the clinical practice.
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Humanos , Masculino , Femenino , Adulto Joven , Facultades de Odontología , Estudiantes de Odontología , /estadística & datos numéricos , /prevención & control , Hepatitis Viral Humana , Equipos y Suministros/prevención & control , Guantes ProtectoresRESUMEN
CONTEXT: Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue. It may affect the craniomaxillofacial complex and result in less bone-implant contact. AIMS: The objective of this study was to measure the endosseous integration of titanium implants using the removal torque test in low-mineral density experimental animal models. MATERIALS AND METHODS: Thirty female New Zealand white rabbits were divided into two groups: control (n=14), sham-operated; and test (n=16), ovariectomized. All animals received 2.2 mm Χ 4.0 mm titanium implants in the right tibia, 120 days after ovariectomy or sham surgery. Animals were killed at 7 and 14 weeks of postimplant insertion, when implants were removed by reverse torque rotation using a digital torque meter. Statistical analysis used was Student's t-test. RESULTS AND CONCLUSION: At the 7-week period, the mean torque values for the control and test groups were 11.6 Ncm and 10.4 Ncm, respectively, with no statistical significance. Implant removal torque analysis showed statistically lower values (P < 0.05) for the test group at the 14-week period (control=16.7 Ncm and test=9.7 Ncm). The results of this study indicate that hormonal privacy compromise implants biomechanical performance.
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Implantes Dentales , Materiales Dentales , Oseointegración/fisiología , Osteoporosis/fisiopatología , Titanio , Absorciometría de Fotón , Animales , Fenómenos Biomecánicos , Densidad Ósea/fisiología , Enfermedades Óseas Metabólicas/fisiopatología , Materiales Dentales/química , Remoción de Dispositivos , Modelos Animales de Enfermedad , Femenino , Ovariectomía , Conejos , Distribución Aleatoria , Estrés Mecánico , Tibia/cirugía , Factores de Tiempo , Titanio/química , TorqueRESUMEN
OBJETIVO: Avaliar quais dos grupos dentários apresentavam-se mais retidos, relacionando com gênero e idade. METODOLOGIA: Estudo transversal, retrospectivo mediante a análise de 3.500 radiografias panorâmicas. Foram incluídos neste estudo pacientes com dentição permanente completa; faixa etária de 15 a 35 anos; ambos os gêneros; radiografias panorâmicas que apresentaram, pelo menos, um dente retido. Para a coleta de dados, utilizou-se uma ficha pré-elaborada, os dados foram analisados de forma descritiva com medidas de tendência central de média, desvio-padrão, valores máximo e mínimo e inferencial com teste de Qui-Quadrado de Pearson, adotando-se em todos os casos, como nível de significância 0,05 (p=0,05). RESULTADOS: O grupo dos molares apresentou maiores médias (2,81). Encontrou-se que não houve diferença estatisticamente significante (p=0,825), quando se relacionou gênero e presença de dente retido. Observou-se associação estatisticamente significante (p=0,001) entre faixa etária e presença do dente retido, estando mais presente entre a faixa etária dos 15 aos 20 anos. CONCLUSÃO: Os molares encontraram-se mais retidos. O gênero feminino apresentou o maior número de dentes retidos, porém a diferença não foi estatisticamente significante. A faixa etária dos 15 aos 20 anos foi a mais prevalente.
AIMS: To evaluate which groups had most impacted teeth in relation to gender and age. MATERIAL AND METHODS: We conducted a retrospective, cross-sectional study, analyzing 3,500 panoramic radiographs. The patients, aged from 15 to 35 years, of both genders, all had complete permanent dentition, and the radiographs showed at least one impacted tooth. A previously prepared form was used for the collection of data, which were descriptively analyzed with measurements showing the main trends in means, standard deviation, maximum and minimum values and inferential statistics using the chi-square test, adopting a significance level of 0.05 (p=0.05) in all cases. RESULTS: The group of molars showed the highest means (2.81). No statistically significant differences (p=0.825) were found between gender and presence of the impacted tooth. There was a statistically significant difference (p=0.001) between age and presence of an impacted tooth, which was most prevalent among patients aged 15 to 20 years. CONCLUSIONS: The molars were found to be the most impacted group of teeth. Females had more impacted teeth than males, but the difference was not statistically significant. The most prevalent age group was 15 to 20 years.
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O objetivo deste trabalho foi o de avaliar o fluxo salivar e a concentração do EGF na saliva de pacientes diabéticos, comparados a um grupo controle de pacientes clinicamente sadios. A amostra foi composta de 15 indivíduos divididos em dois gruops, G0 - controle (n=9) e G1 - diabéticos (n=6). A saliva foi coletada por estimulação mecânica com o auxílio de um hiperboloide. A concentração do EGF foi verificada por meio de imunoensaio do tipo sanduíche, com a utilização de Kit ELISA (R&D Systems®) e auxílio de um leitor de microplaca. Pôde-se observar uma média do fluxo salivar de 1,27 ml/min. no G0 e 1.26 ml/min. no G1, não havendo diferença estatisticamente significativa entre os dois grupos, quando empregado o teste t-Student (p=0,972). Quando ao EGF, foram observadas as médias de 1624,08 pg/ml e 2367,66 pg/ml para o G0 e G1, respectivamente, também não sendo esta diferença significante (p=0,559). Os dados deste trabalho demonstram que não houve diferenças significativas do fluxo salivar e da concentração de EGF na saliva dos pacientes diabéticos em relação ao grupo controle.
The aim of this study was to evaluate the salivary flow and the concentration of EGF in saliva of diabetic patients not insulin-dependents compared with a non diabetic patients (control group). Stimulated saliva was collected in two groups of patients: G0 - control (n=9) and G1 - diabetics (n=6), using a hiperbolóide. Saliva was expelled in the first minute and it was despised. In the following five minutes it was collected with a funnel connected to a graduated tube. EGF concentration measurement was performed using a sandwich-type immunoassay, using an ELISA Kit (R&D Systems®) and a microplate reader. It was observed an average of salivary flow of 1.27ml/min. in G0 and 1,26ml/min. in G1 and it was not found significant differences between the two groups (p=0,972). It was also observed an average of 1624.08 pg/ml of EGF in the G0 and 2367.66 pg/ml in the G1 and as the salivary flow the difference was not statistically significant (p=0.559). The data present in this work demonstrate no differences between salivary flow and EGF concentration of diabetic patients as compared as non-diabetic patients.
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Diabetes Mellitus , Factor de Crecimiento Epidérmico , SalivaRESUMEN
INTRODUCTION: Xenotransplantation and multivisceral transplantation are advanced therapeutic methods that still require a scientific basis. There are no experimental models of multivisceral transplantation available, particularly not the monitoring by endoscopy. Here, we describe the endoscopic features in a model of multivisceral xenotransplantation. METHODS: The distal esophagus, stomach, intestine, colon, liver, pancreas, and the kidneys with a common vascular pedicle were harvested from rabbits and implanted in swine (group I, n = 9) or in rabbits (group II, n = 4). Endoscopy was performed in the stomach, jejunum, and ascending colon at four consecutive time points (immediate after surgery and 10, 90, and 180 min after reperfusion). Lesions were macroscopically graded as mild, moderate, and severe. Biopsies were taken following sacrifice at 180 min after reperfusion. RESULTS: In group I, the stomach, jejunum, and colon manifested a progression of lesions with predominance of mild lesions after 10 min, mild to moderate lesions after 90 min, and moderate to severe lesions after 180 min. In animals from group II, endoscopy showed normal features at all time points after reperfusion. Histopathologic analysis confirmed the diagnosis of hyperacute rejection in group I. Grafts from group II animals presented normal or mild ischemic/reperfusion injury. CONCLUSION: All animals subjected to multivisceral xenotransplantation showed a progression of endoscopic lesions with time after transplantation, while animals subjected to allotransplantation showed no aberrations in endoscopy. We conclude that endoscopy is a useful tool in the assessment of hyperacute rejection of a xenograft.
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Trasplante Heterólogo/métodos , Vísceras/trasplante , Animales , Endoscopía Gastrointestinal , Rechazo de Injerto/patología , Humanos , Conejos , Porcinos , Trasplante Heterólogo/patología , Vísceras/patologíaRESUMEN
Nesta revisão, ficou demonstrado que da mesma maneiraque as células imunológicas agem para reparar os tecidosafetados, as células cancerígenas produzem desordenadamenteos fatores da inflamação para manter ocrescimento e desenvolvimento da lesão tumoral. Elasproduzem exageradamente as mesmas substânciasinflamatórias como citocinas, prostaglandinas e leucotrienos,as quais normalmente desempenham a reparação naturaldos tecidos. O câncer vai se servir dessas substânciaspara induzir sua própria proliferação e tornar permeáveis asbarreiras que o cercam. Assim, o processo que permite aosistema imunológico reparar lesões e destruir os agentesagressores em todos os recônditos do organismo é desviadoem favor das células cancerosas. E graças à inflamação,elas vão se infiltrar nos tecidos vizinhos, penetrar no fluxosanguíneo e linfático para originar as metástases. O excessodessas substâncias inflamatórias nos tecidos contíguosacarreta o bloqueio de um processo natural que se chamaapoptose, ou seja, o suicídio celular geneticamenteprogramado, contribuindo assim para a proliferação anárquicados tecidos. As células cancerosas se veem assimprotegidas da destruição celular, e o tumor vai cada vezmais, ganhando tamanho e corpo...
This review demonstrated that in the same way the immunecells act to repair the affected tissues, cancer cells producedisorderly inflammation factors to sustain growth anddevelopment of the tumor. They produce exaggeratedly thesame inflammatory substances such as cytokines,prostaglandins and leukotrienes, which usually play thenatural tissue repair. The cancer uses those substances toinduce its own proliferation and to make permeable barrierssurrounding it. Then the process that allows the immunesystem to repair damage and to destroy aggressors in allreaches of the body is skewed in favor of cancerous cells.And due to inflammation, such cells will infiltrate throughsurrounding tissues, penetrate into lymphatic and blood flowuntil give rise to metastases. The excess of these inflammatorysubstances in the surrounding tissues, leads to blockage ofa natural process called apoptosis, or genetically programmedcell suicide, thereby contributing to the uncontrolledproliferation of tissues. Cancerous cells are thus protectedfrom cell destruction, and the tumor will increasingly gainingsize and body...