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Comprehensive treatment is crucial for patients with a cleft lip/palate. While studies have investigated its impact on children's quality of life, few have examined the effects on primary caregivers. The aim of the study was to compare the quality of life of caregivers of children with cleft lip/palate to a control group at the National School for Higher Studies, National Autonomous University of Mexico, Guanajuato. A cross-sectional study was conducted at a teaching dental clinic of the National School of Higher Studies, National Autonomous University of Mexico, Guanajuato, México, from May to December 2021 involving 140 caregivers (70 in each group). The WHOQoL Bref instrument assessed the quality of life. In addition to the descriptive analysis, a binary logistic regression analysis was carried out, taking dichotomized reported quality of life as the dependent variable. Among the caregivers, 88.6% were female (p > 0.05), and 45 (64.8%) from the study group reported poor quality of life (p < 0.05). A multivariate analysis indicated that caring for a child with cleft lip/palate raised the likelihood of poor quality of life (p < 0.05). The findings emphasize the need for comprehensive support for both patients and caregivers, as their well-being affects patient outcomes.
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Approximately 39 million people worldwide live with human immunodeficiency virus (HIV), and antiretroviral therapy (ART) has improved life expectancy for these individuals, with quality of life (QoL) being a crucial aspect. However, there is limited information on oral health-related quality of life (OHRQoL) for institutionalized patients with HIV. This study used a cross-sectional design and included 43 residents of a non-governmental institution who had a confirmed HIV diagnosis and a history of intravenous drug use. The Spanish version of the Oral Health Index Profile-14 (OHIPsp) was used to assess the OHRQoL, with the 50th percentile serving as the cutoff for good or poor quality of life. All 43 patients had one or more oral lesions, with 44.1% having AIDS-related oral lesions (AROLs). Over half of the participants (48.8%) reported a poor OHRQoL, and females experienced worse quality of life in all dimensions compared to males. Subjects with AROLs were three times more likely to have poor OHRQoL than those without AROLs (p = 0.03; OR = 3.1 IC 1.04-9.6). These results highlight the need for a comprehensive treatment plan for patients with HIV that includes oral health, particularly for women living in precarious conditions or who are institutionalized. Improving oral health can significantly enhance quality of life.
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Odontogenic keratocyst (OK) is a benign intraosseous cystic lesion characterized by a parakeratinized stratified squamous epithelial lining with palisade basal cells. It represents 10-12% of odontogenic cysts. The changes in its classification as a tumor or cyst have increased interest in its pathogenesis. OBJECTIVE: Identify key genes in the pathogenesis of sporadic OK through in silico analysis. MATERIALS AND METHODS: The GSE38494 technical sheet on OK was analyzed using GEOR2. Their functional and canonical signaling pathways were enriched in the NIH-DAVID bioinformatic platform. The protein-protein interaction network was constructed by STRING and analyzed with Cytoscape-MCODE software v 3.8.2 (score > 4). Post-enrichment analysis was performed by Cytoscape-ClueGO. RESULTS: A total of 768 differentially expressed genes (DEG) with a fold change (FC) greater than 2 and 469 DEG with an FC less than 2 were identified. In the post-enrichment analysis of upregulated genes, significance was observed in criteria related to the organization of the extracellular matrix, collagen fibers, and endodermal differentiation, while the downregulated genes were related to defensive response mechanisms against viruses and interferon-gamma activation. CONCLUSIONS: Our in silico analysis showed a significant relationship with mechanisms of extracellular matrix organization, interferon-gamma activation, and response to viral infections, which must be validated through molecular assays.
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Quistes Odontogénicos , Tumores Odontogénicos , Humanos , Interferón gamma , Quistes Odontogénicos/genética , Quistes Odontogénicos/patología , Tumores Odontogénicos/patología , Mapas de Interacción de Proteínas/genéticaRESUMEN
Psychosocial factors influence the development, exacerbation, or aggravation of some oral diseases. However, the possible relationship between personality traits, affective disorders, and psychological stress in oral diseases, and their impact on oral health-related quality of life (OHRQoL), has not been fully clarified. The aim of the present study was to determine the association of neuroticism and stress with the presence of oral lichen planus (OLP), and to discover whether or not these factors impact OHRQoL. This is a case-control study matched for age and sex. The case group (OLP group) was composed of 20 patients diagnosed with OLP, while 20 people with a diagnosis of lesions not associated with stress formed the control group. Three instruments were used: the Holmes-Rahe Social Readjustment Scale, the Five Factor Personality Model, and the OHIP-49. Neuroticism obtained a score of 25.5 (±5.4) in the OLP group, which was higher than the control group value (21.7) (±5.1) (p = 0.03). The OLP group showed a worse quality of life (p < 0.05); the most affected dimensions were psychological discomfort and physical disability. It is important to include a psychological profile to establish a comprehensive treatment for these patients. We propose the recognition of a new area of clinical oral medicine: psycho-stomatology.
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BACKGROUND: Oral cancer has a high prevalence worldwide, and this disease is caused by genetic, immunological, and environmental factors. The main risk factors associated with oral cancer are smoking and alcohol. RESULTS: There are various strategies to reduce risk factors, including prevention programs as well as the consumption of an adequate diet that includes phytochemical compounds derived from cranberries (Vaccinium macrocarpon A.) and blueberries (Vaccinium corymbosum L.); these compounds exhibit antitumor properties. RESULTS: The main outcome of this review is as follows: the properties of phytochemicals derived from cranberries were evaluated for protection against risk factors associated with oral cancer. CONCLUSIONS: The secondary metabolites of cranberries promote biological effects that provide protection against smoking and alcoholism. An alternative for the prevention of oral cancer can be the consumption of these cranberries and blueberries.
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Background and Objectives: Healthcare workers (HCWs) play important roles in mitigating the COVID-19 pandemic and are more likely to become infected with COVID-19. Mexico, among other countries, had a high incidence and prevalence of cases and deaths from this disease. Material and Methods: This retrospective study evaluated the clinical characteristics as well as the geographical distribution of cases, deaths, and active cases of COVID-19 in HCWs and non-HCWs using official information from the Ministry of Health of Mexico. Results: A total of 235,343 cases of COVID-19 were reported in healthcare workers, and 2,094,191 cases were reported in non-healthcare workers. A total of 76.0% of cases in healthcare workers occurred in those who were between 25 and 50 years of age, and 71.4% of deaths occurred in those who were 50 to 69 years of age. Among healthcare workers, the most frequent comorbidities were obesity (15.2%), hypertension (10.9%), and diabetes (6.8%). Nurses were the group with the most cases (39.7%), followed by other healthcare workers (30.6%), physicians (26%), and dentists (1.6%). Physicians were the group with the most deaths (46%), followed by other professionals (30%), nurses (19%), and dentists (3%). Conclusion: These findings are likely the result of healthcare workers in Mexico being at a greater risk of exposure to SARS-CoV-2.
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COVID-19 , Pandemias , Anciano , Personal de Salud , Humanos , México/epidemiología , Estudios Retrospectivos , SARS-CoV-2RESUMEN
BACKGROUND: Palatal perforations not associated with syndromes or neoplasms are rare lesions whose frequency has increased recently. However, their clinical and demographic characteristics have not been fully described. Therefore, this report aimed to establish the demographic and clinical characteristics of patients with non-syndromic and non-neoplastic palatal perforations. MATERIAL AND METHODS: The file of an oral medicine teaching clinic from January 2004 to December 2018 was reviewed to identify and isolate all cases with a diagnosis of palatal perforation. Cases with a diagnosis of palatal perforation related to congenital alteration, syndrome, or neoplasia were excluded. Age, sex, medical history, and diagnosis were obtained from the clinical history. In addition, a systematic review of the literature was performed using a PICO strategy. MEDLINE electronic databases from January 1990 to December 2018 were systematically reviewed using the combination of keywords with Boolean terms "OR" (palatal perforation, destruction of the palate) and "AND" (drugs, cocaine, mycosis, syphilis, mucormycosis, tuberculosis, trauma). The PRISMA guide was used to identify the different results of the literature search and article selection process. Case reports and case series were included. RESULTS: Five cases of non-syndromic, non-neoplastic palatal perforations were identified. All cases were male with a mean age of 42 years. Two cases were related to cocaine use, 2 cases were caused by mucormycosis, and one case by trauma. As for the systematic literature review, 51 non-neoplastic and non-syndromic cases were collected. The cases showed a male predominance, with a mean age of 41 years. The most frequent etiology was chronic cocaine use followed by mucormycosis. CONCLUSIONS: Since cocaine use and type II Diabetes Mellitus, risk factors related to non-syndromic and non-neoplastic palatal perforations, have shown a worldwide increase, the clinician should be alert to make an early diagnosis and initiate appropriate treatment. Key words:Palatal perforation, cocaine-induced, mucormycosis, mycotic infection, drug users.
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Necrotizing Sialometaplasia (NS) is a rare, benign, self-limited, inflammatory and necrotizing reaction of the salivary glandular tissue. Due to the clinical picture (a painful ulcer with well-defined edges), and histopathological characteristics (nuclear and cellular pleomorphism of ductal cells) NS can mimic a malignant lesion. The correct diagnosis is important because NS shows a spontaneous resolution and therefore no further treatment is needed. We report a very unusual case of spontaneous and recurrent NS located on the anterior tonsillar pillar in a 43-year old man, which clinically mimics a malignant lesion. The clinician should be aware to include NS in the differential diagnosis of ulcers in soft palate and tonsillar pillars. Key words:Minor salivary gland, necrotizing sialometaplasia, oral ulcer, squamous cell carcinoma, tonsillar pillar.
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Abstract Candida albicans is the etiological agent most frequently associated with oral candidiasis in human immunodeficiency virus (HIV) carriers. Strain typification is important to disease epidemiology, particularly with simple, low-cost methodologies such as resistotyping. The present study was designed to use resistotyping to identify possible phenotypic differences between C. albicans strains isolated from the oral cavity of HIV+ and HIV-seronegative patients. Analyses were run using resistotyping (boric acid, cetrimide, sodium periodate, sodium selenite and silver nitrate) to identify phenotypical differences between C. albicans. Descriptive statistics was performed. Of the 149 clones isolated from HIV+ patients the most frequent (47.0%) resistotype was ABCDE. The most frequent resistotype (64.8%) in the 74 clones from HIV-seronegative patients was --CDE. Phenotypic differences were identified between the strains isolated from each group. HIV+ patients exhibited greater strain diversity. Although it has limitations, resistotyping effectively identified differences between C. albicans strains.
Resumen Candida albicans es el agente etiológico más frecuentemente asociado con la candidiasis oral en portadores del virus de la inmunodeficiencia humana (VIH). La tipificación de la cepas es importante para conocer la epidemiología de la enfermedad, particularmente con metodologías simples y de bajo costo, como la resistotipificación. El presente estudio fue diseñado para identificar posibles diferencias fenotípicas por el método de resistotipificación entre cepas de C. albicans aisladas de la cavidad oral de pacientes VIH+ y seronegativos. Se realizó estadística descriptiva. Los análisis se realizaron utilizando resistotipificación (ácido bórico, cetrimida, peryodato de sodio, selenito de sodio y nitrato de plata) para identificar diferencias fenotípicas entre C. albicans. De las 149 clonas aisladas de pacientes VIH+, el resistotipo más frecuente (47.0%) fue ABCDE. El resistotipo más frecuente (64.8%) en las 74 clonas de pacientes seronegativos al VIH fue --CDE. Se identificaron diferencias fenotípicas entre las cepas aisladas de cada grupo. Los pacientes VIH + exhibieron una mayor diversidad de cepas. Aunque tiene limitaciones, la resistotipificación identificó de manera efectiva las diferencias entre las cepas de C. albicans.
Asunto(s)
Humanos , Candida albicans/patogenicidad , Candidiasis Bucal/etiología , VIHRESUMEN
BACKGROUND: Odontogenic cysts (OC) are the most frequent lesions of the jaws and their constant epidemiological update is necessary and indispensable. Therefore the principal objective of this report was To determine prevalence and clinical-demographical characteristics of OC in a Mexican sample. MATERIAL AND METHODS: 753 cases of OC coming from the archive of a head and neck histopathological teaching service, from January 2000 to December 2013, were included. OC cases were re-assessed according 2005 WHO classification. Chi square test was used to establish possible associations (p<0.05IC95%). RESULTS: From 753 OC, 369 were female and 384 male; 52.9% of them were in their 2nd- 4th decade of life. The most common location (41%) was the mandibular posterior area. Radicular cysts were more frequent in maxillary anterior zone of females (p 0.0002) at their fourth decade of life. Dentigerous cysts were more frequent in the mandibular posterior zone of males (p 0.0000) in their second decade of life. Six cases of periodontal lateral cyst; 4 cases of paradental cysts; 4 eruption cysts and 4 cases of adult gingival cyst, as well were identified. CONCLUSIONS: Radicular cyst and dentigerous cyst are the most prevalent odontogenic cyst in this Mexican sample. Due to their etiology, dental pulpar necrosis and impacted teeth, radicular cyst and dentigerous cyst could be prevenible. Therefore, it is necessary to establish preventive strategies to diminish dental decay and programs of prophylactic extractions of impacted teeth, to in consequence decrease the prevalence of odontogenic cysts. Key words:Cyst, dentigerous cyst, mexican, odontogenic cyst, radicular cyst.
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El curetaje apical con apicectomía forma parte del procedimiento quirúrgico endodóntico. Tiene la finalidad de remover el contenido presente en el interior de la cavidad quirúrgica, como tejido de granulación, restos de membrana quística, cuerpos extraños y eliminar el ápice dental involucrado. Sin embargo, en determinados casos el realizar una apicectomía puede influir en la estabilidad de la restauración en donde la alternativa del tratamiento pudiera ser un curetaje apical sin apicectomía. En este artículo se presenta un caso clínico donde se realizó un curetaje apical y obturación retrógrada con cemento agregado trióxido mineral en un diente con fracaso de un tratamiento endodóntico convencional.
Apical curettage with apicoectomy is a component of many endodontic surgical procedures. It purports the aim of removing any contents present inside the surgical cavity, such as granulation tissue, cystic membrane remnants, or foreign bodies, as well as removing the involved dental apex. Nevertheless, in some cases, performing an apicoectomy can negatively influence the restoration's stability; in these cases an alternative treatment could be performing apical curettage without apicoectomy. The present article documents a clinical case where apical curettage and retrograde obturation with mineral trioxide aggregate cement were performed on a tooth where previous conventional endodontic treatment had failed.
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UNLABELLED: Sialolipoma is rare benign neoplasm arise from salivary glands (majors and minors) characterized by neoplastic adipose tissue with scattered non-neoplastic salivary gland acinus. To date 60 cases (including 5 cases reported in the present paper) have been reported in scientific literature. This article presents 5 new cases of sialolipoma affecting minor salivary glands (MiSG) and additionally reviews and analyzes the previously published cases to assess possible demographical differences between sialolipoma from minor and from major salivary glands. CASE REPORTS: 5 cases (3 females; 2 males; age means 63.8 years), of sialolipoma from MiSG, are reported. 2 of them were located in buccal mucosa, 1 in upper lip mucosa, 1 in floor of the mouth and 1 in retromolar area. All tumors were composed by neoplastic adipocytes cells interlaced with normal salivary gland acinus cover it by a fibrous tissue capsule. Analyzes of literature showed that MiSG sialolipoma is most frequent in females over 60 years old, therefore and in conclusion this article assess different demographical profile of sialolipoma in respect to their topography.
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Antecedentes: El tumor de Warthin -tumor benigno de glándulas salivales- fue reportado por primera vez en 1895 por Hildebrand y posteriormente en 1929 Warthin lo describió ampliamente. Es la segunda neoplasia más frecuente de las glándulas salivales, representando el 10% de todos los tumores de glándulas salivales. Métodos: Se realizó un estudio retrospectivo de tumores de glándulas salivales del Departamento de Anatomía Patológica del Hospital «Calixto García¼ de La Habana, Cuba, durante el periodo de enero del 2001 a diciembre del 2008. Los casos fueron rediagnosticados por dos expertos en patología bucal, basados en los criterios diagnósticos propuestos por la Organización Mundial de la Salud en el 2005. Resultados: De 159 casos, 113 (71.1%) fueron tumores benignos (48 hombres, 65 mujeres; promedio de edad 50.8 [± 15], rango de edad 20-80 años). El tumor más frecuente fue el adenoma pleomorfo con 77 casos (68.1%), seguido del tumor de Warthin con 33 casos, que constituyen el 20.7% del total de tumores de glándulas salivales incluidos y el 29.2% del total de los tumores benignos. Conclusiones: En nuestro estudio la proporción del tumor de Warthin está dentro de las más altas, acorde a lo reportado en la literatura de los últimos años.
Background: Warthin's tumor, a benign tumor of the salivary glands, was first described by Dr. Hildrebrand in 1896. It was later extensively described by Dr. Warthin in 1929. It represents the second most frequent neoplasia found in the salivary glands. It constitutes 10% of all salivary glands tumors. Methods: A salivary gland retrospective study was conducted at the Pathological Anatomy Department of the «Calixto García¼ Hospital in Havana, Cuba. The study was conducted in the period comprised between January 2001 and December 2008. Two oral pathology experts re-diagnosed the cases following diagnostic criteria proposed in 2005 by the World Health Organization (WHO). Results: Out of 159 studied cases, 113 (71.1%) were benign tumors (48 male patients, 65 female, average age 50.8 [± 15], age range 20-80 years). Most frequently found tumor was pleomorphic adenoma, which counted 77 cases (68.1%) followed by Warthin's tumor with 33 cases (20.7%) of all included salivary glands tumors and 29.2% of benign tumors. Conclusions: The present study revealed the fact that Warthin's tumor proportion is among the highest reported in recent years in scientific literature.
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OBJECTIVE: Determine the frequency of candida in the oral cavity of children with a risk of developing opportunistic infections, and establish if there is an association between the frequency of this oral colonization and three categories of at-risk populations. METHODS: Four infant population groups in Mexico were studied: an HIV/AIDS group undergoing highly active antiretroviral therapy (35 girls and 25 boys); a malnourished group (26 girls and 29 boys); a group from the Tarahumara indigenous people, one of the poorest ethnic populations in the country (37 girls and 20 boys); and a control group (8 girls and 21 boys in apparently good health). The children with HIV/AIDS were immunologically and virologically classified according to the EC Clearinghouse criteria, while malnutrition was determined through the World Health Organization's weight/height index. A sample of oral mucosa was taken with a sterile swab, which was incubated in Sabouraud dextrose agar and in Candida CHROMagar®. The species of candida were confirmed through the API ID32C test. RESULTS: The HIV/AIDS and malnutrition groups showed the higher frequency of Candida spps (51.7% and 38.2%, respectively), while the frequency level in the Tarahumara group was similar to that of the control group (17.5% versus 10.3%). With regard to the species of candida, the malnutrition group had the greatest diversity: C. albicans, C. tropical, C. krusei, and C. glabrata. CONCLUSIONS: The children with HIV/AIDS and malnutrition require strategies designed to reduce oral candidal colonization and reduce the risk of opportunistic infections.
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Candidiasis Bucal/epidemiología , Infecciones por VIH/epidemiología , Indígenas Norteamericanos/estadística & datos numéricos , Desnutrición/epidemiología , Adolescente , Candida/aislamiento & purificación , Portador Sano/epidemiología , Niño , Preescolar , Comorbilidad , Estudios Transversales , Femenino , Humanos , Huésped Inmunocomprometido , Masculino , México , Mucosa Bucal/microbiología , Infecciones Oportunistas/epidemiología , Poblaciones Vulnerables/estadística & datos numéricosRESUMEN
OBJETIVO: Determinar la frecuencia de Candida en cavidad bucal de niños con riesgo de desarrollar infecciones oportunistas y establecer si existe asociación entre la frecuencia de esta colonización bucal y tres tipos de población en riesgo. MÉTODOS: Se estudiaron cuatro grupos de población infantil de México: grupo VIH/sida bajo terapia antirretroviral altamente activa (TAAA) (35 niñas y 25 niños); grupo desnutrición (26 niñas y 29 niños); grupo tarahumara (37 niñas y 20 niños), una de las poblaciones étnicas más pobres del país, y grupo control (8 niñas y 21 niños aparentemente sanos). Los niños con VIH/sida fueron inmunológica y virológicamente clasificados según los criterios de EC-Clearinghouse, mientras que la desnutrición fue determinada a través del índice peso/talla de la Organización Mundial de la Salud. Se tomó una muestra de la mucosa bucal con hisopo estéril, que fue incubada en agar dextrosa Sabouraud y en CHROMagar-Candida®. Las especies de Candida se confirmaron con la prueba API ID32C. RESULTADOS: Los grupos VIH/sida y desnutrición mostraron la frecuencia más alta de Candida spp. (51,7 por ciento y 38,2 por ciento, respectivamente) mientras que el grupo tarahumara presenta una frecuencia semejante a la del grupo control (17,5 por ciento vs 10,3 por ciento). Respecto a las especies de Candida, el grupo desnutrición mostró la mayor diversidad: C. albicans, C. tropicalis, C. krusei y C. glabrata. CONCLUSIONES: Los infantes con inmunodeficiencia y con desnutrición requieren de estrategias diseñadas para disminuir la colonización bucal candidal y disminuir el riesgo de infecciones oportunistas.
OBJECTIVE: Determine the frequency of candida in the oral cavity of children with a risk of developing opportunistic infections, and establish if there is an association between the frequency of this oral colonization and three categories of at-risk populations. METHODS: Four infant population groups in Mexico were studied: an HIV/AIDS group undergoing highly active antiretroviral therapy (35 girls and 25 boys); a malnourished group (26 girls and 29 boys); a group from the Tarahumara indigenous people, one of the poorest ethnic populations in the country (37 girls and 20 boys); and a control group (8 girls and 21 boys in apparently good health). The children with HIV/AIDS were immunologically and virologically classified according to the EC Clearinghouse criteria, while malnutrition was determined through the World Health Organization's weight/height index. A sample of oral mucosa was taken with a sterile swab, which was incubated in Sabouraud dextrose agar and in Candida CHROMagar®. The species of candida were confirmed through the API ID32C test. RESULTS: The HIV/AIDS and malnutrition groups showed the higher frequency of Candida spps (51.7 percent and 38.2 percent, respectively), while the frequency level in the Tarahumara group was similar to that of the control group (17.5 percent versus 10.3 percent). With regard to the species of candida, the malnutrition group had the greatest diversity: C. albicans, C. tropical, C. krusei, and C. glabrata. CONCLUSIONS: The children with HIV/AIDS and malnutrition require strategies designed to reduce oral candidal colonization and reduce the risk of opportunistic infections.
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Candidiasis Bucal/epidemiología , Infecciones por VIH/epidemiología , Indígenas Norteamericanos/estadística & datos numéricos , Desnutrición/epidemiología , Candida/aislamiento & purificación , Portador Sano/epidemiología , Comorbilidad , Estudios Transversales , Huésped Inmunocomprometido , México , Mucosa Bucal/microbiología , Infecciones Oportunistas/epidemiología , Poblaciones Vulnerables/estadística & datos numéricosAsunto(s)
Candida , Candida albicans , Candida tropicalis , Salud Bucal , Salud Infantil , Odontología Pediátrica , VIH , Síndrome de Inmunodeficiencia Adquirida , México , Salud Bucal , Salud Infantil , Odontología Pediátrica , VIH , Síndrome de Inmunodeficiencia Adquirida , Candidiasis Bucal , Indígenas Norteamericanos , Portador Sano , Comorbilidad , Huésped Inmunocomprometido , Mucosa Bucal , Infecciones por VIH , Desnutrición , Estudios Transversales , Infecciones Oportunistas , Poblaciones VulnerablesRESUMEN
Los criterios histológicos para determinar el grado de displasia, la clasificación de Broders y el frente de invasión tumoral (FIT) son parámetros subjetivos no cuantificables que pueden indicar el grado de evolución de displasias y carcinomas. Un factor importante a considerar durante la valoración histológica, es la variabilidad del diagnóstico entre patólogos. El objetivo es estandarizar los criterios y determinar la variabilidad intra e inter observador en el diagnóstico de displasias y COCE. Se seleccionaron y estandarizaron los criterios morfológicos para el diagnóstico y se revisaron los casos seleccionados aleatoriamente por tres patólogos bucales (30 displasias y 30 carcinomas) del Laboratorio de Patología Clínica y Experimental de la DEPeI de la FO, UNAM. Cada patólogo analizó y registró los parámetros establecidos para displasia, COCE y FIT en 2 ocasiones. Se aplicó el test Kappa para valorar la concordancia intra e inter observador. El Observador 1 v/s el 2 obtuvo una concordancia para COCE de 0,75 y en displasias de 0,60 e intraobservador de 0,90. El observador 2 v/s el 3 presentó una concordancia para COCE de 0,75 y en displasias de 0,59 e intraobservador de 0,91. El Observador 3 Vs el 1 tuvo una concordancia para COCE de 0,77, y en displasias de 0,59 e intraobservador de 0,92. La concordancia intraobservador e interobservador en COCE fue de buena a excelente, pero en displasias fue aceptable confirmando que su evaluación presenta mayor grado de dificultad. Con una adecuada estandarización se puede obtener una buena concordancia entre patólogos.
In the histological criteria for determining the degree of dysplasia, the Broders classification and the front of tumor invasion (FTI) are unquantifiable subjective parameters that may indicate the degree of development of carcinomas. An important factor to consider during the histological evaluation is the variability in the diagnosis of pathologists. The objective to standardize criteria and determine the intra and inter-observer variability in the diagnosis of dysplasias and OSCC. We selected and standardized morphological criteria for the diagnosis, and the cases were reviewed randomly by three oral pathologists (30 dysplasias and 30 carcinomas) from the Laboratory of Clinical and Experimental Pathology of the FO DEPeI, UNAM. Each pathologist analyzed and recorded the parameters for dysplasia and OSCC FIT on two occasions. Kappa test was applied to assess intra and inter-observer agreement. Observer 1 v/s 2 match for OSCC was 0.75, 0.60 for dysplasias and intra observer 0.90. Observer 2 v/s 3 presented a concordance of 0.75 for OSCC, 0.59 for dysplasias and intra-observer 0.91. Observer 3 v/s observer 1 for OSCC was 0.77, 0.59 for dysplasias and intra-observer 0.92. Intra observer and inter-observer concordance in OSCC were good or excellent, but in dysplasia was acceptable, confirming that its assessment showed the greatest difficulty with proper standardization we can obtain a better consensus between pathologists.
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Femenino , Células Epiteliales/citología , Células Epiteliales/clasificación , Células Epiteliales/ultraestructura , Epitelio/anatomía & histología , Variaciones Dependientes del ObservadorRESUMEN
OBJECTIVE: To establish the time trends of the frequency and prevalence of oral cavity cancer in regard to age and gender in a 20-years (time period 1989 - 2008) cohort of Mexicans. DESIGN AND SETTING: 13,235 head and neck biopsies from the archive of the Oral Pathology Laboratory, Dental School, National Autonomous University of Mexico were revised. The cases with diagnoses of oral cancer were selected. Gender and age at diagnosis was obtained from medical records. The frequency and prevalence of oral cavity cancer and oral squamous cell carcinoma were assessed biannually in regard to the total number of population served by the oral pathology laboratory. The statistical significance of trends was established using the linear logistic regression (curve estimation) test (s 0.05). RESULTS: 298 cases (138 males; 160 females) of oral cancer were included; 167 (92 females; 75 males; female:male ratio: 1.1:1) corresponded to oral squamous cell carcinoma. From 1989 to 2008 the prevalence of oral cancer and oral squamous cell carcinoma increased 200% (s 0.05) and 100% (s 0.000) respectively. The increase of frequency and prevalence was observed in both genders however only in females was significant (s 0.000). We do not identify changes in the age at diagnosis. CONCLUSIONS: Oral cancer, specifically oral squamous cell carcinoma, has increase in Mexicans females in the last 20 years.
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Carcinoma de Células Escamosas/epidemiología , Neoplasias de la Boca/epidemiología , Adulto , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de TiempoRESUMEN
Oral candidiasis is the most prevalent complication in HIV-infected and AIDS patients. Topical antifungal treatment is useful for the initial episodes of oral candidiasis, but most patients suffer more than one episode and fluconazole or itraconazole can help in the management, and voriconazole may represent a useful alternative agent for the treatment of recalcitrant oral and oesophageal candidiasis. The aim of this research was to study the in vitro activity of voriconazole and fluconazole against Mexican oral isolates of clinically relevant yeast. The in vitro susceptibility of 187 oral yeast isolates from HIV-infected and healthy Mexicans was determined for fluconazole and voriconazole by the M44-A disc diffusion method. At 24 h, fluconazole was active against 179 of 187 isolates (95.7 %). Moreover, a 100% susceptibility to voriconazole was observed. Voriconazole and fluconazole are highly active in vitro against oral yeast isolates. This study provides baseline data on susceptibilities to both antifungal agents in Mexico.