RESUMEN
In recent years, the incidence of oral opportunistic infections has increased, partly due to the widespread implementation of organ and bone marrow transplantation and the increase in the prevalence of human immunodeficiency virus (HIV) infection. Cytology can be used as a rapid, inexpensive and simple routine procedure in diagnosing infectious diseases of the mouth. Moreover, ancillary methods can be applied to cytological samples, increasing the specificity and sensitivity for the diagnosis of infectious diseases. This review describes the cytopathological features of the main viral, fungal, bacterial and parasitic infections of the mouth. Cytological techniques of specimen collection, identification of infectious agents by cytomorphological approaches and ancillary methods, and diagnostic pitfalls will be discussed.
Asunto(s)
Enfermedades Transmisibles/diagnóstico , Enfermedades de la Boca/diagnóstico , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/microbiología , Enfermedades Transmisibles/microbiología , Citodiagnóstico , Humanos , Enfermedades de la Boca/microbiología , Micosis/diagnóstico , Micosis/microbiología , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/microbiología , Enfermedades Parasitarias/diagnóstico , Enfermedades Parasitarias/microbiología , Virosis/diagnóstico , Virosis/virologíaRESUMEN
Plasmablastic lymphoma (PBL) is an HIV-associated non-Hodgkin's lymphoma that primarily affects the oral cavity. We describe the case of an HIV patient with a lesion in the maxilla that lasted four months. He was diagnosed with PBL and received highly active antiretroviral therapy as well as chemotherapy and local radiotherapy. The lesion regressed after the third cycle of chemotherapy. The patient interrupted antiretroviral treatment and the lesion recurred. The immune reconstitution secondary to the use of antiretroviral therapy seems to participate in the regression of PBL and maintains the remission of the tumour, but it might not be enough to prevent the development of PBL.
Asunto(s)
Antirretrovirales/uso terapéutico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Neoplasias Maxilares/tratamiento farmacológico , Cumplimiento de la Medicación , Neoplasias de la Boca/tratamiento farmacológico , Recurrencia Local de Neoplasia/prevención & control , Adulto , Terapia Antirretroviral Altamente Activa , Humanos , Linfoma Relacionado con SIDA/patología , Masculino , Neoplasias Maxilares/patología , Boca/patología , Neoplasias de la Boca/patología , Recurrencia Local de Neoplasia/patologíaRESUMEN
AIM: This study evaluated the effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia. METHODS: Twelve patients with severe xerostomia were treated with acupuncture after radiation therapy. The baseline data were obtained preceding acupuncture treatment, and used as reference values. Acupuncture was performed in 12 sessions, 20 min each, twice a week, during a 6-week period. Clinical response was evaluated objectively by saliva collection measuring resting and stimulated whole salivary flow rates, and subjectively by a visual analogue scale patients' self-evaluation questionnaire. Statistical analyses were performed with a repeated-measures analysis of variance by using a mixed-effect modeling procedure. RESULTS: The results showed a statistically significant improvement for salivary flow rates on both objective and subjective evaluations (P<0.05). On objective evaluation there was an increase for resting salivary flow of 142.2% (mean=0.04 mL/min to 0.12 mL/min) and of 73.5% (mean=0.09 mL/min to 0.21 mL/min) for stimulated salivary flow. On subjective evaluation, visual analogue scale raised 36 points (mean=18.4 to 53.8) for sensation of more saliva production. CONCLUSION: According to the results of the present study, acupuncture showed a significant effect on saliva production, suggesting this therapy as a useful treatment for patients suffering from radiation-induced xerostomia.
Asunto(s)
Terapia por Acupuntura , Traumatismos por Radiación/complicaciones , Salivación , Xerostomía/etiología , Xerostomía/terapia , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Xerostomía/fisiopatologíaRESUMEN
AIM: To assess the efficacy of a medicated dressing in the socket on the healing after dental extractions in HIV positive patients. PATIENTS AND METHODS: Forty HIV positive patients with CD4 counts below 200 cells/mm(3) who were to have molar teeth extracted were randomly allocated to have the socket dressed with a medicated paste (Rifocort) with camphorated parachlorophenol and iodoform) and sutured (treated group), or merely sutured (control group). RESULTS: The sockets in the treated group healed more quickly than in the control group.
Asunto(s)
Antibacterianos/uso terapéutico , Seropositividad para VIH/complicaciones , Diente Molar/cirugía , Prednisolona/análogos & derivados , Rifamicinas/uso terapéutico , Extracción Dental , Alveolo Dental/efectos de los fármacos , Administración Tópica , Adulto , Antibacterianos/administración & dosificación , Antiinfecciosos Locales/administración & dosificación , Antiinfecciosos Locales/uso terapéutico , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Recuento de Linfocito CD4 , Alcanfor , Clorofenoles , Portadores de Fármacos , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Hidrocarburos Yodados/administración & dosificación , Hidrocarburos Yodados/uso terapéutico , Masculino , Persona de Mediana Edad , Pomadas , Polietilenglicoles , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Rifamicinas/administración & dosificación , Cicatrización de Heridas/efectos de los fármacosRESUMEN
The aim of this study was to present clinical, histological and immunohistochemical aspects of a polymorphous low grade adenocarcinoma occurring in the mandible. A radiolucent tumour, located in the right mandible, was removed from a 40-year-old woman. Radiographic and CT exams revealed that the lesion expanded bucco-lingual cortical plates and presented an irregular scalloping of the bone. The surrounding lining mucosa was intact. The patient underwent total surgical removal of the lesion with an intraoperative biopsy. Histological diagnosis was polymorphous low-grade adenocarcinoma confirmed by immunohistochemical study. One-year follow up was uneventful. The accurate diagnosis of lesions presenting unusual clinical aspects, as the one presented here, is critical for correctly handling treatment.
Asunto(s)
Adenocarcinoma/diagnóstico por imagen , Neoplasias Mandibulares/diagnóstico por imagen , Adenocarcinoma/patología , Adulto , Femenino , Humanos , Neoplasias Mandibulares/patología , Radiografía Panorámica , Tomografía Computarizada por Rayos XRESUMEN
The oral findings of 12 patients with Moebius syndrome are described. Facial weakness, hypoplastic upper lip, microstomia, mouth-angle drooping, hypoplasia of mandible, gothic palate, tongue weakness, fissured tongue, tongue atrophy and open bite were found. In addition to describing the oral findings, this report discusses some implications for dental treatment of patients with this syndrome.