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A new series of compounds planned by molecular hybridization of the nucleobases uracil and thymine, or the xanthine theobromine, with coumarins, and linked through 1,2,3-triazole heterocycles were evaluated for their in vitro anticancer activity against the human tumor cell lines: colon carcinoma (HCT116), laryngeal tumor cells (Hep-2), and lung carcinoma cells (A549). The hybrid compound 9a exhibited better activity in the series, showing an IC50 of 24.19 ± 1.39 µM against the HCT116 cells, with a selectivity index (SI) of 6, when compared to the cytotoxicity against the non-tumor cell line HaCat. The in silico search for pharmacological targets was achieved through molecular docking studies on all active compounds, which suggested that the synthesized compounds possess a high affinity to the Topoisomerase 1-DNA complex, supporting their antitumor activity. The in silico toxicity prediction studies suggest that the compounds present a low risk of causing theoretical mutagenic and tumorigenic effects. These findings indicate that molecular hybridization from natural derivative molecules is an interesting approach to seek new antitumor candidates.

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Introdução: Assim como observado no cenário nacional, o município de Mossoró apresentou altas taxas de letalidade nos primeiros meses de pandemia. Todavia, o conhecimento epidemiológico em torno da COVID-19 no município tem ocorrido, sobretudo, através de documentos institucionais das Secretarias de Saúde. Desse modo, a finalidade deste estudo é fornecer evidências que permitam ampliar a compreensão da ocorrência da doença em nível local, ofertar dados e informações que venham a subsidiar as políticas públicas de saúde municipais e gerar hipóteses sobre a morbimortalidade da doença para futuras investigações científicas. Objetivo: Analisar o perfil epidemiológico dos casos internados e confirmados de COVID-19 no município de Mossoró no estado do Rio Grande do Norte/Brasil. Metodologia: Estudo observacional transversal, baseado em dados secundários de casos internados de COVID-19 registrados no Sistema Único de Saúde entre março e outubro de 2020.Resultados:Foram incluídos na amostra 664 pacientes, dos quais 46,5% evoluíram para óbito. Entre as internações, 63,1% resultaram em internações em unidades de terapia intensiva. Observamos diferenças estatísticas significativas entre 'admissão na unidade de terapia intensiva e evolução para óbito' e 'faixa etária e evolução para óbito' e, maior risco entre idosos acima de 60 anos, com comorbidades, dispneia e saturação de O2 <95%. A necessidade de suporte ventilatório invasivo foi considerada fator predisponente para óbito. O risco de internação na unidade de terapia intensiva foi maior entre as idosas. Conclusões: A hospitalização e o óbito de pacientes com COVID-19foram maiores em pacientes idosos com comorbidades (AU).

Introduction:As observed in the national scenario, the city of Mossoró showed high lethality rates in the first months of the pandemic. However, the epidemiological knowledge around COVID-19 in the municipality has occurred mostly through institutional documents from the Health Secretariats. Thus, the purpose of this study is to provide evidence to broaden the understanding of the occurrence of the disease at the local level, provide data and information that will support municipal health public policies and generate hypotheses about the morbidity and mortality of the disease for future scientific investigations. Objective: To analyze the epidemiological profile of hospitalized and confirmed cases of COVID-19 in the municipality of Mossoró in the state of Rio Grande do Norte/Brazil. Methodology:This is a cross-sectional and observational study, based on secondary data from the hospitalized COVID-19 cases recorded in the Unified Health System (Sistema Unificado de Saúde, SUS) between March and October 2020. Results:664 patients were included in the sample, of which 46.5% evolved to death. Among hospitalizations, 63.1% resulted in intensive care units admissions. We observed significant differences between intensive care unit admission and evolution to death' and 'age group and evolution to death' and, higher risk among elderly individuals over 60 years, with comorbidities, dyspnea and O2 saturation<95%. Need for invasive ventilatory support was considered a predisposing factor for death. The risk of intensive care unit admission was higher among eldery women.Conclusions:Hospitalization and death of patients with COVID-19 were higher in elderly patients with comorbidities (AU).

Introducción: Como se observó en el escenario nacional, el municipio de Mossoró presentó altas tasas de letalidad en los primeros meses de la pandemia. Sin embargo, el conocimiento epidemiológico en torno al COVID-19 en el municipio se ha dado principalmente a través dedocumentos institucionales de las Secretarías de Salud. Por lo tanto, el objetivo de este estudio es proporcionar evidencias para ampliar el conocimiento de la ocurrencia de la enfermedad en el ámbito local, proporcionar datos e informaciones que apoyen las políticas públicas municipales de salud y generar hipótesis sobre la morbilidad y mortalidad de la enfermedad para futuras investigaciones científicas. Objetivo: Analizar el perfil epidemiológico de los casos hospitalizados y confirmados de COVID-19 en el municipio de Mossoró en el estado de Rio Grande do Norte/Brasil.Metodología: Se trata de un estudio transversal y observacional, basado en datos secundarios de los casos hospitalizados de COVID-19 registrados en el Sistema Unificado de Salud (SUS) entre marzo y octubre de 2020. Resultados: La muestra incluyó 664 pacientes, de los cuales el 46,5% falleció. Entre los ingresos, el 63,1% resultaron en ingresos en la unidad de cuidados intensivos. Se observaron diferencias estadísticas significativas entre el "ingreso en la unidad de cuidados intensivos y la evolución hasta la muerte" y el "grupo de edad y la evolución hasta la muerte", y un mayor riesgo entre los pacientes mayores de 60 años, con comorbilidades, disnea y saturación de O2 <95%. La necesidad de soporte ventilatorio invasivo se consideró un factor predisponente para la muerte. El riesgo de ingreso en la unidad de cuidados intensivos fue mayor entre las mujeres de edad avanzada. Conclusiones: La hospitalización y la muerte de los pacientes con COVID-19 fueron mayores en los pacientes de edad avanzada con comorbilidades (AU).

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To provide a synthesis of diverse evidence on the impact of the non-therapeutic preventive measures, specifically quarantine, physical distancing and social isolation, on the control of COVID-19. A scoping review conducted in the PubMed, Embase, LILACS, CENTRAL and SCOPUS databases between 2019 and August 28th, 2020. The descriptors used were the following: "quarantine", "physical distancing", "social isolation", "COVID-19" and "SARS-Cov2". Studies that addressed the non-therapeutic preventive measures in people exposed to SARs-CoV-2 in community settings and health services were included. A total of 14,442 records identified through a database search were reduced to 346 studies and, after a standardized selection process, a total of 68 articles were selected for analysis. A total of 35 descriptive, cross-sectional or longitudinal observational studies were identified, as well as 3 reviews, in addition to 30 studies with mathematical modeling. The main intervention assessed was social distancing (56.6%), followed by lockdown (25.0%) and quarantine (18.4%). The main evidence analyzed points to the need for rapid responses to reduce the number of infections, deaths and hospital admissions, especially in intensive care unit beds.The current review revealed consistent reports that the quarantine, physical distancing and social isolation are effective strategies to contain spread of the new coronavirus.

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Apesar do uso de plantas medicinais para tratamento de problemas de saúde ser tradicionalmente aceito, esta prática da medicina popular ainda encontra resistência por profissionais da saúde, sobretudo sob a alegação da falta de comprovação de seus efeitos. Durante o surto de Covid-19, houve aumento significativo do estresse, sintomas ansiosos e insônia e o uso de plantas medicinais e fitoterápicos surge como uma alternativa terapêutica. O objetivo deste estudo foi realizar uma revisão da literatura sobre a eficácia de plantas medicinais como terapia alternativa e/ou complementar para transtornos de ansiedade e insônia. As plantas investigadas foram selecionadas a partir do Formulário de Fitoterápicos e Memento Fitoterápico da Farmacopeia Brasileira, sendo utilizados como descritores o nome científico da planta e os termos "anxiety" e "insomnia" com recorte temporal de 2015 a 2020. 230 resultados foram encontrados, 42 selecionados (27 em humanos e 15 em animais). Foi possível demonstrar efeitos ansiolíticos para as plantas capim santo (Cymbopogon citratus), lavanda (Lavandula officinalis), melissa (Melissa officinalis), maracujá (Passiflora incarnata)e valeriana (Valeriana officinalis) e sedativos para melissa, maracujá e valeriana. A kava-kava (Piper methysticum) demonstrou apenas efeito sedativo e a camomila (Matricaria chamomilla) apresentou eficácia clínica ansiolítica. Portanto, a potencial aplicação clínica dessas plantas é indicada para tratamento dos sintomas de ansiedade e insônia, ajudando a reduzir os sintomas psicológicos decorrentes da pandemia de Covid-19. Contudo, vale ressaltar a necessidade da padronização dos procedimentos metodológicos e avanço da fitoterapia na prática médica. [au]

Although the use of medicinal plants to treat health problems is traditionally accepted, this practice of popular medicine still finds resistance from health professionals, especially under the allegation of lack of scientific proof of its effects. During the outbreak of COVID-19, there was a significant increase in stress, anxiety, and insomnia symptoms, and the use of plants and herbal medicines emerged as a possible therapeutic alternative. The objective of this study was to conduct a literature review about the effectiveness of medicinal plants as an alternative and/or complementary therapy for anxiety and insomnia disorders. The main medicinal plants were selected from the Phytotherapeutic Formulary and Phytotherapeutic Memento of the Brazilian Pharmacopoeia, using the 'scientific name' and terms 'anxiety' and 'insomnia' as descriptors between 2015-2020. 230 results were found and 42 studies were selected (27 in humans and 15 in animals). Anxiolytic effects have been demonstrated to Cymbopogon citratus, Lavandula officinalis, Melissa officinalis, Passiflora incarnata, and Valeriana officinalis and sedatives effects to M. officinalis, P. incarnata, and V. officinalis. Piper methysticum revealed only a sedative effect and Matricaria chamomilla showed anxiolytic clinical efficacy. Then, the potential clinical application of these plants in the treatment of anxiety and insomnia symptoms is indicated, helping to reduce the psychological symptoms resulting from the Covid-19 pandemic. However, it is worth emphasizing the need to standardize methodological procedures and advance phytotherapy in medical practice. [au]

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Introdução:O carcinoma de células escamosas de cavidade oral e orofaringe é uma neoplasia epitelial maligna comum, respondendo pela maioria dos casos de tumores de cabeça e pescoço. Ele está relacionado a hábitos comportamentais, como tabagismo e etilismo de longa duração, e à infecção pelo Papilomavírus humano. Objetivos:Esse estudo objetivou descrever o perfil epidemiológico dos pacientes diagnosticados com essa neoplasia na Liga Mossoroense de Estudos e Combate ao Câncer. Metodologia: Foi realizado um estudo observacional com delineamento transversal a partir de dados presentes nos prontuários clínicos e laudos anatomopatológicos e no Sistema de Informações sobre Mortalidade no período entre 2006 a 2018. Os dados foram analisados a partir do Software R, utilizandoo teste de Wilcoxon-Mann-Whitney para as análises inferenciais e o método de Kaplan-Meier para análise da sobrevida. Resultados:225 prontuários foram analisados, sendo 70,22% de homens, 65,33% na faixa etária entre 46-70 anos e cor branca (51,57%). Destes, 25,78% eram tabagistas e 39,11% tabagistas e etilistas. O principal tratamento identificado foi a associação de cirurgia, quimioterapia e radioterapia. Observou-se que 49,10% dos óbitos foram em decorrência dessa neoplasia. O principal estádio patológico encontrado foi o quatro A (34,22%). Foi identificada maior sobrevida nos pacientes acima de 70 anos, cujo tratamento foi exclusivamente cirúrgico. Menor sobrevida foi identificada em indivíduos que tinham associação de hábitos (etilismo e tabagismo). Conclusões:Nossos resultados sugerem que a evolução à óbito foi o principal desfecho clínico e, isso pode estar relacionado aos hábitos comportamentais que influenciam diretamente o curso e prognóstico da doença. Ademais, destaca-se a importância do diagnóstico precoce a fim de reduzir óbitos e melhorar a qualidade de vida dos indivíduos, assim como a necessidade de implementar políticas educativas sobre os principais fatores de risco associados ao desenvolvimento dessa neoplasia (AU).

Introduction: Squamous cell carcinoma of the oral cavity and oropharynx is a common malignant epithelial neoplasm, accounting for most cases of head and neck tumors. It is related to behavioral habits, such as long-standing smoking and alcoholism, as well as to the human Papillomavirus infection. Objectives: This study aimed at describing the epidemiological profile of the patients diagnosed with this neoplasm in the Mossoró League for Studying and Combating Cancer. Methodology:An observational study with a cross-sectional design was carried out based on data present in the medical records and anatomopathological reports and in the Mortality Information System during the 2006-2018 period. The data were analyzed using the R Software, resorting to the Wilcoxon-Mann-Whitneytest for the inferential analyses and to the Kaplan-Meier method for survival analysis. Results: 225 medical records were analyzed: 70.22% belonging to men, 65.33% aged between 46 and 70 years old and white-skinned (51.57%). Of these, 25.78% were smokers and 39.11% were smokers and alcoholics. The main treatment identified was the association of surgery, chemotherapy and radiotherapy. It was observed that 49.10% of the deaths were due to this neoplasm. The main pathological stage found wasfour A(34.22%).Longer survival was identified in patients over 70 years of age, whose treatment was exclusively surgical. Shorter survival was identified in individuals who had associated habits (alcoholism and smoking). Conclusions:Our results suggest that evolution to death was the main clinical outcome; this can be related to the behavioral habits that exert a direct influence on the course and prognosis of the disease. Furthermore, the importance of early diagnosis is highlighted in order to reduce the number of deaths and improve the individuals' quality of life, as well as the need to implement educational policies on the main risk factors associated with the development of this neoplasm (AU).

Introducción: El carcinoma de células escamosas de la cavidad oral y la orofaringe es una neoplasia epitelial maligna común, que representa la mayoría de los casos de tumores de cabeza y cuello. Se relaciona con hábitos de comportamiento, como el tabaquismo y el alcoholismo, y la infección por el virus papiloma humano. Objetivos:Este estudio tuvo como objetivo describir el perfil epidemiológico de los pacientes diagnosticados con esta neoplasiaen la Liga Mossoroense de Estudios y Combate al Cáncer. Metodología: Se realizó un estudio observacional, transversal a partir de los datos presentes en las historias clínicas e informes patológicos y en el Sistema de Información de Mortalidad en el período 2006-2018. Los datos se analizaron mediante el Software R, con utilización de la Prueba de Wilcoxon-Mann-Whitney para análisis inferencial y el método de Kaplan-Meier para análisis de supervivencia. Resultados:Se analizaron 225 historias clínicas, 70,22% en hombres, 65,33% con edades entre 46-70 años y blancos (51,57%). De estos, 25,78% eran fumadores y 39,11% eran fumadores y alcohólicos. El principal tratamiento identificado fue la asociación de cirugía, quimioterapia y radioterapia. 49,10% de las muertes se debieron a esta neoplasia. El principal estadio patológico encontrado fue cuatro A (34,22%). Se identificó mayor sobrevida en pacientes mayores de 70 años, cuyo tratamiento fue exclusivamente quirúrgico. Se identificó una menor sobrevida en personas que tenían hábitos asociados. Conclusiones:Nuestros resultados sugieren que la evolución hacia la muerte fue el principal resultado clínico y esto puede estar relacionado con hábitos de comportamiento que influyen directamente en el curso y pronóstico de la enfermedad. Además, se destaca la importancia del diagnóstico precoz para reducir las muertes y mejorar la calidad de vida, así como la necesidad de implementar políticas educativas sobre los principales factores de riesgo asociados al desarrollo de esta neoplasia (AU).

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The purpose of this study was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClPc) on several periodontal parameters includingsalivary glutathione (GSH) and MDA (malondialdehyde) levels in periodontal sites presenting with periodontitis. Randomized clinical trial, comprising 40 test group (TG) sites and 23 control group (CG) sites. The TG was treated with scaling and root planning (SRP) and aPDT, and CG, only with SRP. Visible plaque index [VPI], gingival bleeding index [GBI], bleeding on probing [BOP], probing depth [PD] and clinical attachment level [CAL] were calculated and saliva samples were taken at baseline (T0), three (T3) and six months (T6). Data was analyzed by the Wilcoxon and Mann-Whitney tests. An intragroup analysis indicated significant differences at T3 and T6 for GBI, CAL and GSH only in the CG (p < 0.05). For BOP, a significant decrease was observed only in the TG between T0 and T6 (p = 0.008). No significant differences were observed for VPI, BOP and MDA. In the intergroup analysis, significant differences were observed for GBI at T6 (p = 0.041), and for GSH at T3 (p = 0.031), being higher in the TG. Although aPDT with AlClPc did not present statistically proven benefits, but the employed periodontal treatment resulted in decreased BOP, PD, CAL and MDA after 3 and 6 months of treatment. In addition, the lower need for glutathione production may initially suggest an additional benefit of AlClPc aPDT in the early reestablishment of the balance between oxidative and non-oxidative agents related to oxidative stress.

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The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T0 and T3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months.

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Introdução: O câncer do colo do útero é um importante problema de saúde pública na população feminina brasileira e seu diagnóstico precoce aumenta consideravelmente a probabilidade de cura. A taxa de cura é próxima aos 100%, demonstrando que medidas preventivas, comoo exame Papanicolau, são fundamentais para prevenção desse problema. Objetivo:O objetivo deste estudo foi descrever os resultados dos principais indicadores dos exames citopatológicos em mulheres do Município de Mossoró, estado do Rio Grande do Norte no período de 2014-2019.Metodologia:Foi realizado um estudo observacional descritivo de série temporal, com levantamento retrospectivo analítico dos exames citopatológicos cadastrados no banco de dados doSistema de Informação do Câncer de Colo de Útero entre o período de 2014 e 2019. Os dados foram coletados e descritos em valores absoluto e percentual.Resultados:Um total de 46606 casos foram incluídos e analisados. Houve uma tendência de aumento na realização dos testes ao longo dos anos. 83,8% dos casosrepresentam células escamosas atípicas de significado indeterminado. 70% das lesões intraepiteliais escamosas foram diagnosticadas como sendo de baixo grau. Não houve diagnóstico citopatológico de carcinoma de células escamosas e, apenas 2 casos de adenocarcinoma in situ. Conclusões: O município de Mossoró segue um padrão nacional de maiores resultados celulares atípicos segundo os achados que surgiram. Resultados sugestivos de alto grau de malignidade existem em menor frequência nos exames preventivos e necessitam ser avaliados por exames mais invasivos (AU).

Introduction:Cervical cancer is an important public health problem in the Brazilian female population and its early diagnosis considerably increases the likelihood of a cure. The cure rate is close to 100%, demonstrating that preventive measures, such as the Papanicolau test, are fundamental for overcoming this problem. Objective:The objective of this study isdescribe the main indicators in cytopathological tests accomplished in women in the City of Mossoró, state of Rio Grande do Norte, in the period of 2014-2019. Methodology:This is a descriptive observational study of time series was carried out, in which we analyzed all citopathological tests that are registered in the System Database Information about cervical cancer between the period of 2004 and 2019 for their epidemiological profile. The data were collected and checked and demonstrated in absorbed value and percentage. Results:A total of 46606 cases were included and analyzed. There has been an increasing trend in testing in recent years. 83.8% of cases represent atypical squamous cells of undetermined importance. 70% of squamous intraepithelial lesions were diagnosed as low-grade. There was no cytopathological diagnosis of squamous cell carcinoma and only 2 cases of adenocarcinoma in situ. Conclusions:The municipality of Mossoró follows a national pattern of higher atypical cell results according tothe findings that emerged. Suggestive results of a high degree of malignancy are observed less frequently and should be evaluated by more invasive and sensitive tests for the final diagnosis (AU).

Introducción: El cáncer de cuello uterin es um importante problema de salud pública en la población femenina brasileña y su identificación precoz aumenta considerablemente la probabilidad de cura. La tasa de curación es cercana al 100%, lo que demuestra que las medidas preventivas, como la prueba de Papanicolaou, son fundamentales para prevenir ese problema. Objetivo: El objetivo de este estudio es describir los principales indicadores en las pruebas citopatológicas en mujeres del municipio de Mossoró, estado de Rio Grande do Norte, en el periodo de 2014-2019.Metodología: Este es un estudio descriptivo observacional de la serie temporal, retrospectivo en el que analizamos todas las pruebas citopatológicas que están registradas en la Información de la base de datos del sistema sobre el cáncer de cuello uterino entre el período de 2004 y 2019 para su perfil epidemiológico. Los datos fueron recopilados y verificados y demostrados en valores absolutos y porcentuales. Resultados: Se incluyeron y analizaron un total de 46606 casos. Hubo una tendencia de aumento en las pruebas en los últimos años. El 83,8% de los casos representan células escamosas atípicas de importancia indeterminada. El 70% de las lesiones escamosas intraepiteliales fueron diagnosticadas como de bajo grado. No hubo diagnóstico citopatológico de carcinoma de células escamosas y solo 2 casos de adenocarcinoma in situ. Conclusiones: El municipio de Mossoró sigue un patrón nacional de mayores resultados de células atípicas según los hallazgos que han surgido. Los resultados sugestivos de un alto grado de malignidad se observan con menos frecuencia y deben evaluarse mediante pruebas más invasivas y sensibles para el diagnóstico final (AU).

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Background and objective: To evaluate the effects of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClFc) adjuvant to scaling and root planing (SRP) on periodontal clinical parameters of patients with chronic periodontitis. Materials and methods: Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP+aPDT)-using a low-power laser application Photon Lase III (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 100 mW for 15 sec, and 27 in the control group (SRP). SRP was performed in a single session and the periodontal clinical parameters such as visible plaque index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level were assessed at the baseline (T0) and 3 months after aPDT (T3). Results: Regarding BOP, a decrease in both treatment groups, the test group (p = 0.003) and control group (p = 0.001), was reported between T0 and T3. A reduction in PD and clinical insertion gain for both treatment groups (p < 0.05) after 3 months of therapy was observed, although nonsignificant (p > 0.05) in intergroup comparison. Conclusions: aPDT with AlClFc adjuvant to SRP did not provide additional benefits in reducing PD and clinical insertion gain.

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Embora a terapia fotodinâmica venha sendo utilizada como uma ferramenta útil nos últimos 30 anos em oncologia, poucos estudos clínicos em odontologia têm sido conduzidos. A terapia fotodinâmica (TFD) utiliza fotossensibilizantes atóxicos e seletivos que são administrados nas células alvo seguida de aplicação local de luz visível, produzindo espécies reativas de oxigênio capazes de ocasionar morte celular por apoptose ou necrose, de afetar a vascularidade local, além de exercer importantes efeitos no sistema imune. Novas gerações de fármacos fotossensibilizantes, como as ftalocianinas nanoparticuladas tem apresentado excelentes resultados na atividade antitumoral e antibacteriana. Neste contexto, o presente trabalho realizou o primeiro protocolo clínico de aplicação local da nanoemulsão de cloroalumínio ftalocianina (AlClFc) seguida de irradiação em gengiva de humanos, e analisou descritiva e comparativamente, por meio de imunoistoquímica, a expressão de RANK, RANKL, OPG e VEGF em um modelo split-mouth. Oito voluntários saudáveis com indicação clínica de exodontia foram incluídos no estudo. Sete dias antes da exodontia, foi aplicado na gengiva dos participantes, 5µM de nanoemulsão de AlClFc seguida de irradiação com laser diodo (660nm, 7J/cm2), o lado contralateral foi utilizado como controle. Os espécimes teciduais foram removidos sete dias após a TFD e subdivididos em dois grupos (grupo teste e grupo controle) para análise histológica e imunoistoquímica. Os pacientes foram monitorados no dia aplicação, 7, 14 e 30 dias após a terapia para avaliação de efeitos adversos da terapia. Alterações vasculares foram observadas nas amostras gengivais que receberam a TFD. Áreas de edema e congestão vascular, além de intensa vascularização foram visualizadas. Adicionalmente, focos de calcificação distrófica em região subepitelial foram visualizados nos espécimes do grupo teste. Os resultados demonstraram um padrão similar dos escores de imunomarcação de RANK, RANKL e VEGF entre os grupos teste e controle, não havendo diferença estatística significante (p=0.317, p=0.777, p=0.814, respectivamente). RANK e RANKL exibiram imunomarcação fraca ou ausente na maioria dos espécimes analisados. Não houve imunomarcação para a OPG. O VEGF mostrou imunomarcação moderada a forte nos espécimes do grupo teste. Adicionalmente, o estudo clínico mostrou que a terapia foi bem tolerada por todos os pacientes. Os efeitos adversos foram de curta duração e totalmente reversíveis. Tomados em conjunto, os resultados apresentados neste estudo mostraram que o protocolo utilizado por nós, mediado por nanoemulsão contendo AlClFc, é seguro para aplicação clínica em tecido gengival e, sugerem uma forte imunomarcação para o VEGF após a terapia. (AU)

Although photodynamic therapy have been used as a useful tool over the past 30 years in oncology, few clinical trials have been conducted in dentistry. Photodynamic therapy (PDT) uses non-toxic photosensitizers and selective which are administered in target cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, injured the local vasculature, and exert important effects on the immune system. New generations of photosensitizing agents, such as nanoparticulate phthalocyanines, has shown excellent results in antitumor and antibacterial activity . In this context, the present work constitutes the first clinical protocol of local application of nanoemulsion chloro-aluminum phthalocyanine (AlClFc) followed by irradiation in human gingiva, and analyzed descriptively and comparatively , by means of immunohistochemistry , the expression of RANK , RANKL , OPG and VEGF in a split -mouth model. Eight healthy volunteers with clinical indication for extraction were included in the study . Seven days before the extraction, was injected in the gingiva of participants, 5µM of nanoemulsion AlClFc followed by irradiation with diode laser (660nm, 7J/cm2 ), the contralateral side was used as control. Tissue specimens were removed seven days after the TFD is performed. Tissues sample were divided into two groups (test and control groups) for histological and immunohistochemical analysis. Patients were monitored at days, 0, 7, 14 and 30 to assess adverse effects of the therapy. Vascular alterations were seen in gingival samples that received PDT. Areas of edema and vascular congestion, and intense vascularization were viewed . Additionally, dystrophic calcification in subepithelial region were observed in the test group. The results showed a similar pattern of immunostaining scores of RANK, RANKL and VEGF between the test and control groups, with no statistically significant difference (p = 0.317, p = 0.777, p = 0.814, respectively). RANK and RANKL exhibited weak or absent immunostaining in most specimens analyzed. There was no immunostaining for OPG. VEGF showed moderate to strong immunostaining in specimens from the test group. In addition, the clinical study showed that therapy was well tolerated by all patients. Adverse effects were short-time and completely reversible. Taken together, the results presented in this study showed that PDT mediated by nanoemulsion containing AlClPc is safe for clinical application in gingival tissue and suggests that a strong immunostaining for VEGF after therapy. (AU)

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INTRODUCTION: The aim of this study was to evaluate and compare the immunohistochemical expression of transforming growing factor beta (TGF-ß) and interferon gamma (IFN-γ) between radicular cysts (RCs) and dentigerous cysts (DCs). METHODS: Twenty RCs and DCs were selected for analysis of the immunoexpression of TGF-ß and IFN-γ in the epithelium and capsule. RESULTS: The cell reactivity of TGF-ß and IFN-γ in the lining epithelium and capsule of RCs showed no significant differences when compared with DCs (P > .05). There was a tendency of a higher expression of TGF-ß in the capsule of DCs. CONCLUSIONS: Our results showed the presence of TGF-ß and IFN-γ in RCs and DCs, supporting the hypothesis that both participate in the development of these lesions, where IFN-γ usually plays a role in bone resorption, which is counterbalanced by the osteoprotective activity performed by TGF-ß.

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PURPOSE: The aim of the present study was to compare the immunohistochemical detection of receptor activator nuclear κB ligand (RANKL) and osteoprotegerin (OPG) in radicular cysts (RCs), dentigerous cysts (DCs), solid ameloblastomas (SAs), and keratocystic odontogenic tumors (KOTs). MATERIALS AND METHODS: A total of 20 RCs, 20 DCs, 20 KOTs, 14 dental follicles (DFs), and 18 SAs were evaluated by immunohistochemistry using anti-RANKL and anti-OPG antibodies. The analysis was quantitative, and the number of positive cells was counted in 10 microscopic high-power fields (400×). RESULTS: The DFs, KOTs, and SAs showed higher expression of RANKL than did the RCs and DCs in the epithelium (P < .05). The epithelial expression of OPG was higher in the DFs, KOTs, RCs, and DCs than in the SAs (P < .05). The ratio of OPG less than RANKL was more frequent in SAs and OPG greater than RANKL in DCs (P < .05). CONCLUSIONS: Our results have shown differences in RANKL and OPG detection in the odontogenic cysts and tumors studied. The higher RANKL and lower OPG detection in SA could play a role in bone resorption, compatible with the tumor's biologic behavior.

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BACKGROUND: Radicular (RC) and dentigerous cysts (DC) can show a range from little to quite extensive primary/secondary inflammation and it is possible that the variation seen in the fibrous capsule of these cysts might reflect differences in the osteolytic activity. Moreover, the presence of hemorrhagic areas in the fibrous capsule of DC could also contribute to the increase in osteolytic activity. The aim of this study was to compare immunohistochemical expression of nuclear factor κappaB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG), vascular endothelial growth factor (VEGF) and angiogenic index in RC and DC. METHODS: These proteins were evaluated in 20 RC and DC by immunohistochemistry. Angiogenic index was determined by microvessel count (MVC) using anti-von Willebrand factor antibody. RESULTS: RANK and RANKL were higher in DC than RC in fibrous capsule. RC showed higher expression of VEGF in the epithelium and capsule. DC exhibited higher MVC than RC. CONCLUSIONS: Ours results suggest that RANK and RANKL play an important role in bone resorption in DC and the hemorrhagic areas in the capsule of DC could be explained by increased vessel's number. The higher VEGF expression in RC might be related to nature of these lesions, where the inflammatory process contributes significantly to these findings.

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Kaposi's sarcoma is a malignant neoplasm of vascular origin. It occurs mainly among immune deficient individuals, thus it is the most common neoplasm among HIV- positive patients. Its pathogenesis is complex and has not been fully clarified. This case arouses particular interest due to its anatomic location in the retromolar region of a 39-year-old male HIV- positive patient, who presented low white blood cell count and was not undergoing antiretroviral therapy. The emergence of this lesion may be associated with highly active antiretroviral therapy (HAART) discontinuation and leukopenia. Hence, the reestablishment of therapy allows a suitable therapeutic approach and contributes to prognosis and survival rates.

Sarcoma de Kaposi é uma neoplasia maligna de origem vascular que ocorre principalmente em indivíduos com deficiência imunológica, sendo a neoplasia mais comum em pacientes HIV positivos. Sua patogênese é complexa e não está bem estabelecida. Este caso é de interesse pela localização anatômica em região retromolar de paciente soropositivo, que apresentou baixa contagem de células brancas do sangue e que não realizava terapia antirretroviral. O surgimento da lesão pode estar associado à interrupção da terapia antirretroviral altamente ativa (HAART) e à baixa contagem leucocitária. Assim, o restabelecimento da terapia pode permitir a abordagem terapêutica e contribuir para o prognóstico e a sobrevida.

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BACKGROUND: Peripheral giant cell lesion (PGCL) is a reactive process associated with a local irritating factor that shows low recurrence after treatment, especially if the irritating factor is eliminated. On the other hand, central giant cell lesion (CGCL) presents a variable clinical behavior ranging from slow and asymptomatic growth without recurrence to rapid, painful and recurrent growth. Our aim was to compare the immunoexpression of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-ß) in CGCL and PGCL. METHODS: Twenty CGCL and 20 PGCL were selected for analysis of the immunoexpression of TNF-α and TGF-ß in multinucleated giant cells (MGC) and mononucleated cells (MC). RESULTS: The PGCL showed lightly higher expression of TNF-α than CGCL. In comparison with PGCL, the CGCL showed higher expression of TGF-ß in MC and MGC (P < 0.05) and in total cells (P < 0.05). Significant positive correlation was found between expressions of TGF-ß and TNF-α in CGCL (P < 0.05). CONCLUSIONS: Our results suggest that, in CGCL, coordinated interactions between TGF-ß and TNF-α may be important for osteoclastogenesis and bone resorption. PGCL occasionally cause bone resorption but to a lower extent, a fact that might be explained by the lower expression of TGF-ß in these lesions.

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Burning mouth syndrome (BMS) is defined as a chronic pain condition, characterized symptomatically by a generalized or localized burning sensation in the oral cavity. Various drugs have been used in attempting to treat BMS, but there is insufficient evidence to show the effect of any effective treatment. The aim of this review was to assess the effectiveness of therapies for BMS. Randomized controlled trials (RCTs) enrolling patients with a diagnosis of BMS were identified by searching Pubmed and Scoppus databases. The methodological quality of included studies was assessed on the basis of the method of allocation concealment, blindness of the study, loss of participants, size sample, and outcome concealment. A total of 12 relevant articles were analyzed. Therapies that used capsaicin, alpha-lipoic acid (ALA), and clonazepam were those that showed more reduction in symptoms of BMS. However, many studies of therapeutic interventions in BMS lack consistency in their results, because they use in their methodology, sample and a relatively short time of therapy and often do not provide a follow-up of patients treated. Thus, future studies are required to establish the treatment for patients suffering from this chronic and painful syndrome.

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A terapia fotodinâmica é tratamento pouco invasivo e de fácil execução que vem sendo utilizado para tratamento de neoplasias de cabeça e pescoço e, mais recentemente, no tratamento de desordens potencialmente malignas de mucosa oral, já que essas lesões acarretam risco de malignizar. A terapia fotodinâmica utiliza fotossensibilizadoresatóxicos e seletivos que são administrados nas células e tecidos-alvo seguidos de aplicação local de luz visível, produzindo espécies de oxigênios reativas capazes de ocasionar morte celular por apoptose ou necrose, de afetar a vascularidade local, além de exercer importante papel no sistema imunitário por meio de fenômenos imunoestimulatórios.Tradicionalmente, derivados das porfirinas de primeira geração vinham sendo utilizados como fotossensibilizadores de escolha. Entretanto, apresentavam, como desvantagens, baixa absorção de luz além de fototoxicidade cutânea. Desse modo, novas gerações de agentes fotossensibilizadores vêm sendo desenvolvidos com o intuito de melhorar as reações de fotoxicidade e as propriedades físico-químicas, alcançando bons resultados clínicos e ainda favorecendo a manutenção da qualidade de vida do indivíduo que, muitas vezes, é comprometida em tratamento mutiladores com grandes cirurgias ressectivas e no tratamento quimioterápico. Esta revisão aborda os principais estudos em que seusa essa terapia para o tratamento do câncer e das desordens potencialmente malignas de mucosa oral no sentido de identificar a eficácia dessa modalidade terapêutica no tratamento e controle dessas lesões.

Photodynamic therapy is a minimally invasive and easy treatment that has been used for treatment of head and neck cancers and more recently in the treatment of potentially malignant disorders of the oral mucosa, since these lesions are at risk of malignization. Photodynamic therapy uses non-toxic and selective photosensitizers that are administered in target tissues and cells followed by local application of visible light, producing reactive oxygen species capable of causing cell death by apoptosis or necrosis, affecting local vascularity, as well as playing an important role in the immune system using immunostimulatory phenomena. Traditionally, derivatives from the first generation of porphyrins have been used as photosensitizers of choice, though they present disadvantages as low absorption of light as well as skin phototoxicity. Thus, new generations of photosensitizing agents have been developed in orderto improve phototoxic reactions and physical-chemical properties achieving good clinical outcomes and still favoring the maintenance of quality of life of individuals often compromised when submitted to major resection surgery and chemotherapy. This review covers the main studies using this therapy for treating cancer and potentially malignantdisorders of the oral mucosa in order to identify the effectiveness of this therapeutic modality in the treatment and control of these lesions.

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OBJECTIVE: Receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG) are members of the superfamily of ligands and receptors of tumour necrosis factor family involved in bone metabolism. The formation, differentiation and activity of osteoclasts are regulated by these proteins. To clarify the roles of osteoclast regulatory factors in cystic expansion of odontogenic cysts, expression of these proteins were analysed in radicular and dentigerous cysts. DESIGN: The immunohistochemistry expression of these biomarkers were evaluated and measured in lining epithelium and fibrous capsule of the radicular (n=20) and dentigerous cysts (n=20). RESULTS: A similar expression in lining epithelium was observed in the lesions. The fibrous capsule of dentigerous cyst showed a higher content of RANK-positive and RANKL-positive cells than fibrous capsule of radicular cyst. In the lining epithelium the RANKL/OPG ratio showed higher numbers of OPG-positive than RANKL-positive cells, whereas fibrous capsule of the cysts had a tendency to present a similar expression (OPG=RANKL). CONCLUSION: Ours findings indicate the presence of RANK, RANKL and OPG in cysts. Moreover, increased expression of OPG compared to RANKL in the lining epithelium could contribute to the differential bone resorption activity in theses lesions.

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Odontogenic fibroma (OF) is a benign odontogenic tumor characterized by various amounts of odontogenic epithelium in a mature fibrous stroma. Two variants can be distinguished: an intraosseous or central OF (COF) and an extraosseous or peripheral. The intraosseous variant is an extremely rare tumor that presents clinical, radiographic, and histopathologic variable findings. A thorough review of the English literature revealed 78 cases of COF so far. Thus, we report an additional case of COF occurring in the maxilla of a 36-year-old woman. In addition, we performed a brief description and discussion of the cases reported in the maxilla and mandible.

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A síndrome de Sjögren é doença sistêmica autoimunitária, caracterizada por infiltração linfocítica nas glândulas exócrinas. Na cavidade oral, esta síndrome potencialmente desencadeia a destruição de ácinos e ductos de glândulas salivares, ocasiona diminuição da secreção salivar com consequente xerostomia e predispõe o indivíduo à cárie dentale à doença periodontal. Com a dificuldade de diagnóstico e a necessidade de tratamento adequado para o alívio dos sintomas e a melhora do estado bucal do paciente, propõe-se uma revisão dos conceitos atuais e conduta clínica a ser adotada diante das alterações na cavidade oral, abordando-se os mecanismos etiopatogênicos, as características clínicas e histopatológicas, os métodos de diagnóstico e tratamento para doentes com síndrome de Sjögren.

Sjögren?s syndrome is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. In the oral cavity, this syndrome potentially triggers the destruction of acini and ducts of the salivary glands, causing reduction of the salivary secretion with consequent xerostomia, leaving the the individual susceptible to thedental caries and the periodontal disease. Due to difficult diagnosis and the requirement of an adequate treatment aiming at the relief of the symptoms and the improvement of the buccal health of the patient. A review of current concepts and clinical management to be adopted in the face of changes in the oral cavity, to be adopted, approachingthe pathophysiology, the clinical and histopathological features, diagnostic methods and treatment for patients with Sjögren?s syndrome.