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OBJECTIVE: This study aimed to analyse the clinical and histopathological characteristics of focal oral melanocytic lesions in a Brazilian reference service in Oral and Maxillofacial Pathology. MATERIALS AND METHODS: A cross-sectional study was conducted over an 18-year period. Demographic data and clinical features were collected from the archives, and all biopsy specimens diagnosed as oral melanocytic lesions were retrieved and reviewed. RESULTS: We identified 339 melanocytic lesions. Of these, 191 were melanotic macules, 112 melanocytic nevi, 14 mucosal lentigo simplex, 12 melanomas, 9 solar lentigos, and 1 melanoacanthoma. Lesions occurred mostly in white-skinned (74.2%) women (65.2%). The main reported clinical aspect was the macule (67.4%), and the most affected site was the lip vermilion (25.4%), followed by the palate (22.9%). Melanomas were larger in size and were observed in older patients with an overall shorter time of onset. The most frequent subtypes of melanocytic nevi were intramucosal (44.6%), compound (24.1%), and blue nevus (20.5%). They showed a heterogeneous architectural pattern with the presence of the three cell types. CONCLUSION: The most frequent lesions are melanotic macule and nevus, especially the intramucosal subtype. Patients are usually white-skinned women presenting a small, long-lasting, macular lesion on the lip vermilion or palate.
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Melanoma , Nevo Pigmentado , Neoplasias Cutâneas , Humanos , Feminino , Idoso , Masculino , Mucosa Bucal/patologia , Estudos Transversais , Nevo Pigmentado/epidemiologia , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/patologia , Melanoma/epidemiologia , Melanoma/diagnóstico , Melanoma/patologiaRESUMO
AIMS: Autoimmune polyglandular syndrome type I (APS-I) is a rare condition of autosomal recessive and monogenic inheritance, which is characterized clinically by at least two signs of the classic triad: mucocutaneous candidosis, hypoparathyroidism, and Addison's disease. This study aims to report the oral manifestations of APS-I in a 42-year-old woman, who attended the Special Care Dentistry Center. METHODS AND RESULTS: The patient presented with hypoparathyroidism, diabetes mellitus, and autoimmune hepatitis. Chronic hyperplastic candidosis (CHC) was the main oral manifestation and it was diagnosed based on clinical and cytologic characteristics. Microstomia, angular cheilitis, xerostomia, enamel hypoplasia, and microdontia were also present. CONCLUSIONS: CHC was treated with topical nystatin and oral fluconazole, resulting in a significant improvement of the lesions.
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Doença de Addison , Candidíase Mucocutânea Crônica , Hipoplasia do Esmalte Dentário , Hipoparatireoidismo , Poliendocrinopatias Autoimunes , Adulto , Feminino , Humanos , Poliendocrinopatias Autoimunes/complicações , Poliendocrinopatias Autoimunes/diagnóstico , Poliendocrinopatias Autoimunes/tratamento farmacológicoRESUMO
objetivo desse estudo foi avaliar o desempenho diagnóstico da Análise da Discrepância de Bolton (DB) anterior e total proposta pelo programa ClinCheck®, bem como dos softwares ortodônticos Dolphin Imaging® e 3D Slicer, comparado com mensurações manuais realizados em modelos impressos tridimensionalmente. Cinquenta e cinco pares de modelos digitais da fase inicial de pacientes tratados com sistema Invisalign® (Align, San Jose, Califórnia, EUA) foram impressos tridimensionalmente por estereolitografia e usados para mensuração da DB por método manual, com paquímetro digital, por um operador previamente calibrado. Os valores da DB fornecidos pelo software de planejamento ClinCheck® foram tabulados e os arquivos da amostra em formato STL foram medidos utilizando os softwares Dolphin Imaging® e 3D Slicer. Para avaliar a confiabilidade das análises usadas como referência das comparações seguintes, o erro do método foi calculado utilizando vinte por cento da amostra, com intervalo de 2 semanas. A análise estatística foi executada no software Jamovi (versão 2.0) e um nível de significância de 5% foi adotado. Os dados em milímetros foram avaliados pelo coeficiente de correlação intraclasse (ICC), fórmula de Dahlberg, teste t pareado e método de Bland-Altman. Os resultados indicaram que os três métodos evidenciaram medidas confiáveis (ICC ≥ 0,7), sendo a DB anterior ligeiramente mais confiável. No entanto, apenas as medidas da DB anterior realizadas pelo ClinCheck e Dolphin Imaging® foram acuradas (p>0,5, sem viés de proporção). Para o DB total, todos os programas pesquisados apresentaram diferença estatisticamente significativa em relação ao método manual (p<0.001), embora essas diferenças não tenham implicação clínica relevante. Conclui-se que as ferramentas disponíveis apresentam validade para aplicação no diagnóstico e planejamento ortodôntico no que diz respeito a DB, especialmente as medidas indicadas pelo ClinCheck® e Dolphin Imaging® para região anterior do arco. (AU)
This study aimed to evaluate the diagnostic performance of the analysis of anterior and overall Bolton Discrepancy (BD) proposed by the ClinCheck® program, as well as the orthodontic software Dolphin Imaging® and 3D Slicer, compared with manual measurements performed on three-dimensionally printed models. Fifty-five pairs of early-stage digital models of patients treated with the Invisalign® system (Align, San Jose, California, USA) were three-dimensionally printed by stereolithography and used to measure BD by manual method with a digital caliper by a previously calibrated operator. DB values provided by ClinCheck® planning software were tabulated and sample files in STL format were measured using Dolphin Imaging® and 3D Slicer software. To assess the reliability of the analyzes used as a reference for the following comparisons, the method error was calculated using twenty percent of the sample, with an interval of 2 weeks. Statistical analysis was performed using the Jamovi software (version 2.0) and a significance level of 5% was adopted. Data in millimeters were evaluated using the intraclass correlation coefficient (ICC), Dahlberg formula, paired t-test, and the Bland-Altman method. The results indicated that the three methods showed reliable measurements (ICC ≥ 0.7), with the anterior BD slightly more reliable. However, only anterior BD measurements performed by ClinCheck® and Dolphin Imaging® were accurate (p>0.5, without proportion bias). For overall BD, all programs surveyed showed a statistically significant difference from the manual method (p<0.001), although these differences have no relevant clinical implications. The available tools studied are valid for application in the diagnosis and orthodontic planning concerning BD, especially the measures indicated by ClinCheck® and Dolphin Imaging® for the anterior region of the arch. (AU)
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Ortodontia , Software/normas , Diagnóstico por Computador/métodos , Impressão Tridimensional , PlanejamentoRESUMO
Control and the care are continuous challenges in the treatment of chronic diseases, and it is necessary to know the users' realities in order to seek intervention alternatives. The study aimed to identify the participants' knowledge in a therapeutic group of the elderly regarding diabetes mellitus and systemic arterial hypertension. Descriptive and exploratory study with a qualitative approach, conducted with 12 elderly in the therapeutic group. Semi-structured interviews were used as data collection technique. Data were transcribed and analyzed using the content analysis technique. In the results the category about the participants' knowledge on the diseases emerged, namely: etiological factors; main signs, symptoms and complications; drug therapy; use of herbal medicines; food control; lifestyle and regular follow up at the health unit. It was concluded that the participants have knowledge about the diseases; however, they cultivate habits that can trigger complications. Knowledge from experience should not be neglected, but should be directed towards achieving the goal of the therapeutic group, helping to improve the understanding of the elderly about their disease (s) and stimulating self-care. (AU)
O controle e o cuidado são desafios contínuos na terapêutica das doenças crônicas, sendo necessário conhecer as realidades dos usuários para buscar alternativas de intervenção. O estudo objetivou identificar o conhecimento dos participantes de um grupo terapêutico de idosos em relação ao diabetes mellitus e hipertensão arterial sistêmica. Estudo descritivo e exploratório, com abordagem qualitativa dos dados. A pesquisa foi realizada no munícipio de Itabuna na Bahia, na Unidade de Saúde da Família Simão Fitterman, no ano de 2014. Participaram do estudo 12 idosos do Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos (HIPERDIA), que participaram das reuniões do grupo terapêutico de idosos. A técnica utilizada para coleta de dados foi a entrevista com roteiro semiestruturado, realizadas nas reuniões do grupo terapêutico da unidade referida. O instrumento de coleta foi composto por dados sócio demográficos, conceitos e fatores desencadeantes das doenças estudadas, tratamento não farmacológico, complicações, prevenção e noções de autocuidado. Concluiu-se que os participantes possuem conhecimento sobre as doenças, entretanto cultivam hábitos que podem desencadear complicações. O conhecimento advindo da experiência, não deve ser negligenciado, mas direcionado ao alcance do objetivo do grupo terapêutico, contribuindo na melhoria do entendimento dos idosos sobre sua (s) doença (s), e estimulando o autocuidado. (AU)
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Abstract The Buschke-Lowenstein tumor, known as the giant condyloma acuminatum, is a rare lesion of the anorectal and PerianaL region; it is sexually transmitted and associated with human papilloma virus, types 6 and 11. Histologically, it is a benign tumor, but it can reach big proportions and may behave aggressively. The purpose of this study is to report the case of a patient diagnosed with HIV and psoriasis 14 years ago, associated with Buschke-Lowenstein tumor and other diffuse condylomatous lesions in the body.
Resumo O tumor de Buschke-Lowenstein, também conhecido como condiloma acuminado gigante, é uma lesão rara da região anorretal e perianal, sexualmente transmitida, associada ao papiloma vírus humano, Tipos 6 e 11. Histologicamente, trata-se de um tumor benigno, mas clinicamente atinge grandes proporções e pode se comportar de forma agressiva. O objetivo deste estudo é relatar o caso de um paciente com diagnóstico de HIV e psoríase há 14 anos, associado ao tumor de Buschke-Lowenstein e outras lesões condilomatosas difusas no corpo.
Assuntos
Humanos , Masculino , Psoríase/complicações , Infecções por HIV/complicações , Tumor de Buschke-Lowenstein/patologia , PapillomaviridaeRESUMO
Introdução: O tumor de células granulares (TCG) é uma neoplasia benigna de tecido mole incomum que acomete principalmente mulheres na quarta e sexta década de vida. A lesão possui predileção pela região de cabeça e pescoço, sendo a superfície dorsal da língua o local de maior acometimento. Clinicamente, apresenta-se como um nódulo submucoso firme, de coloração semelhante a mucosa ou levemente amarelada, de crescimento lento e assintomático. O objetivo deste trabalho é relatar um caso de TCG apresentando suas características clínicas, histopatológicas bem como os possíveis diagnósticos diferenciais. Relato de caso: Paciente sexo feminino, 46 anos de idade, apresentando nódulo localizado no bordo lateral posterior da língua. Ao exame intraoral foi possível observar tumefação firme à palpação, com coloração amarelada, medindo aproximadamente 1cm no seu maior diâmetro. Baseado na hipótese diagnóstica de lipoma, foi realizada uma biópsia excisional. A análise histopatológica revelou características morfológicas compatíveis com o TCG. Considerações finais: O Cirurgião-Dentista deve conhecer os diagnósticos diferenciais clínicos e histopatológicos, uma vez que a conduta terapêutica pode ser distinta em alguns casos... (AU)
Introduction: Granular cell tumor (GCT) is a benign neoplasm of uncommon soft tissue that mainly affects women in the fourth and sixth of life. The lesion has a predilection for the head and neck region, and the dorsal surface of the tongue is the site of major involvement. Clinically, it presents as a firm, mucosal or slightly yellowish, slowly growing, asymptomatic submucosal nodule. The objective of this work is to report a case of GCT presenting its clinical, histopathological and possible differential diagnoses. Case report: A 46-year-old female patient with a nodule located on the posterior lateral border of the tongue. On intraoral examination, it was found on a table, with a yellowish color, measuring approximately 1cm in its largest diameter. Based on the diagnostic hypothesis of lipoma, an excisional biopsy was performed. A histopathological analysis revealed morphological characteristics compatible with GCT. Final considerations: The Dentist should know the differential clinical and histopathological diagnoses, since the therapeutic behavior may be different in some cases... (AU)
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Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Língua/patologia , Tumor de Células Granulares/patologia , Biópsia , Diagnóstico DiferencialRESUMO
BACKGROUND: Actinic cheilitis is induced by chronic exposure to ultraviolet radiation and shows solar elastosis, a feature that has been associated with mast cell infiltrates. This study aimed to investigate the area of solar elastosis, collagen loss, and mast cell infiltrates in a series of actinic cheilitis. METHODS: We evaluated the epithelial dysplasia in 52 cases of actinic cheilitis and the solar elastosis with Weigert's resorcin-fuchsin. Collagen loss was evaluated with Picrosirius red, analyzed under polarized microscopy, and scored from 1 to 3. Elastosis proportionate area (EPA) was calculated with image software. Mast cells were highlighted with toluidine blue stain. RESULTS: EPA varied from 2% to 45%, with a mean of 17.1% in the cases, with no differences among epithelial dysplasia degrees. Most cases presented collagen loss scores of 2 or 3, and higher loss of type I collagen was associated with older age. Mast cell density was higher in severe epithelial dysplasia (P = 0.002) and in high-risk cases (P = 0.01). CONCLUSION: Actinic cheilitis presented variable EPA and marked loss of type I collagen; however, these features were not associated with the degrees of epithelial dysplasia. Besides, mast cell density increased with epithelial dysplasia worsening and this was not associated with elastosis area or collagen loss.
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Queilite/patologia , Tecido Elástico/patologia , Células Epiteliais/patologia , Mastócitos/patologia , Adolescente , Adulto , Idoso , Criança , Colágeno Tipo I/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Luz Solar/efeitos adversos , Adulto JovemRESUMO
OBJECTIVE: We conducted a systematic review to evaluate the efficacy of PDT in the management of recurrent herpes labialis (RHL). STUDY DESIGN: systematic review. METHODS: This study was reported according to the PRISMA checklist and we performed a literature search on five databases. RESULTS: The search revealed that there are no published clinical trials addressing PDT on RHL, therefore we conducted a review of case reports and five studies were included for qualitative review. The number of treated patients varied from 2 to 6 in each article. Most studies used methylene blue as a photosensitizer, while one used 5-aminolevulinic acid. For light irradiation, most studies used laser and one used a red light from halogen lamp. Patients' follow-up varied from 24â¯h to 12 months. All articles reported good outcomes with resolution of disease and no recurrences. Only one study reported adverse effects during treatment (burning and pain). CONCLUSION: The results of this review suggest that PDT could be an effective treatment for herpes labialis. However, due to very few case reports and heterogeneity among protocols, there is a call for well-designed randomized clinical trials to confirm the efficacy of this therapy and to establish standardized protocols. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD CRD42018108973.
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Herpes Labial/tratamento farmacológico , Fotoquimioterapia/métodos , Humanos , Terapia com Luz de Baixa Intensidade , Satisfação do Paciente , Fármacos Fotossensibilizantes/uso terapêutico , RecidivaRESUMO
Clear cell odontogenic carcinoma (CCOC) is a rare and aggressive malignant epithelial neoplasm, which occurs most frequently in the mandible of elderly patients. Morphologically, CCOC shares similar characteristics with other clear cell tumors, especially hyalinizing clear cell carcinoma of the salivary glands (HCCC). Both CCOC and HCCC are known to harbor EWSR1 rearrangements, especially the EWSR1-ATF1 gene fusion, which indicates a possible link between the two lesions. So far, this fusion has been demonstrated in five cases of CCOC in the literature. Herein, we add another CCOC case to the literature, which arose in the mandible of an 82-year-old female patient and was proven to harbor the EWSR1-ATF1 gene fusion. Immunohistochemically, this case was focally positive for CK7, CK14, CK19 and p63. The patient was referred to surgical treatment; however, she died of disease 2 months after the diagnosis, thereby demonstrating the aggressive nature of this tumor.
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Carcinoma/genética , Carcinoma/patologia , Tumores Odontogênicos/genética , Tumores Odontogênicos/patologia , Proteínas de Fusão Oncogênica/genética , Idoso de 80 Anos ou mais , Evolução Fatal , Feminino , HumanosRESUMO
PURPOSE: Salivary gland tumors are complex and have a great histomorphological diversity; more than 30 histological subtypes are currently described and the study of proteins that help understand and differentiate these tumors is essential. We aimed to analyze the immunoexpression of cyclooxygenase-2 (COX-2) and cyclin D1 proteins in pleomorphic adenomas (PA), mucoepidermoid carcinomas (MEC) and adenoid cystic carcinomas (AdCC) of salivary glands. METHODS: A total of 38 PA, 12 AdCC and 12 MEC underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed semi-quantitatively. For statistical analysis, a significance level was set at p ≤ 0.05. RESULTS: Overall, these tumors were more prevalent in women (n = 37). The mean age of these patients was 58-year-old and the parotid gland was the most affected anatomic site (n = 33). All cases of AdCC and MEC showed immunopositivity to cyclin D1; however, 39.5% of the PAs were negative (p < 0.001). Regarding COX-2 immunoexpression, we observed that all cases of CME were positive, whereas 60.5% of the PA and 75% of the CAC analyzed were completely negative (p = 0.042). CONCLUSIONS: The overexpression of COX-2, observed only in MEC, emphasizes that salivary gland tumors have different profiles. Cyclin D1 is more immunoexpressed in malignant tumors. Together, these immunohistochemical findings may be useful in differentiating the studied tumors.
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Adenoma Pleomorfo/metabolismo , Carcinoma Adenoide Cístico/metabolismo , Carcinoma Mucoepidermoide/metabolismo , Ciclina D1/metabolismo , Ciclo-Oxigenase 2/metabolismo , Neoplasias das Glândulas Salivares/metabolismo , Adenoma Pleomorfo/patologia , Adulto , Biomarcadores Tumorais/metabolismo , Carcinoma Adenoide Cístico/patologia , Carcinoma Mucoepidermoide/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/patologiaRESUMO
PURPOSE: The aim of this work was to evaluate the expression of the cancer stem cell (CSC) markers CD44, ALDH1 and p75NTR in the ultraviolet-induced lesions actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC), and to correlate it with p53 expression. METHODS: Immunohistochemistry was performed in 4 cases of normal lip (NL), 43 of AC and 20 of LSCC. RESULTS: All cases were positive for CD44, showing a membranous staining without differences between the groups. ALDH1 showed cytoplasmic staining and it was invariable amongst the grades of epithelial dysplasia and between AC and LSCC. p75NTR presented membranous/cytoplasmic staining in the basal and parabasal layer of NL and AC, while LSCC presented cytoplasmic staining in the peripheral layers of the tumor islands. p75NTR showed different expression amongst the dysplasia grades (p < 0.001) but no differences between AC and LSCC. p53 expression was similar amongst the dysplasia grades and between AC and LSCC. CD44, ALDH1 and p75NTR were unrelated amongst themselves and to p53 expression. CONCLUSIONS: CSC markers are expressed in potentially malignant and malignant lesions of the lip. Their expressions were invariable between AC and LSCC and unrelated to p53. p75NTR expression increased with the worsening of epithelial dysplasia grade.
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Carcinoma de Células Escamosas/metabolismo , Queilite/metabolismo , Receptores de Hialuronatos/metabolismo , Isoenzimas/metabolismo , Neoplasias Labiais/metabolismo , Proteínas do Tecido Nervoso/metabolismo , Receptores de Fator de Crescimento Neural/metabolismo , Retinal Desidrogenase/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Família Aldeído Desidrogenase 1 , Biomarcadores/metabolismo , Carcinoma de Células Escamosas/patologia , Queilite/patologia , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Labiais/patologia , Masculino , Pessoa de Meia-Idade , Células-Tronco NeoplásicasRESUMO
BACKGROUND: We analyzed the different grades of dysplasia in the epithelium adjacent to lip squamous cell carcinoma (LSCC), as a parallel to actinic cheilitis (AC) that suffered malignant transformation. METHODS: Forty samples of epithelium adjacent to LSCC were histologically graded according to the World Health Organization (WHO) and the binary systems. The expression of mutated p53 was evaluated through immunohistochemistry. RESULTS: According to WHO system, 37.5% of the cases were graded as mild, 45% as moderate and 17.5% as severe dysplasia (P = 0.09). Considering the binary system, 90% of the cases were classified as low-risk and 10% as high-risk lesions. Mutated p53 was present in 73.3% of mild, 88.8% of moderate and 71.4% of severe dysplasia cases. Considering the binary system, 80.5% of the low-risk and 75% of high-risk lesions were immunopositive; 62.5% expressed the protein in both tumor cells and adjacent epithelium; 17.5% in adjacent epithelium only, and 7.5% in LSCC islands only (P = 0.03). CONCLUSIONS: We observed heterogeneous grades of epithelial dysplasia in the epithelium adjacent to LSCC, which indicates that the analysis of AC morphological features is insufficient to predict patient's prognosis and to determine a treatment decision. Positive expression of mutant p53 in mild dysplasia reinforces this idea.
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DNA repair systems play a critical role in protecting the human genome against cumulative damage. The apurinic/apyrimidinic endonuclease 1 is a protein involved in DNA base excision repair and its expression still needs to be investigated in salivary gland tumors. The objective of this study is to analyze the immunoexpression of apurinic/apyrimidinic endonuclease 1 in pleomorphic adenomas and carcinomas ex pleomorphic adenomas of the salivary glands. A total of 33 pleomorphic adenomas and 16 carcinomas ex pleomorphic adenomas of the salivary glands underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed quantitatively. For statistical analysis, Mann-Whitney test was performed and a significance level was set at p ≤ 0.05. All analyzed tumors (n = 49) were positive for apurinic/apyrimidinic endonuclease 1. However, there was a higher median expression in carcinomas ex pleomorphic adenomas (p < 0.001). There was no difference between this protein immunoexpression and tumors of major or minor salivary gland. Overexpression was found mainly in cases of carcinomas ex pleomorphic adenomas with lymph node metastasis (p = 0.002) and invasive growth (p = 0.003), when compared to cases without metastasis and without capsular invasion (intracapsular pattern). Our findings revealed that apurinic/apyrimidinic endonuclease 1 is downregulated in pleomorphic adenomas and overexpressed in carcinomas ex pleomorphic adenomas, suggesting that this protein is possibly deregulated in pleomorphic adenoma malignant transformation. Furthermore, the increased expression of this protein is associated with a more aggressive behavior in carcinomas ex pleomorphic adenomas, which suggests that this protein may represent a prognostic biomarker in the studied salivary gland tumors.
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Adenoma Pleomorfo , Carcinoma , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/genética , Neoplasias das Glândulas Salivares , Adenoma Pleomorfo/genética , Adenoma Pleomorfo/patologia , Adulto , Carcinoma/genética , Carcinoma/patologia , Transformação Celular Neoplásica/genética , Feminino , Perfilação da Expressão Gênica , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Proteômica/métodos , Neoplasias das Glândulas Salivares/genética , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologiaRESUMO
BACKGROUND: DNA repair systems play a critical role in protecting the human genome from damage caused by carcinogens. Modifications in DNA repair genes may be responsible for tumor development and resistance of malignant cells to chemotherapeutic agents. The major pathway for oxidative DNA damage repair is the base excision repair pathway. This study aimed to assess the immunoexpression of DNA repair proteins APE-1 and XRCC-1 and its association with clinical, histologic, and survival parameters in oral tongue squamous cell carcinoma, to investigate a possible role for those proteins in tumor behavior. METHODS: The expression of APE-1 and XRCC-1 was evaluated by immunohistochemistry in 82 cases of oral tongue squamous cell carcinoma. Histopathological grading was performed for each case. Pearson's chi-square and Fisher's exact tests were used to determine the association between protein expressions and clinicopathological features of tumors, whereas Kaplan-Meier curves and Cox regression were used to analyze disease-specific and disease-free survival. Statistical significance was set at P ≤ 0.05. RESULTS: APE-1 was highly expressed in the nucleus and cytoplasm in 64.6% of cases, and XRCC-1 showed overexpression only in the nucleus in 61% of cases. High expression of XRCC-1 was significantly associated with tumors at early clinical stages (I and II, P < 0.01) and nodal status (P = 0.03). Both proteins were not associated with other clinical parameters, histopathological grading, or survival. CONCLUSIONS: DNA base excision repair proteins APE-1 and XRCC-1 are upregulated in oral tongue squamous cell carcinoma, and XRCC-1 expression is associated with better clinical staging and nodal status.
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Carcinoma de Células Escamosas/genética , Reparo do DNA , DNA Liase (Sítios Apurínicos ou Apirimidínicos)/genética , Neoplasias da Língua/genética , Proteína 1 Complementadora Cruzada de Reparo de Raio-X/genética , Adolescente , Adulto , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Núcleo Celular/genética , Criança , Citoplasma/genética , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Fatores de Risco , Neoplasias da Língua/mortalidade , Neoplasias da Língua/patologia , Regulação para Cima , Adulto JovemRESUMO
Odontogenic tumors (OTs) are important lesions of the gnathic bones due to their clinicopathological heterogeneity and variable biological behavior; therefore, epidemiological studies are needed to outline the incidence and behavior of these tumors. To evaluate the incidence and epidemiological profile of ameloblastoma (AMB) and keratocystic odontogenic tumor (KCOT) from an oral pathology service, and correlate morphological findings of these tumors with the immunoexpression of a cellular proliferation marker (Ki-67), a retrospective study (2002-2012) was conducted to characterize demographic, clinical, radiological, and morphological data of AMBs and KCOTs. Then, a representative sample composed of 49 cases of each tumor was selected to perform immunohistochemical (IHC) analysis of Ki-67 through the streptavidin biotin peroxidase technique. For statistical analysis, we used Fisher's exact test (p < 0.05). A total of 279 OTs were found in the service, in which 91 (32.6%) were AMB and 98 (35 %) were KCOT. Most cases occurred in white women, and the average age of patients with AMB and KCOT was 32 and 33 years, respectively. The maxilla-mandible ratio was 1:6 and 1:3.6 for AMB and KCOT, respectively. Regarding IHC analysis, AMB and KCOT had similar levels of cellular proliferation. However, KCOTs with intense inflammation showed higher Ki-67 expression (p < 0.001). Recurrent cases had similar Ki-67 immunoexpression. The demographic profile of the studied tumors corroborates with data reported in the literature, and the levels of cellular proliferation were similar in both tumors, although the inflammation seems to induce a differential proliferative behavior in KCOT.
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Neoplasias Mandibulares/patologia , Neoplasias Maxilares/patologia , Tumores Odontogênicos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ameloblastoma/epidemiologia , Ameloblastoma/metabolismo , Ameloblastoma/patologia , Brasil/epidemiologia , Proliferação de Células , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Incidência , Antígeno Ki-67/metabolismo , Masculino , Neoplasias Mandibulares/epidemiologia , Neoplasias Mandibulares/metabolismo , Neoplasias Maxilares/epidemiologia , Neoplasias Maxilares/metabolismo , Pessoa de Meia-Idade , Tumores Odontogênicos/epidemiologia , Tumores Odontogênicos/metabolismo , Estudos Retrospectivos , Adulto JovemRESUMO
Radiation-induced damage to the salivary glands remains a major complication of using radiation therapy to treat head and neck cancer, and it has led a wide range of research attempting to resolve the problem. From this perspective, we sought to briefly discuss relevant and timely approaches aimed at protecting or regenerating irradiated salivary glands, thereby preventing the development of salivary hypofunction or rescuing the functional properties of damaged glands. Such findings include molecular, cell, tissue, organ, and drug-based therapies.
Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Glândulas Salivares/fisiopatologia , Neoplasias de Cabeça e Pescoço/fisiopatologia , HumanosRESUMO
RESUMO: Objetivo: identificar e analisar as características da produção acadêmica sob a rubrica Relato de Caso. Métodos: realizou-se uma pesquisa empírico-analítica dos trabalhos publicados nas revistas de Fonoaudiologia - DIC, CEFAC, CODAS e ACR, dos anos de 2009 a 2014, perfazendo um total de 151 trabalhos. Resultados: (a) uma certa predileção pelos estudos de caso único mas uma tendência clara de estudar até cinco casos em relação aos estudos com maior número de sujeitos; (b) regularidade, em umas das revistas, no número de relatos de casos publicados ao longo do período estudado; progressão em outra e decréscimo nas outras duas; (c) uma hegemonia de artigos no campo da linguagem quando se cruza número de publicações e especialidade da Fonoaudiologia; (d) uma hegemonia de estudos com crianças em relação às outras faixas etárias; (e) equilíbrio entre o número de relatos de casos que discutem diagnóstico e os que discutem intervenção; (f) os relatos de caso cujo foco são os procedimentos clínicos, aqueles em que o diagnóstico e a terapêutica ou intervenção estão associados, ocorrem em menor número. Observou-se a necessidade de analisar criticamente este achado, dado que a Fonoaudiologia, como disciplina clínica, deveria evitar a separação entre terapêutica e diagnóstico. A clínica é uma estrutura e como tal, tem seus elementos componentes em articulação constante para que o sentido da intervenção possa ser identificado, descrito e explicado. Conclusão: embora o relato de caso tenha presença constante nas publicações analisadas, sua importância para o raciocínio clínico ainda é bastante subestimada.
ABSTRACT: Purpose: to identify and analyze the characteristics of academic research under the heading Case Report. Methods: we conducted an empirical-analytical research of papers published in Speech and Language magazines - DIC, CEFAC, CODAS and ACR, during the period of 2009-2014, totaling151 articles. Results: a) a certain preference for single case studies but a clear tendency to study up to five cases in relation to studies with larger numbers of subjects; b) regularity in one of the magazines, in the number of published case reports over the study period; progression in another and decrease in the other two; c) hegemony of articles in the field of language when crossing number of publications and Phonoaudiology specialty; (d) hegemony of studies with children compared to other age groups; (e) balance between the number of case reports discussing diagnosis and those discussing intervention; (f) case reports focusing on clinical procedures -- when diagnosis and therapy or intervention are associated - appear less. There was the need to critically analyze this finding, since Speech and Language Pathology, as a clinical discipline, should prevent separation between therapy and diagnosis. Structurally, the components of clinical practice are in constant articulation so that the direction of intervention can be identified, described and explained. Conclusion: although the case report has a constant presence in the analyzed publications, its importance to clinical reasoning is still quite underestimated.
RESUMO
Quando as condições de perda tecidual coronáriade um dente endodonticamente comprometidosão grandes o bastante para comprometer a manutençãodo dente no arco, é necessário que selance mão do recurso de ancoragem no interior doconduto radicular para oferecer retenção à restauraçãofutura. Dentre os diversos materiais e técnicasdisponíveis, a utilização de pinos anatômicospor meio da modelagem do conduto radicular coma resina composta, associada ao pino pré-fabricadode fibra, tem sido indicado para restauração de dentesestruturalmente debilitados. A técnica do pinoanatômico amplia a indicação dos pinos de resinareforçados por fibras, reduz a espessura da linha decimentação, o que permite melhor adaptação aoconduto radicular. Assim, o objetivo deste trabalhoé descrever o procedimento clínico para confecçãodo pino anatômico, por meio da apresentação deum caso clínico que associa retentor intrarradicularcom faceta direta em resina composta.
When the conditions of coronary tissuesloss in endodontically treated tooth are largeenough to threaten the maintenance ofthe tooth in the arch, it is necessary use ananchorage inside the root canal to provideretention to future restoration. Among thevarious materials and techniques available,the use of posts through the anatomicalshaping of the root canal with composite resinassociated with pre-fabricated fiber posthas been shown to restore tooth structurallyweak. The technique expands the indicationof pre-fabricated posts reinforced by fibers,reduces the thickness of the cement line thatallows a better adaptation in the root canal.The aim of this paper is to describe the clinicalprocedures to make an anatomic postthrough the presentation of a clinical case associatedwith pre-fabricated post reinforcedby fibers and direct facet.