ABSTRACT
Abstract Arsenic contamination in the environment and groundwater is a major global public health problem. Several researchers suggest that the toxicity of arsenic could be related to oral cancer development, usually resulting from potentially malignant lesions. During pathological processes, salivary proteins suffer modifications, which could lead to the discovery of new biomarkers. Objective To analyze the protein profile in human saliva samples from a rural population exposed to high levels of arsenic in drinking water and its association with potentially malignant lesions. Methodology This observational, analytic and cross-sectional design included 121 patients from the state of Graneros (Tucumán, Argentina). Arsenic concentration in drinking water was determined and, according to the values obtained, individuals were divided into 2 groups: exposed group and non-exposed group. Saliva samples were obtained, and total protein concentration was measured by Bradford method. Finally, Laemmli SDS-polyacrylamide gel electrophoresis was conducted to obtain the protein profile. Results Total protein concentration in saliva was lower in the exposed group than in the non-exposed group. Average areas of 20 and 42 KDa bands were significantly lower in exposed group than non-exposed group. Conclusion Chronic intake of high arsenic concentrations in drinking water produces changes in the salivary protein profile, which is associated with the presence of potentially malignant lesions.
Subject(s)
Humans , Arsenic/analysis , Arsenic/toxicity , Water Pollutants, Chemical/analysis , Water Pollutants, Chemical/toxicity , Drinking Water/analysis , Argentina , Rural Population , Salivary Proteins and Peptides , Pilot Projects , Environmental Monitoring , Cross-Sectional StudiesABSTRACT
La fibromatosis gingival es una enfermedad rara que se caracteriza por aumento del tejido gingival por proliferación fibrosa, es de crecimiento lento, cubriendo en algunos casos la totalidad de los dientes comprometidos. Esta nosología comprende un grupo heterogéneo de patologías de causas no determinadas. El objetivo de este trabajo es presentar un caso clínico de una paciente de 13 años con FGI Unilateral, su diagnóstico, tratamiento y seguimiento durante cuatro años. Presenta al examen clínico intraoral, agrandamiento anormal de su encía tanto superior como inferior, afectando solamente los hemiarcos del sector izquierdo. A la palpación es indolora y de consistencia fibrosa. No se encontraron factores locales que justifiquen dicho aumento. El examen físico elimina la posibilidad de otras patologías asociadas, no refiriendo recibir medicaciones inmunosupresivas, antiepilépticos o antihipertensivas. No tiene antecedentes familiares. La paciente fue sometida a extirpación quirúrgica del tejido hiperplasiado y el material obtenido enviado a estudio histopatológico. Después del tratamiento quirúrgico y una buena higiene oral con exámenes de control efectuados durante cuatro años no se observó recurrencia. A pesar de ser una patología poco frecuente el odontólogo debe conocer la fisiopatología y comprender que el manejo de ésta enfermedad es a través de un equipo multidisciplinario. El diagnóstico precoz y el tratamiento oportuno logran la recuperación psicológica, estética y funcional de los pacientes.
Gingival fibromatosis is a rare disease characterized by progressive enlargement of the gingiva caused by an increase in submucosal connective tissue. The enlargement may potentially cover the exposed tooth surfaces. Idiopathic gingival fibromatosis (IGF) is a heterogeneous group of disorders with no definite cause. The aim of this study is to present a 13-year-old female patient with unusual clinical forms of Unilateral FGI with a complete analysis of the features of the clinical diagnosis, treatment and follow-up for four years. Intraoral examination revealed severe gingival overgrowth involving both the upper arch and the lower arch, affecting on the left side. The right side of the mouth was unaffected. There was no significant pain. The lesion was diffuse, firm and fibrotic. Her medical and family history was also non-contributory. The patient was not receiving any antiepileptic, antihypertensive, or immunosuppressive medications that could contribute to the gingival enlargement. Histopathological examination showed hyperparakeratinized stratified squamous epithelium, presence of a thickened acanthotic epithelium and focal hyperplasia. Underlying connective tissue stroma was collagenous with numerous lymphoplasmacytic infiltrate. Unusual findings include the presence of calcified particles. Bevel gingivectomy was taken to remove gingival overgrowth. This case is thus a rare and atypical presentation of gingival fibromatosis. The patient was advised to maintain good oral hygiene to minimize the effect of inflammation on fibroblasts. In our case, even after four years of follow-up, no recurrence of gingival overgrowth was observed. Unilateral IGF is a relatively rare condition with poorly understood etiopathogenesis and recurrence rates. The cases should be treated with a multidisciplinary management. Treatment appreciably improved the patient's psychological, aesthetics and masticatory competence.
Subject(s)
Humans , Female , Adolescent , Fibromatosis, Gingival/diagnosis , Gingivectomy , Gingivoplasty , Radiography, Panoramic , Tomography, X-Ray Computed , Fibromatosis, Gingival/surgery , MalocclusionABSTRACT
Los bisfosfonatos son usados en el tratamiento de pacientes donde es necesario disminuir la reabsorción ósea, principalmente osteoporosis, mieloma múltiple y en metástasis óseas de tumores sólidos, como cáncer de pulmón, mama y próstata. Pero con el advenimiento de los de alto poder, como el zoledronato, pamidronato, administrados por vía endovenosa, aparecen las complicaciones secundarias. En el año 2003 se publicó el primer caso de osteonecrosis de los huesos maxilares (ONM). Desde entonces, se reportaron numerosos casos de pacientes con ONM, que habían recibido tratamientos con bifosfonatos. El objetivo de este trabajo es presentar dos casos clínicos de pacientes medicados con BF que presentaron ONM posterior a una extracción dental.
Bifosfonates are used in the patientss treatment where it is necessary to diminish the bony reabsorption, mainly osteoporosis, multiple myeloma and in bone metastasis of solid tumors as lung, breast and prostate cancer. However secondary complications appear withthe incoming of zoledronate and pamidronate, of high power, administered by intravenous way. In 2003 it was published the first case of osteonecrosis of maxillary bones (ONM). Since then there were reported numerous cases of patients with ONM that had received treatments with bifosfonates. The aim of this work was to present two clinical cases of patients treated with BF that showed ONM posterior to a dental extraction.
Subject(s)
Humans , Male , Female , Middle Aged , Diphosphonates/adverse effects , Jaw Diseases/classification , Jaw Diseases/chemically induced , Osteonecrosis/complications , Osteonecrosis/etiology , Osteonecrosis/chemically induced , Antineoplastic Agents/therapeutic use , Osteonecrosis , Tamoxifen/therapeutic useABSTRACT
El melanoma es un cáncer de origen melanocítico extremadamente raro, de pronóstico grave con una pobre sobrevida a los cinco años. El objetivo del presente trabajo es comunicar un caso clínico de melanoma de la cavidad bucal correspondiente a una mujer de 75 años de edad, en la cuál se estudiaron los niveles séricos de las enzimas lisosomales, Fosfatasa Ácida (FA), Hexosaminidasa (Hex), Beta Galactosidasa ( -Gal) y el Antígeno Carcinoembrionario (CEA). El tratamiento efectuado fue quirúrgico completándose el mismo con quimio e inmunoterapia, falleciendo la paciente a los doce meses del diagnóstico. El dosaje de las enzimas lisosomales séricas al momento del diagnóstico mostraban un valor superior al valor máximo normal, por lo que investigaciones posteriores podrían validar el dosaje de estas enzimas como método complementario para el diagnóstico de esta patología. La identificación de lesiones precursoras del melanoma maligno y la determinación de marcadores tumorales séricos junto a la aplicación de terapias locales y sistémicas mas efectivas podrían contribuir a mejorar la sobrevida de estos pacientes.
The melanoma is a melanocytic start cancer extremely strange, of serious forecast with a poor survive at five year. The aim of the present work is communicate a clinical case of mouth cavity melanoma belonging to a 75-year-old woman, in which were studied lysosomal enzymes levels, Acid Fosfatase (FA), Hexosaminidase (Hex), B-Galactosidasa (B-Gal) and the Carcinoembrionic Antigen (CEA). The treatment carried out was surgical and being completed with quimio and immunotherapy, dying twelve months latter the patient. The seric lysosomal enzymes at the moment of diagnostic showed a value over the normal one, for what this study suggested may be used as complementary method of diagnosis to this pathology. The precursor injuries identification of malignant melanoma and seric determination of tumour scoreboards with the application of local and systemic therapies more effective might help to provide better survive to these patients.