Pro-and Anti-inflammatory Biomarkers as Potential Prognosis Markers in Oral Squamous Cell Carcinoma

ABSTRACT: The most widely used method to classify prognostic factors in cancers today is TNM. However, Oral Squamous Cell Carcinoma (OSCC) often demonstrates different behaviors in relation to aggressiveness and therapeutic response at the same TNM stage. So, in such cases biomarkers can be used to identify the biological diversity of these tumors more reliably, leading to better therapeutic strategies and disease management. The presence of inflammatory immune cells in the tumor microenvironment can have pro or antitumor effects and the investigation of the expression of inflammatory markers in OSSC can be usefulto design immunotherapeutic interventions. The Transforming Growth Factor alpha is a potent stimulator of cell migration that acts on cell proliferation, invasion and metastasis of cancer, as well as immune suppression and angiogenesis. Inflammatory cytokines, such as Interferon-gamma, mediate macrophage differentiation. Macrophages are an important component of the OSCC microenvironment. The greater amount of tumor-associated macrophages, especially the M2 phenotype, may be associated with a more aggressive biological behavior of the OSCC and, consequently, with reduced survival.

RESUMEN: El método más utilizado para clasificar los factores de pronóstico en los cánceres en la actualidad es TNM. Sin embargo, el carcinoma oral de células escamosas (COCE) a menudo muestra diferentes comportamientos en relación con la agresividad y la respuesta terapéutica en la misma etapa TNM. Entonces, en tales casos, los biomarcadores pueden usarse para identificar la diversidad biológica de estos tumores de manera más confiable, lo que lleva a mejores estrategias terapéuticas y manejo de la enfermedad. La presencia de células inmunes inflamatorias en el microambiente tumoral puede tener efectos pro o antitumorales y la investigación de la expresión de marcadores inflamatorios en COCE puede ser útil para diseñar intervenciones inmunoterapéuticas. El factor de crecimiento transformante α es un potente estimulador de la migración celular que actúa sobre la proliferación celular, la invasión y metástasis del cáncer, así como la inmunosupresión y la angiogénesis. Las citocinas inflamatorias, como el IFN-γ, median en la diferenciación de macrófagos. Los macrófagos son un componente importante del microambiente COCE. La mayor cantidad de macrófagos asociados a tumores, especialmente el fenotipo M2, puede estar asociada a un comportamiento biológico más agresivo del COCE y, en consecuencia, a una menor supervivencia.

Prevalência e caracterização das lesões orais na Clínica de Estomatologia da Policlínica Piquet Carneiro ­ Estudo Retrospectivo de 12 anos / Prevalence and characterization of oral lesions in the Stomatology Clinics of the Piquet Carneiro Polyclinics 12-Year Retrospective Study

Objetivo: avaliar a prevalência dos principais tipos de lesões submetidas à biópsia e identificar o perfil dos pacientes atendidos no ambulatório de Estomatologia da Policlínica Piquet Carneiro (PPC/UERJ, Rio de Janeiro) no período compreendido entre 2000 e 2012. Material e Métodos: estudo transversal e retrospectivo em que prontuários de 2078 pacientes foram avaliados e dados referentes às doenças, idade, gênero, cor da pele e localização anatômica das lesões foram coletados e analisados de forma descritiva. Resultados: 69% dos pacientes (1441 casos) obtiveram o diagnóstico conclusivo através de exame histopatológico, ao passo que 31% (637 casos) obtiveram um laudo histopatológico descritivo. Dos casos com diagnóstico histopatológico conclusivo, 58% eram mulheres, 31% homens e em 11% o sexo não foi informado. A média de idade da população estudada foi de 50,63 anos e em 58% dos casos os pacientes eram leucodermas. O maior número de lesões foram as do grupo dos processos proliferativos não-neoplásicos, sendo a hiperplasia fibrosa inflamatória (30,1%) a mais prevalente. Conclusão: o perfil epidemiológico do paciente atendido no período estudado foi composto predominantemente por mulheres com mais de 50 anos de idade e a lesão oral mais prevalente foi a hiperplasia fibrosa inflamatória. Este estudo reforça a importância do papel da análise histopatológica como método auxiliar de diagnóstico e que possibilita a elaboração de estratégias específicas para prevenção e detecção precoce das doenças orais mais frequentes na população

Objective: to evaluate the prevalence of the main types of lesions submitted to biopsy and to identify the profile of patients attended at the Stomatology Clinics of the Piquet Carneiro Polyclinics (PPC/UERJ, Rio de Janeiro) between 2000 and 2012. Material and methods: this is a cross-sectional and retrospective study in which medical records of 2,078 patients were evaluated and data referring to diseases, age, sex, skin color and anatomical location of the lesions were collected and analyzed descriptively. Results: A total of 69% of patients (1,441 cases) obtained the conclusive diagnosis by histopathological examination, whereas 31% (637 cases) obtained a descriptive histopathologic report. Of the cases with conclusive histopathological diagnosis, 58% were women, 31% were men and 11% did not inform their sex. The mean age of the studied population was 50.63 years and in 58% of the cases the patients had light skin. The largest number of lesions were from non-neoplastic proliferative processes, and the inflammatory fibrous hyperplasia (30.1%) was the most prevalent. Conclusion: the epidemiologic profile of patients attended during the study period consisted predominantly of women over 50 years of age and the most prevalent oral injury was inflammatory fibrous hyperplasia. This study reinforces the importance of the histopathological analysis as a diagnostic auxiliary method that enables the elaboration of specific strategies for prevention and early detection of the most frequent oral diseases in the population

Scale-up of collaborative TB/HIV activities in Guyana / Ampliar las actividades de colaboración contra la tuberculosis y la infección por el VIH en Guyana

ABSTRACT Objective To assess scale-up of recommended tuberculosis (TB)/HIV activities in Guyana and to identify specific strategies for further expansion. Methods Medical records and clinic registers were reviewed at nine TB clinics and 10 HIV clinics. At TB clinics, data were collected on HIV testing and antiretroviral therapy (ART) for patients with TB/HIV; at HIV clinics, data were collected on intensified case finding (ICF), tuberculin skin test (TST) results, and provision of isoniazid preventive therapy (IPT). Results At TB clinics, among 461 patients newly diagnosed with TB, 419 (90.9%) had a known HIV status and 121 (28.9%) were HIV-infected. Among the 63 patients with TB/HIV, 33 (52.4%) received ART. Among the 45 patients with TB/HIV for whom dates of HIV diagnosis were available, 38 (84.4%) individuals knew their HIV status prior to TB diagnosis. At HIV clinics, among 127 patients eligible to receive a TST, 87 (68.5%) received a TST, 66 (75.9%) had a TST result, seven (10.6%) had a newly positive result, two had a previously positive result, and six of nine patients with positive results (66.7%) received IPT. ICF could not be assessed because of incomplete or discrepant documentation. Conclusions An in-depth evaluation of TB/HIV activities successfully identified areas of success and remaining challenges. At TB clinics, HIV testing rates are high; further scale-up of ART for persons with TB/HIV is needed. At HIV clinics, use of TST to focus IPT is a feasible and efficient strategy; improving rates of annual TST screening will allow for further expansion of IPT.

RESUMEN Objetivo Evaluar la ampliación de las actividades recomendadas contra la tuberculosis (TB) y la infección por el VIH en Guyana y definir estrategias específicas para nuevas expansiones. Métodos Se examinaron los expedientes médicos y registros clínicos de nueve consultorios de atención de la TB y diez consultorios de atención de la infección por el VIH. En los consultorios de atención de la tuberculosis, se recopilaron datos sobre las pruebas de detección del VIH y el tratamiento antirretroviral (TAR) para pacientes con TB e infección por el VIH; en los consultorios de atención de la infección por VIH, se recopilaron datos a partir de una búsqueda intensiva de casos, los resultados de la prueba de la tuberculina y la provisión de tratamiento preventivo con isoniazida. Resultados En los consultorios de atención de la tuberculosis, de 461 pacientes recién diagnosticados con tuberculosis, 419 (90,9%) conocían su estado con respecto a la infección por el VIH y 121 (28,9%) estaban infectados por el virus. De los 63 pacientes con TB e infección por el VIH, 33 (52,4%) recibieron TAR. De los 45 pacientes con TB e infección por el VIH cuya fecha de diagnóstico de la infección por el VIH se conocía, 38 (84,4%) supieron de su estado con respecto a la infección por el VIH antes de recibir el diagnóstico de la tuberculosis. En los consultorios de atención de la infección por el VIH, de 127 pacientes que reunían los requisitos para la prueba de la tuberculina, 87 (68,5%) recibieron la prueba, 66 (75,9%) tuvieron un resultado, siete (10,6%) tuvieron un resultado positivo nuevo, dos habían tenido un resultado positivo anteriormente, y seis de nueve pacientes con resultados positivos (66,7%) recibieron tratamiento preventivo con isoniazida. No pudo evaluarse la búsqueda intensiva de casos debido a que la documentación estaba incompleta o era discrepante. Conclusiones Una evaluación exhaustiva de las actividades contra la TB y la infección por el VIH permitió determinar las áreas donde se había tenido éxito y los retos pendientes. En los consultorios de atención de la tuberculosis, las tasas de realización de pruebas de detección del VIH son elevadas; se necesita ampliar el alcance del TAR para llegar a las personas con TB e infección por el VIH. En los consultorios de atención de la infección por el VIH, el uso de la prueba de la tuberculina para focalizar la búsqueda intensiva de casos es una estrategia factible y eficaz; el mejoramiento de las tasas de tamizaje anual con la prueba de la tuberculina permitirá ampliar la búsqueda intensiva de casos.

Prevalence of oral lesions caused by removable prosthetics / Chitosan/D. ambrosioides (mastruz) spheres to be applied as a biomaterial

(29%) had some type of associated injury. The lesions found included erythematous candidiasis, inflammatory fibrous hyperplasia, inflammatory papillary hyperplasia, traumatic ulcer, angular cheilitis, irritative keratosis, and denture stomatitis. Inflammatory fibrous hyperplasia was the most prevalent lesion, found in 88 patients (50%),followed by erythematous candidiasis in 75 patients (43%). Of the total number of injured patients, 141 (81%) were women and 34 (19%) were men, and 101 patients (58%) were Caucasian and 37 (21%) were black. Most lesions were located in the upper alveolar ridge and the hard palate. The most widely used type of prosthesis was full upperprosthesis with 84 users (48%). The average usage time for all prostheses was 17 years (SD ± 13). Average patient age was 62 years (SD ± 14). The prevalence of injuries caused by removable prostheses is high, and prolonged use of the device and the presence of oral lesions are strongly associated. Moreover, women represent the largest number of users of the prostheses and therefore carry the majority of the injuries.

Lethal paralytic shellfish poisoning from consumption of green mussel broth, Western Samar, Philippines, August 2013

Background：In July 2013, the Philippines’ Event-Based Surveillance & Response Unit received a paralytic shellfish poisoning (PSP) report from Tarangnan, Western Samar. A team from the Department of Health conducted an outbreak investigation to identify the implicated source and risk factors in coastal villages known for green mussel production and exportation.Methods：A case was defined as a previously well individual from Tarangan, Western Samar who developed gastrointestinal symptoms and any motor and/or sensory symptoms after consumption of shellfish from 29 June to 4 July 2013 in the absence of any known cause. The team reviewed medical records, conducted active case finding and a case-control study. Relatives of cases who died were interviewed. Sera and urine specimens, green mussel and seawater samples were tested for saxitoxin levels using high performance liquid chromatography.Results：Thirty-one cases and two deaths were identified. Consumption of > 1 cup of green mussel broth was associated with being a case. Seawater sample was positive for Pyrodinium bahamense var. compressum and green mussel samples were positive for saxitoxin. Inspection revealed villagers practice open defecation and improper garbage disposal.Conclusion：This PSP outbreak was caused by the consumption of the green mussel broth contaminated by saxitoxin. As a result of this outbreak, dinoflagellate and saxitoxin surveillance was established, and since the outbreak, there have been no harmful algal blooms event or PSP case reported since. A “Save Cambatutay Bay” movement, focusing on proper waste disposal practice and clean-up drives has been mobilized.

Clinical profile of pertussis among pediatric patients admitted at the Philippine General Hospital

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> The aim of this research was to describe the epidemiologic, clinical laboratory and microbiologic characteristics, complications and outcome of pertussis among pediatric patients at the Philippine General Hospital.<br /><strong>METHODS:</strong> A retrospective chart review was performed which included pediatric patients with final diagnosis of pertussis, both clinical and laboratory -confirmed admitted from December 2012 to August 2013 at the Philippine General Hospital. <br /><strong>RESULTS:</strong> This chart review included 28 pertussis patients highest in those aged 1-3 months (86%), females (57%) and from region 4A (57%). 26 (93%) had exposure to household members with respiratory symptoms and unknown pertussis vaccination status. Of those patients who were eligible for vaccination, only 24% received age-appropriate DPT vaccination.<br />Onset of illness varied from 3-56 days; majority 9/L, range: 14.7-111.5x109/L;), lymphocytic predominance (mean lymphocyte 0.47, range: 0.20-0.72;) and thrombocytosis (mean platelet count: 567x109/L, range: 269-823x109/L;). 28% were culture positive for B. pertussis, while 86% tested positive for PCR.<br />The most common complications  were pneumonia requiring mechanical ventilation (64%), ARDS (28%), seizures (21%), nosocomial pneumonia (11%) and myocarditis (11%). The average length of hospital stay was 7.4 days with 13 deaths or 46% case fatality rate. Deaths were attributed to respiratory failure due to progressive pneumonia and ARDS. Other contributing causes were arrhythmia, MODS, and  septic shock.<br /><strong>CONCLUSION:</strong> Susceptible young infants acquire pertussis from household contacts with respiratory symptoms. Paroxysmal cough and cyanosis are common clinical features, with leukocytosis, lymphocytosis and thrombocytosis. High case fatality rate for pertussis was noted among these patients.<br /><br /></p>

Avaliação de pacientes odontológicos para auxílio no diagnóstico precoce da osteoporose / Evaluation of dental patients to aid in early dignosis of osteoporosis

A osteoporose, doença osteometabólica mais frequente, é caracterizada pela diminuição da massa óssea e deterioração do tecido ósseo. O objetivo deste estudo foi verificar a relevância dos exames clínico e radiográfico no auxílio do diagnóstico precoce da osteoporose. Participaram do estudo 57 pacientes de ambos os gêneros, acima dos 30 anos atendidos na Clínica da FO-UNESA. Após anamnese, os pacientes foram submetidos aos exames radiográficos. As radiografias panorâmicas foram analisadas através dos índices radiomorfométricos quantitativos e qualitativos. Conclui-se que os índices radiomorfométricos, principalmente o IMC, apresentaram maior precisão na detecção da redução da densidade óssea quando associados aos fatores de risco para o desenvolvimento da osteoporose.

Osteoporosis, the most common osteometabolic disease, is characterized by decreased bone mass and deterioration of bone tissue. The aim of this study was to assess the relevance of clinical and radiographic examinations aid in early diagnosis of osteoporosis. The study included 57patients of both sexes over age 30 treated at the Clinic FO-UNESA. After interview, the patients underwent radiographic examinations. Panoramic radiographs were analyzed using quantitative and qualitative radiomorphometric indexes. We concluded that the radiomorphometric indexes, mainly IMC, were more accurate in the detection of low bone density when associated with risk factors for the development of osteoporosis.

Aferição da glicemia capilar na clínica odontológica - rastreamento de casos de Diabete tipo II / Measurement of blood glucose in the dental clinic - tracking cases of Type II Diabetes

Estimativas mostram que, no ano de 2025, a população brasileira atingirá 228 milhões de habitantes. A Diabete tipo 2 foi a terceira causa de morte no Brasil e a primeira causa de morte entre os 40 e 49 anos (Censo 2010). Em 2025, serão 11 milhões de diabéticos no país, representando um aumento de mais de 100% em relação aos 5 milhões do ano 2000. Este trabalho propõe o rastreamento de casos suspeitos através do teste de aferição da glicemia capilar pós-prandial. Avaliamos 69 mulheres e 34 homens, um percentual de 8% de casos suspeitos os quais apresentaram glicemia capilar média pós-prandial além de duas horas de 232,75mg/dl e a máxima de 412mg/dl em concordância com o Ministério da Saúde.

Estimates show that in 2025, the Brazilian population is expected to reach 228 million. The type 2 Diabetes was the third leading cause of death in Brazil (Censo 2010). By 2025, should be about 11 million diabetics in the country, representing an increase of over 100 % compared to 5 million in 2000,. This study aims to track possible cases through benchmarking test postprandial blood glucose. The evaluation of 69 women and 34 men showed a percentage of 8% possible cases which had mean postprandial blood glucose of more than two hours of 232.75 mg/dl and a maximum of 412mg/dl in agreement with Ministry of Health studies.

Tumor odontogênico cístico calcificante com proliferação ameloblastomosa em seio maxilar / Calcifying cystic odontogenic tumor with ameloblastoma proliferation in the maxillary sinus

O tumor odontogênico cístico calcificante (TOCC) com proliferação ameloblastomosa é uma variante rara entre os cistos maxilares. Este trabalho objetiva apresentar o relato clínico de um paciente do sexo masculino, 18 anos de idade, que apresentava aumento de volume extra e intraoral do lado esquerdo da maxila, firme à palpação, de característica normocrômica e indolor. A conduta consistiu em realização de tomografia Cone Beam, biópsia incisional, remoção completa da lesão, curetagem e fixação maxilar. O paciente encontra-se em acompanhamento clínico e radiográfico sem recidiva após doze meses. Dessa forma, ressalta-se a importância do diagnóstico precoce, a conduta clínica empregada e o acompanhamento periódico.

Calcifying cystic odontogenic tumors (CCOT) with proliferative ameloblastoma are a rare variant among maxillary cysts. This study aims to present a clinical report of an 18-year-old male patient with extra and intra oral swelling of the left maxilla, firm to touch, with normochromic characteristics and painless. The clinical approach comprised cone-beam tomography, incisional biopsy, complete removal of the lesion, curettage and maxilla fixation. His clinical and radiographic follow-up has revealed no relapse after 12 months. Hence, this study corroborates the importance of early diagnosis, clinical approach and periodical follow-ups.

Massive hard coral loss after a severe bleaching event in 2010 at Los Roques, Venezuela / Pérdida masiva de coral duro después de un evento de blanqueamiento severo en 2010 en Los Roques, Venezuela

Thermal anomalies have become more severe, frequent and well-documented across the Caribbean for the past 30 years. This increase in temperature has caused coral bleaching resulting in reef decline. At Los Roques National Park, Venezuela, temperature has been monitored at four reef sites. In mid-September 2010, seawater temperature reached 30.85°C at 5 m depth in Los Roques, an archipelago only slightly affected by previous bleaching events. For example, bleaching in Los Roques in 2005 was mild compared to the rest of the Caribbean and to the results in this study. In 2010, seawater temperatures remained above 29.0°C from mid-August until the first week of November, resulting in +16 Degree Heating Weeks by that time. Our annual survey of four reef sites indicated that 72% of 563 scleractinian colonies were partial or totally bleached (white) or pale (discolored) in October 2010. In February 2011, there were still 46% of coral colonies affected; but most of them were pale and only 2% were bleached. By February, coral cover had declined 4 to 30% per transect, with a mean of 14.3%. Thus, mean coral cover dropped significantly from 45 to 31% cover (a 34% reduction). In addition to bleaching, corals showed a high prevalence (up to 16%) of black band disease in October 2010 and of white plague (11%) in February 2011. As a consequence, coral mortality is expected to be larger than reported here. Reef surveys since 2002 and personal observations for more than 20 years indicated that this bleaching event and its consequences in Los Roques have no precedent. Our results suggest that reef sites with no previous record of significant deterioration are more likely to become affected by thermal anomalies. However, this archipelago is relatively unaffected by local anthropogenic disturbance and has a high coral recruitment, which may contribute to its recovery.

Durante las últimas décadas las anomalías térmicas han sido más frecuentes y severas en el Caribe, quedando pocos arrecifes exentos de eventos masivos de blanqueamiento (EMB). En el Parque Nacional Los Roques, Venezuela, un archipiélago poco afectado previamente por EMB, la temperatura del agua a 5m de profundidad alcanzó 30,85°C en septiembre 2010, y fue >29,0°C entre mediados de agosto y la primera semana de noviembre en cuatro arrecifes. El 72% de 563 colonias de escleractinios estaban blanqueadas o pálidas para octubre de 2010, mientras que para febrero 2011, el 46% de las colonias aún estaban afectadas. Para febrero 2011, la cobertura béntica coralina promedio disminuyó de 45 a 31%. Además, los arrecifes mostraron una alta prevalencia (de hasta 16%) de enfermedad de banda negra en Octubre 2010, y de plaga blanca (11%) en Febrero 2011. Como consecuencia, es probable que la mortalidad coralina resulte mayor a la reportada acá. Sin embargo, Los Roques es poco afectado por perturbaciones antropogénicas y cuenta con un alto reclutamiento de corales, lo cual podría contribuir a su recuperación.