Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

Virtual learning object about oral ulcerative lesions: controlled educational intervention study

Abstract The aim of this study was to develop a virtual learning object (VLO) to teach undergraduate dental students about the diagnostic and therapeutic approaches to oral ulcerative lesions. The VLO was developed with information on the diagnostic process, lesion classification, and clinical-surgical management of oral ulcerative lesions. The VLO content was initially validated by a group of specialists. Learning was evaluated in a sample of 58 undergraduate dental students, divided into control group (conventional theoretical class, n = 29) and intervention group (interaction with VLO, n = 29). All students answered a pre-test and post-test questionnaire. The VLO group also answered a specific questionnaire on the evaluation of the VLO. Both quantitative and qualitative descriptive analyses were performed. The validation showed that professors and students considered the VLO adequate. The use of the VLO was recommended by 100% of professors and 86.6% of students. In the intervention group, the results showed a significantly higher number of correct answers in the post-test (p < 0.01). In conclusion, the VLO proved to be a useful tool for teaching oral medicine, contributing significantly to the knowledge of ulcerated lesions in the mouth.

Distance learning course improves primary care dentists' diagnosis and self-efficacy in the management of oral lesions

Abstract Oral cancer represents a public health issue because of its high mortality rate, resulting mainly from diagnostic delays. Insufficient training in oral diagnosis is usually perceived by dentists. Distance learning could be used as an auxiliary tool to bridge that gap. This study evaluated the impact of a distance learning course on oral mucosal lesion diagnosis offered to public healthcare dentists. Participants of an online course answered a pretest/posttest comprising clinical images of 30 clinical cases. Participants were questioned about the diagnosis and informed their decision on the cases (referring the cases to a specialist or managing them themselves), as a parameter of perceived self-efficacy. A total of 442 dentists enrolled in the course. Their pass rate was 97%. Classification of the nature of the lesions, diagnostic hypotheses, sensitivity, and specificity improved by 13.4%, 10.0%, 13.4%, and 6.6%, respectively (p<0.01, Wilcoxon test). Regarding management, there was a 16.6% reduction in the intention to refer cases, while confidence in the diagnosis of benign lesions increased by 40%. A distance learning course may be useful in continuing education actions for primary care dentists, improving their diagnostic abilities and encouraging them in the management of oral lesions. Moreover, this strategy could contribute to disseminating knowledge to remote regions, particularly among primary health care professionals.

Prognostic factors from squamous cell carcinoma of the hard palate, gingiva and upper alveolar ridge

Abstract: The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.

Investigation of oral and general health status and IL-1β gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients

Abstract: The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1β profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1β levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1β gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1β levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1β gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1β in the context of OM pathobiology and to validate cytokine analysis in larger cohorts.

Cistos e tumores odontogênicos: estudo retrospectivo dos casos diagnosticados no período de 10 anos em um hospital no sul do Brasil / Odontogenic cysts and tumors: a retrospective study of the cases diagnosed in a period of 10 years in a southern Brazilian hospital

Introdução: as lesões odontogênicas (LOs) compreendem um grupo heterogêneo de patologias orais e maxilofaciais que apresentam características distintas. O objetivo do presente estudo foi identificar as características clínico--patológicas das LOs diagnosticadas em um hospital da região sul do Brasil. Materiais e métodos: foi realizado um estudo retrospectivo para levantamento dos casos com diagnóstico histopatológico de LOs no período entre 2007 e 2017. Os laudos dos pacientes foram avaliados para extração das características clínico-patológicas e dos diagnósticos histopatológicos de cada caso. Resultados: um total de 255 casos de LOs foram identificados. Destes casos, 197 (77%) cistos odontogênicos e 58 (23%) tumores odontogênicos foram coletados, sendo que somente um caso (0,39%) possuiu o diagnóstico de neoplasia odonto-gênica maligna. Os diagnósticos mais prevalentes foram cisto radicular (32,5%) e cisto dentígero (31,76%), seguidos de ceratocisto odontogênico (10,98%), odontoma (10%) e ameloblastoma (10%). A maioria dos casos acometeu mandíbula (53,7%), com uma discreta predileção pelo sexo feminino (51%). A média de idade foi de 34±20,53 anos. Discussão: os dados apresentados corroboram com a literatura no que se refere à raridade do diagnóstico de tumores odontogênicos. Conclusão: o presente estudo demonstrou as principais características clínico-pato-lógicas de LOs diagnosticadas em um hospital no sul do Brasil, contribuindo para um maior conhecimento do perfil destas lesões.

Introduction: odontogenic lesions (OLs) represent a heterogeneous group of oral and maxillofacial patho-logies presenting distinct characteristics. The present study aimed to identify the clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital. Materials and methods: a retrospective study was performed to evaluate cases with histopathological diagnosis of OLs identified in the period between 2007 and 2017. The patient's medical records were evaluated in order to obtain the clinical and pathological charac-teristics and the histopathological diagnosis from each case. Results: a total of 255 cases of OLs were identified. From these, 197 (77%) odontogenic cysts and 58 (23%) odontogenic tumors were surveyed, with only one case (0,39%) of a malignant odontogenic neoplasm. The most prevalent diagnosis were radicular cyst (32.5%) and den-tigerous cyst (31.76%), followed by odontogenic keratocyst (10.98%), odontoma (10%) and ameloblastoma (10%). The majority of the cases affected the mandible (53.7%) with a slight preference by female individuals (51%). The mean age was 34±20.53 years old. Discussion: the presented data are in accordance with the literature regarding the rarity of the diagnosis of odontogenic tumors.Conclusion: the present study demonstrated the main clinical and pathological characteristics of OLs diagnosed in a southern Brazilian hospital, contrib-uting to a better understanding of these injuries profiles.

Analysis of referrals to the stomatology service in a Southern Brazilian hospital: a retrospective study

Abstract This paper intends to describe the demand for referrals to the stomatology service requested by the medical teams for inpatients in a reference hospital in the south of Brazil. This research is a retrospective cross-sectional descriptive study focusing on data collection and assessment of information about referrals to the stomatology unit carried out from January 2008 to December 2018. All information was obtained from the hospital management software database, then transferred and analyzed individually for descriptive statistics. A total of 4433 cases were referred to the stomatology team, with an average of 403 cases by year. Hematology/hemato-oncology (37.3%) was the specialty asking for the majority of the referrals, followed by Oncology (20.4%) and Pneumology (8.2%). The mean patients' profile was males (55.5%), receiving a diagnosis of oral mucositis (43.5%), and with the first and second decades of life being the most prevalent ones (34.9%), with a mean age of 34.8±22.3 years. The most common treatment performed by the stomatology team was the photobiomodulation therapy (44.8%). This retrospective study demonstrated the important profile of the stomatological care in hospitalized patients from a specific hospital, especially referred by the hematology/hemato-oncology team. These results evidenced the importance of the stomatology specialty in the hospital environment.

Mortality due to oral and oropharyngeal cancer in Uruguay from 1997 to 2014

Abstract Oral and oropharyngeal cancer is considered a public health problem in several countries due to its high incidence and mortality rate. Objective: This study aimed to analyze oral and oropharyngeal cancer mortality in Uruguay from 1997 to 2014 by age, sex and country region. Methodology: A time series ecological study using secondary data was performed. Data on mortality due to oral and oropharyngeal cancers were obtained from the Vital Statistics Department of Uruguay's Ministry of Public Health. Results: The cumulative mortality rate due to oral and oropharyngeal cancer over the study period was of 19.26/100,000 persons in women and 83.61/100.000 in men, with a mean annual rate of 1.75/100,000 in women and 7.60/100,000 in men. Mortality rate from both sites during the study period was 4.34 times higher in men than in women. Malignant neoplasms of other parts of the tongue and base of tongue showed the highest mortality rate. The means of the annual coefficients of deaths were higher for the age groups between 50 and 69 years. Higher mortality rates of oral and oropharyngeal cancer were observed in Artigas (4.63) and Cerro Largo (3.75). Conclusions: Our study described a high mortality rate for oral and oropharyngeal cancer in Uruguay from 1997 to 2014. According to the country's health department, men, tongue cancer, and oral cavity had higher mortality rates, with some variation. Prevention strategies with control of risk factors and early diagnosis are necessary to improve survival in the Uruguayan population.

TGF-ß1 and its association with clinicopathological features, proliferative activity and prognosis in oral squamous cell carcinoma: an immunohistochemical study

Introduction: The prognostic value of transforming growth factor beta-1 (TGF-ß1) in oral cancer remains unclear. Therefore, the aim of this study was to evaluate TGF-ß1 expression in oral squamous cell carcinoma (OSCC) samples and its association with clinicopathological data, tumor proliferative activity, and patients' prognosis. Methods: A total of 68 patients with histopathological diagnosis of OSCC were included, as well as 9 cases of normal oral mucosa for comparison purposes. The OSCC sample was categorized according to patients' outcomes in favorable prognosis (n=30) or unfavorable prognosis (n=38). Immunohistochemical staining for TGF-ß1 and Ki-67 were performed. The slides were semi-quantitatively and quantitatively evaluated for TGF-ß1 and Ki-67, respectively. Results: TGF-ß1 was significantly increased in OSCC compared to normal oral mucosa (<0.01). An inverse correlation was found between TGF-ß1 and Ki67 staining in OSCC (p=0.01). No association was found between TGF-ß1 expression and OSCC clinicopathological features, prognosis or survival. Conclusions: TGF-ß1 had no prognostic value and appears to maintain its suppressive role concerning cell proliferation. (AU)

Impact of highly active antiretroviral therapy in the development and remission of oral plasmablastic lymphoma.

Plasmablastic lymphoma (PBL) represents a rare type of non-Hodgkin lymphoma associated with human immunodeficiency virus (HIV) infection. The impact of highly active antiretroviral therapy (HAART) in this tumor is poorly known due to its small incidence. This study reports a case of a 33-year-old HIV-positive woman who was referred to the Stomatology Department complaining about a painful gingival growth and cervical nodule both with 20 days of evolution. The lesions appeared 7 months after the patient stopped HAART. The final diagnosis was PBL. After resuming HAART for 45 days, the gingival lesion presented complete remission. The patient continued with HAART alongside chemotherapy. At 24 months follow-up, the patient was stable. The dental surgeon plays an essential role in orientation and retention in care of HIV patients once the adherence of HAART seems to play an important role in PBL development and response to treatment.

Deposition and nutritional quality of the litter of pure stands of Eucalyptus camaldulensis and Acacia mangium / Aporte e qualidade nutricional da serapilheira de plantios puros de Eucalyptus camaldulensis e Acacia mangium

The aim of this study was to evaluate the contribution of pure stands of Eucalyptus camaldulensis and Acacia mangium for litter deposition and nutrient return in a pit of clay extraction in northern Rio de Janeiro (RJ). We conducted a randomized block design experiment with two treatments and three replications. For the evaluation of the annual deposition of litter and nutrients (N, P, K, Ca and Mg), we used circular collectors during a year (from July 2006 to June 2007). The planting of Acacia mangium in clay extraction pits contributed with the largest annual deposition of litter and with a litter of better quality compared to Eucalyptus camaldulensis, with higher levels of P and N and lower C:N and polyphenol:N ratios. This fact possibly allows higher rates of decomposition by edaphic microorganisms and, hence, a faster release of these nutrients to the soil. In addition, the planting of legumes showed higher annual deposition of P and N.

O objetivo deste estudo foi avaliar a contribuição de plantios puros de Eucalyptus camaldulensis (Eucalipto) e Acacia mangium (Acácia) na deposição de serapilheira e retorno de nutrientes em uma cava de extração de argila na região norte fluminense (RJ). Realizou-se um experimento, cujo delineamento utilizado foi o de blocos casualizados com dois tratamentos e três repetições. Para a avaliação do aporte anual de serapilheira e nutrientes (N, P, K, Ca e Mg), utilizaram-se coletores circulares, durante o período de um ano (julho de 2006 a junho de 2007). O plantio de Acacia mangium na cava de extração de argila contribuiu com o maior aporte anual de serapilheira total, bem como, uma serapilheira de melhor qualidade em relação ao Eucalyptus camaldulensis, apresentando maiores teores de P e N e menores relações C:N e Polifenol:N. Este fato possivelmente permite maiores taxas de decomposição pelos microrganismos edáficos, e consequente mais rápida liberação desses nutrientes para o solo. Além disso, o plantio da leguminosa apresentou maior aporte anual de P e N.

Oral mucosal lesions and their association with sociodemographic, behavioral, and health status factors

The aim of this study was to evaluate the frequency of oral mucosal lesions and their associations with sociodemographic, health, and behavioral factors in a southern Brazilian population. Information was collected from participants (n = 801) using a structured questionnaire during an oral cancer screening campaign held at an agribusiness show in southern Brazil in 2009. Data were described using frequency distributions or means and standard deviations. Associations between independent variables and outcomes were assessed using the Chi-squared test. A total of 465 lesions were detected (actinic cheilitis: n = 204, 25.5%; candidiasis: n = 50, 6.2%; fibrous inflammatory hyperplasia: n = 42, 5.2%; ulceration, n = 33, 4.1%; hemangioma: n = 14, 1.7%; leukoplakia: n = 11, 1.4%). Candidiasis, actinic cheilitis, and fibrous inflammatory hyperplasia were associated significantly with literacy. Actinic cheilitis was also associated significantly with sun exposure and hat use, and leukoplakia was associated with smoking. The high frequency of oral mucosal lesions observed highlights the importance of education about risk factors. Additionally, training of health professionals, mainly those from public health services, in the use of preventive and community education strategies is needed.

Extracellular production of avicelase by the thermophilic soil bacterium Bacillus sp SMIA-2 / Produção de avicelase extracelular pela bactéria termofílica Bacillus sp SMIA-2

Nowadays, the isolation of new bacterial strains that produce enzymes with novel properties is a subject of great relevance to the scientific community. This study, in order to search for producers of new cellulase strains, investigated the avicelase production by thermophilic Bacillus sp. strain SMIA-2. The best avicelase activity was observed in a culture medium containing 0.5% (w v-1) avicel and 0.5% (w v-1) corn steep liquor with initial pH 7.5- 8.0 incubated at 50 oC. When avicel was replaced in the medium by the treated sugarcane bagasse (0.5%, w v-1) the avicelase activity levels were not affected. Studies on the avicelase characterization revealed that the optimum pH of the enzyme was found to be 8.5 and the enzyme retained more than 80% of its activity after incubation at room temperature for 2h at pH 6.5-8.5. The optimum temperature of this enzyme was 70oC and the enzyme retained 67% of the original activity after 20 min. of heat treatment at 70oC. Avicelase was stimulated by Mn2+ and Co2+, whereas Hg2+ greatly inhibited the enzyme activity.

Atualmente, o isolamento de estirpes de bactérias que produzem enzimas com novas propriedades é um tema de grande relevância para a comunidade científica. Este trabalho, buscando por novas cepas produtoras de celulases, investigou a produção de avicelases pelo termofílico Bacillus sp. cepa SMIA-2. A melhor atividade da enzima foi obtida em uma cultura contendo 0,5% (p v-1) avicel e 0,5% (p v-1) água de maceração de milho com pH inicial de pH 7,5-8,0 e incubada a 50oC. A substituição da avicel no meio de cultura pelo bagaço de cana- de- açúcar tratado (0,5%, p v-1) não afetou os níveis de atividade da avicelase. Estudos sobre a caracterização da avicelase revelaram que o pH para atividade ótima da enzima foi 8,5 e que a mesma reteve mais de 80% de sua atividade após ser incubada à temperatura ambiente por 2 h a pH 6,5-8,5. A temperatura ótima da avicelase foi 70oC e a enzima reteve 67% da sua atividade original após 20 min. de incubação a 70oC. A avicelase foi estimulada pelos íons Mn2+ e Co2+, ao passo que Hg2+ inibiu a atividade da enzima.

Tumor de células granulares: relato de dois casos / Granular cell tumor: report of two cases

O tumor de células granulares (TCG) é uma neoplasia benigna incomum de tecidos moles. Dorso e borda lateral de língua são os sítios mais comumente afetados. Clinicamente, apresenta-se como uma lesão nodular, firme à palpação, bem delimitada, de crescimento lento. O objetivo deste trabalho é relatar dois casos clínicos de TCG mostrando seu aspecto clínico, histopatológico e discutir as hipóteses de diagnóstico e conduta realizada em cada caso.

The granular cell tumor (GCT) is an uncommon benign neoplasm of soft tissue. The sites most commonly affected are the dorsum and lateral border of the tongue. Clinically it presents as a nodular lesion, firm to palpation, well-defined with slow-growing. The aim of this study is to report two cases of GCT showing its clinical and histopathological aspects, and discuss the diagnosis and management of each case.

Expansive lesion of the anterior mandible in child a case report of calcifying cystic odontogenic tumor

The calcifying cystic odontogenic tumor is an uncommon lesion that occurs in both jaws. This odontogenic neoplasm is generally asymptomatic, found either in routine radiographic examination or when causing bone expansion. The purpose of this report was to describe a case of calcifying cystic odontogenic tumor involving mandible in a 9-year-old girl, as well as discuss the importance of careful diagnostic procedures for the correct final diagnosis and establishment of the most appropriate treatment of this uncommon odontogenic lesion that can affect the patients of the pediatric group.

Síndrome de Cushing como complicação do tratamento de líquen plano oral erosivo / Cushing´s Syndrome as a complication of treatment of oral lichen planus

O líquen plano oral (LPO) é uma doença mucocutânea inflamatória crônica relacionada com alterações na imunidade mediada por células T. Diversos medicamentos têm sido utilizados no tratamento desta doença, especialmente nas formas erosivas e ulcerativas, com resultados variados. O objetivo deste trabalho é descrever e discutir um caso clínico de líquen plano oral erosivo tratado com corticóide sistêmico que resultou em Síndrome de Cushing, que se manteve com o uso de corticóide tópico.

Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease involving T cells-mediated immunity. Several drugs have been used to treat OLP, specially the erosive and ulcerative forms, with varying results. The aim of this paper was to describe and discuss one clinical case of erosive oral lichen planus treated with systemic corticosteroids that resulted in Cushing´s syndrome that maintained with topical corticosteroid.

Variação da composição e toxicidade do material particulado ao longo do dia na cidade de São Paulo / Composition and toxicology variations of particle matter during the day in São Paulo city

Este estudo avalia os efeitos adversos na saúde causados pelas variações na composição do material particulado em curtos períodos de tempo. Para tanto, foram determinados Black Carbon (BC), massa e composição elementar do PM2.5 coletado em dois diferentes períodos, Dia e Noite, na cidade de São Paulo. Além das análises químicas, gravimetria, análise de reflectância e espectrometria por fluorescência de Raios-X, foram realizados testes toxicológicos de contagem de micronúcleos utilizando ressuspensão do PM2,5 em raízes de Allium cepa (cebola). O PM2.5 foi amostrado na saída do Concentrador de Partículas Finas Ambientais de Harvard (CPFAH) e as amostras foram coletadas diariamente por quinze dias, entre Maio e Junho (Experimento 1) e entre Outubro e Novembro (Experimento 2) de 2009, durante o Dia (8:00h - 11:00h e 14:00h - 17:00h) e a Noite (20:00h - 23:00h). A variabilidade na composição do PM2.5 foi analizada utilizando o método de componentes principais, por meio da qual foram identificados três fatores significantes: Fator 1, onde encontramos BC e os elementos Ca, Fe, K, Si, Zn e Ti que podem ser característicos da emissão do tráfego veicular em geral; Fator 2 onde encontramos Ni e Cr que podem ser interpretados como resultado das emissões industriais; e o Fator 3 é formado pelos elementos V e S que podem ser característicos das emissões das queimas de diesel e óleo combustível. A análise univariada da contagem dos três fatores mostrou uma diferença significativa somente para o Fator 3 (p=0,022) entre os dois períodos, fazendo-se mais presente no período noturno. A frequência do número de micronúcleos das células de raízes de cebola foi maior para período noturno. Os resultados indicam que existem diferenças na composição e toxicidade do PM2,5 coletado em diferentes períodos na cidade de São Paulo. Os dados sugerem que a toxicidade do PM2,5 pode ser influenciada pelas mudanças nos padrões de tráfego e processos fotoquímicos da atmosfera.

The objective of this study was to evaluate the adverse health effects of shortterm variations in particle composition. For this purpose, black carbon, particle mass and elemental composition of PM2.5 collected along the two different periods in São Paulo city were determined. In addition to the chemical measurements, toxicological evaluation was performed using the Allium cepa micronuclei assay test and particle suspensions of PM2.5 as test substrate. PM2.5 was sampled at the output of the Harvard Ambient Fine Particle Concentrator (HAFPC). The samples were collected daily from May 19th to June 4th (period 1) of 2009, during the morning (from 8 AM to 11 AM), afternoon (from 2 PM to 5 PM), and evening (from 8 PM to 11 PM), and from November 11th (period 2) of 2009, during the morning (from 8 AM to 11 AM), and evening (from 8 PM to 11 PM). Samples collected during the morning and afternoon were called Day and those collected during the evening, EVENING. Concentrations of PM2.5 mass (gravimetric method), black carbon (reflectance analysis) and trace elementals (X-ray fluorescence spectrometry) were determined. Variability in PM2.5 composition measured was analyzed using Principal Components Analysis in which 3 significant factors were identified. Results of black carbon (BC) and of elements Ca, Fe, K, Si, Zn and Ti were grouped in Factor 1, that can be characteristic of general traffic emission; In Factor 2, Ni and Cr were included and it can be interpreted as a result of industry emissions; and Factor 3 is formed by V and S what characterizes diesel/oil combustion emissions. Univariate Analysis of factor scores indicated a significant difference between the periods scores of factor 3 (p=0.022). The frequency of number of micronuclei obtained was also higher in samples collected at the EVENING than those of DAY. In conclusion, our results indicate that there are differences in the composition and toxicity of PM2.5 collected in different periods of the day...

Osteonecrose dos maxilares associada ao uso de bisfosfonatos: importante complicação do tratamento oncológico: [revisão] / Bisphosphonate-associated jaws osteonecrosis: an important complication of oncology treatment: [review]

Os bisfosfonatos são um grupo de medicamentos utilizados no tratamento de doenças malignas metastáticas e em outras doenças ósseas como osteoporose e doença de Paget. A despeito dos seus benefícios, uma importante complicação denominada de osteonecrose dos maxilares vem sendo observada nos pacientes usuários crônicos dos bisfosfonatos que se caracteriza clinicamente por exposições ósseas na região maxilofacial persistente, acompanhadas de osteomielite, geralmente sintomáticas e cujo tratamento é complexo. Este estudo tem por objetivo revisar a literatura sobre a osteonecrose associada ao uso dos bisfosfonatos, em especial, em oncologia, no período de 2003 a 2008. Serão apresentados e discutidos os fatores de risco, aspectos etiopatogênicos, clínicos, imagenológicos, terapêuticos e preventivos desta doença. Devido à dificuldade de tratamento da osteonecrose associada aos bisfosfonatos, o foco deve ser a prevenção, sendo o ideal a eliminação de quadros infecciosos orais antes da terapia com os bisfosfonatos ter sido iniciada e minimizar traumas em boca após o uso destes medicamentos.

Bisphosphonates are drugs used in the treatment of malignant metastatic diseases and in other bone lesions such as osteoporosis and Paget´s disease. Besides their benefits, jaw osteonecrosis, an important side effect, has been observed in long-term users of these drugs. Jaw osteonecrosis is clinically characterized by prolonged maxillary and mandible bone exposure accompanied by osteomyelitis. These lesions are usually symptomatic and difficult to treat. This study has the objective of reviewing publications from 2003 to 2008 about bisphosphonate-associated jaw osteonecrosis, in particular in relation to oncology. Risk factors, and etiopathological, clinical, radiographic, therapeutic, and preventive aspects of this condition are presented and discussed. Due to the difficulty to treat this disease, the focus must be prevention, with the ideal therapy being the elimination of oral infections before treatment with bisphosphonates is initiated thereby attempting to minimize possible traumas to the mouth with the use of these medications.

Intra-oral schwannoma: case report and literature review.

Schwannoma is a relatively uncommon, slow-growing benign tumor that is derived apparently from the Schwann cells. The tongue is the most common site, followed by the palate, floor of mouth, buccal mucosa, lips, and jaws. It can present itself at any age. Usually, this lesion is not taken into account during clinical practice and the differential diagnosis includes numerous benign neoformations based on epithelial and connective tissues. Immunohistochemical features can be useful in determining the neural differentiation. Anti-S100 protein is probably the most used antibody to identify this lesion. The schwannoma is usually a solitary lesion, and can be multiple when associated with neurofibromatosis. In the current study, authors report a case of an intraoral schwannoma situated at the vestibule with 20 years of evolution treated by complete surgical excision. The diagnosis was established based on clinical, histopathological, and immunohistochemical aspects. The patient is under clinical control, with no signs of recurrence even after four years.

Avaliação do conhecimento sobre o câncer bucal entre universitários / Evaluation of knowledge of oral cancer among students

Introdução: O câncer oral é uma doença de alta incidência no mundo e que vem sendo considerada como problema de saúde pública. A prevenção e o diagnóstico precoce constituem as melhores formas de reverter essa situação. Objetivo: Avaliar o nível de conhecimento de uma população de universitários de Odontologia sobre o câncer de boca. Métodos: Foi aplicado um questionário contendo 37 questões para 148 alunos de Odontologia. Após a coleta, foi confeccionada uma planilha no programa de computador Excel (Microsoft). Foram comparadas as porcentagens de acerto entre os anos (teste qui-quadrado de tendência) e verificada a consistência e coerência (coeficiente de Cronbach) com nível de significância de 5% ou calculado o p-valor correspondente. As análises foram feitas utilizando-se o programa SAS for Windows, v.9.1.3. Resultados: O valor do de Cronbach para o questionário foi de 0,7681, considerado o instrumento consistente e coerente, tornando-o um método adequado para avaliação do nível de conhecimento sobre o câncer bucal. Na análise individual das questões, notou-se que, mesmo havendo diferença significativa entre algumas respostas corretas entre os anos, isso não significa que, com o passar do tempo, a porcentagem de acertos aumente. Quanto ao conhecimento sobre o câncer bucal, notou-se maior nível de acerto nos alunos de 3º e 4º ano. Os alunos demonstram alto índice de acertos quanto ao conhecimento sobre os fatores de risco do câncer bucal. Conclusão: Para melhorar o nível do conhecimento dos alunos sobre o câncer bucal, faz-se necessário um programa universitário de prevenção de câncer bucal envolvendo os alunos de todos os anos do curso.

Introduction: The oral cancer has a high incidence worldwide and it is considered a public health problem. Prevention and early diagnosis are the best solution to reverse this situation. Objective: To evaluate the level of knowledge about oral cancer in a group of Odontology students. Methods: A 37-question questionnaire was applied to 148 Odontology students. After collecting all the data, a worksheet using Microsoft Excel was created. The percentage of right answers was compared among university-level classes (Chi-square test of tendency), and the consistency and coherence were checked (Cronbach's coefficient) with 5% significance level or calculated the correspondent p-value. The analyses were conducted using the SAS system for windows 9.1.3. Results: The Cronbach's value in the questionnaire was 0.7681, considering the instrument consistent and coherent as an appropriate method to evaluate the students' level of knowledge about oral cancer. An individual analysis of the questions showed that, although there was an expressive difference in some of the right answers in different university-level classes, it does not mean that the percentage of accurate answers increases in the course of time. Regarding the level of knowledge about oral cancer, a larger number of right answers among students of the 3rd and 4th years was observed. Students had a large number of right answers concerning risk factors for oral cancer. Conclusion: It is essential to create a university program on oral cancer prevention for the students of all levels, in order to improve their knowledge about oral cancer.