Diagnóstico y tratamiento de extravasación salival asociado a glándulas salivales BlandinNuhn: Reporte de caso clínico y revisión de la literatura / Diagnosis and treatment of salivary extravasation associated with BlandinNuhn salivary glands: Clinical case report and literature review

Los mucoceles son lesiones de extravasación salival asociados a la ruptura de los conductos que generalmente se asocian con trauma. Son azuláceos, con aspecto traslúcido, fluctuantes a la palpación, expansivos y de crecimiento rápido. Mayoritariamente se manifiestan en población joven. El sitio más común de localización es la mucosa de labio inferior, sin embargo, pueden presentarse en cualquier zona que contenga glándulas salivales menores, como vientre de lengua, donde se encuentran las glándulas Blandin-Nuhn. La frecuencia de las lesiones asociadas a éstas glándulas es del 2.25% reportándose aproximadamente 400 casos hasta la fecha. La finalidad de ésta publicación es la descripción de una patología infrecuente, así como realizar una revisión a la literatura. Se presenta el caso de una niña de tres años con historia de aumento de volumen congénito en el dorso de la lengua sin síntomas compatibles con mucocele, se realiza biopsia excisional bajo anestesia general. El resultado del estudio histopatológico reporta: fenómeno de extravasación de mucosa. Paciente evoluciona satisfactoriamente. Estas lesiones expansivas pueden repercutir en el desenvolvimiento normal de la vida de las personas causando dislalia, disfagia y disnea. El tratamiento de este tipo de lesiones en la infancia favorece a un adecuado desarrollo del habla y mejora las condiciones de alimentación.

Mucoceles are salivary extravasation lesions associated with rupture of ducts that are generally associated with trauma. They are bluish, translucent in appearance, fluctuating on palpation, expansive and fast growing. They mostly occur in young people. The most common site of location is the mucosa of the lower lip, however, they can occur in any area that contains minor salivary glands, such as the belly of the tongue, where the Blandin-Nuhn glands are located. The frequency of lesions associated with Blandin-Nuhn's glands is 2.25%, with approximately 400 cases reported to date. The purpose of this publication is the description of an uncommon pathology, as well as a review of the literature. The case of a three-year-old female with a history of congenital volume increase at the dorsum of the tongue without symptoms compatible with mucocele is reported, an excisional biopsy was performed under general anesthesia. The result of the histopathological study reports: extravasation mucus phenomenon. Patient evolves satisfactorily. These expansive lesions can affect the normal development of people's lives, causing dyslalia, dysphagia and dyspnea. Treatment of this type of injuries in childhood favors adequate speech development and improves feeding conditions.

Efeitos imediatos da fotobiomodulação na produção de saliva / Immediate effects of photobiomodulation on saliva production

RESUMO Objetivo Verificar os efeitos imediatos da fotobiomodulação na produção do fluxo salivar e a correlação dos dados demográficos, antropométricos e de uso de medicamentos. Método Participaram do estudo 100 indivíduos saudáveis, com idade entre 18 e 76 anos (média 27,2 anos), divididos de forma randomizada em grupo experimental e grupo placebo. Foram realizadas as avaliações das medidas antropométricas, autopercepção da produção de saliva e a sialometria. Na sequência, realizou-se a irradiação do LASER no comprimento de onda infravermelho (808 nanômetros) com 100 miliwatts (mw) de potência em cinco pontos intraorais: nas glândulas sublingual e bilateralmente nas submandibulares e parótidas, nas doses 9, 18 e 24 joules (J). A sialometria foi repetida após cada aplicação. O grupo controle recebeu os mesmos procedimentos com equipamento placebo. Resultados Houve associação estatística na autopercepção de redução da saliva no grupo experimental para a dose de 24J e na sialometria e na redução do fluxo salivar para as doses 18J e 24J e aumento para 9J, em ambos os grupos. Não houve associação quando comparado entre os grupos experimental e placebo. A análise de regressão multinomial múltipla revelou que a redução ou o aumento do fluxo salivar independe das variáveis demográficas, antropométricas e uso de medicamentos. Conclusão A ação bioinibitória da fotobiomodulação sobre as glândulas salivares saudáveis ocorreu em dose de 18J e 24J, já ação bioestimulante na dose 9J, independe das variáveis demográficas, antropométricas e uso de medicamentos. A autopercepção da redução do fluxo salivar ocorreu em 24J.

ABSTRACT Purpose To verify the immediate effects of photobiomodulation on the production of salivary flow and the correlation of demographic, anthropometric and medication use data. Methods The study included 100 healthy individuals, aged between 18 and 76 years (mean 27.2 years), randomly split into an experimental group and a placebo group. Assessments of anthropometric measurements, self-perception of saliva production and sialometry were performed. Next, LASER irradiation was carried out at an infrared wavelength (808 nanometers) with 100 milliwatts (mw) of power at five intraoral points: on the sublingual glands and bilaterally on the submandibular and parotid glands, at doses of 9, 18 and 24 joules (J). Sialometry was repeated after each application. The control group received the same procedures with placebo equipment. Results There was a statistical association in the self-perception of reduced saliva in the experimental group for the 24J dose and in sialometry and in the reduction in salivary flow for the 18J and 24J doses and an increase to 9J, in both groups. There was no association when comparing the experimental and placebo groups. Multiple multinomial regression analysis revealed that the reduction or increase in salivary flow is independent of demographic, anthropometric and medication use variables. Conclusion The bioinhibitory action of photobiomodulation on healthy salivary glands occurred at a dose of 18J and 24J, while the biostimulant action happened at a dose of 9J, regardless of demographic, anthropometric variables and medication use. The self-perception of reduced salivary flow occurred at 24J.

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review

Purpose: This systematic review analyzed the clinical behavior and odds of malignancy of the palatal recurrent pleomorphic adenomas. Methods: Systematic review of patients with recurrent pleomorphic adenoma arising in the palate. Database search: MEDLINE, Scopus, Web of Science, Cochrane, EMBASE, Virtual Health Library, Google Scholar, and OpenGrey. A binomial logistic regression was performed to assess the odds of detecting recurrence five, 10 and 20 years after the treatment of primary tumor. Results: Thirteen studies (n = 18 patients) out of 336 were included. The recurrent pleomorphic adenoma in palate was more common in females (61.6%), average age was 49 years old (range 9-73 years old). Four patients progressed to malignant transformation. The odds ratio (OR) of detecting a recurrence at 10 (OR = 5.57; 95% confidence interval - 95%CI 1.13-27.52), and 20 years (OR = 18.78; 95%CI 3.18-110.84) after treatment of primary pleomorphic adenoma was significantly higher than at one-year follow-up. Conclusions: The recurrence of pleomorphic adenoma in palate remains a rare event of late occurrence. It mainly affects middle-aged female and carries a risk of malignant transformation. Although uncommon, patients with palatal pleomorphic adenoma should be warned about the possibility of recurrence or malignant transformation of tumor at advanced ages.

Evaluation of Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum

ABSTRACT Purpose: To assess Meibomian gland dysfunction using meibography in patients with xeroderma pigmentosum and correlate with ocular surface changes. Methods: This cross-sectional study evaluated patients with xeroderma pigmentosum. All patients underwent a comprehensive and standardized interview. The best-corrected visual acuity of each eye was determined. Detailed ophthalmic examination was conducted, including biomicroscopy examination of the ocular surface, Schirmer test type I, and meibography, and fundus examination was also performed when possible. Meibomian gland dysfunction was assessed by non-contact meibography using Oculus Keratograph® 5M (OCULUS Inc., Arlington, WA, USA). Saliva samples were collected using the Oragene DNA Self-collection kit (DNA Genotek Inc., Ottawa, Canada), and DNA was extracted as recommended by the manufacturer. Factors associated with abnormal meiboscores were assessed using generalized estimating equation models. Results: A total of 42 participants were enrolled, and 27 patients underwent meibography. The meiboscore was abnormal in the upper eyelid in 8 (29.6%) patients and in the lower eyelid in 17 (62.9%). The likelihood of having abnormal meiboscores in the lower eyelid was 16.3 times greater than that in the upper eyelid. In the final multivariate model, age (p=0.001), mutation profile (p=0.006), and presence of ocular surface malignant tumor (OSMT) (p=0.014) remained significant for abnormal meiboscores. For a 1-year increase in age, the likelihood of abnormal meiboscores increased by 12%. Eyes with OSMT were 58.8 times more likely to have abnormal meiboscores than eyes without ocular surface malignant tumor. Conclusion: In the final model, age, xeroderma pigmentosum profile, previous cancer, and clinical alterations on the eyelid correlated with a meiboscore of ≥2. Meibomian gland dysfunction was common in patients with xeroderma pigmentosum, mainly in the lower eyelid. The severity of Meibomian gland dysfunction increases with age and is associated with severe eyelid changes.

Instability of tear film and loss of meibomian glands in patients with acne vulgaris / Instabilidade do filme lacrimal e perda de glândulas meibomianas em pacientes com acne vulgaris

ABSTRACT Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.

RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.

Clinical manifestations of I-131 induced salivary gland dysfunction in patients with thyroid carcinoma

Aim: To carry out a retrospective analysis of the frequency and severity of clinical signs of radioiodine (131I)-induced damage to the salivary glands in the early and long-term post-radiation periods, and identify risk factors for their occurrence in patients with differentiated thyroid carcinomas. Methods: A total of 330 patients underwent thyroidectomy with dissection of lymphatic nodes. One month after surgery, all the patients received radioiodine therapy. The dose and number of courses varied depending on the stage and morphological type of the tumor. In the late post-radiation period, the patients were surveyed with the use of a standard questionnaire, which allowed retrospective assessment of the nature and severity of symptoms of radiationinduced damage, as well as the time of their onset/subsidence. Results: Radiation-induced sialoadenitis of the salivary glands was observed in 51.2% of patients treated with 131I. The main symptoms included pain and discomfort in the salivary glands (51.2% of patients), swelling (48.8%), transient or permanent dry mouth (38%), and distortion of taste (38%). There were statistically significant correlations between the presence and severity of the main clinical symptoms of salivary gland irradiation. A significant relationship (r = 0.91, p < 0.001) was found between swelling of the salivary glands and the feeling of pain or discomfort, which was indicative of inflammation and retention of saliva. Conclusion: The main factors influencing the formation of chronic radiation-induced sialoadenitis and the severity of the inflammatory process included the tumor stage, the total dose of radiopharmaceuticals, and the duration following radioiodine therapy

Exploring the mechanism of Xihuang Pill's anti-hyperplasia of mammary glands effect based on UPLC-Q-orbitrap-MS technology / 药学学报

Based on UPLC-Q-orbitrap-MS and biological network analysis tools, the mechanism of Xihuang Pill in improving hyperplasia of mammary glands was systematically analyzed. The rat model of hyperplasia of mammary glands was established by intramuscular injection of estradiol benzoate and progesterone. LC-MS tissue metabolomics was used to explore the key metabolites and metabolic pathways of Xihuang Pill in improving hyperplasia of mammary glands in rat. The network analysis of the key metabolites regulated by Xihuang Pill was carried out by integrating biological network analysis tools, focusing on the key metabolic pathways, and exploring the potential targets of Xihuang Pill to improve hyperplasia of mammary glands. Compared with the control group, there were significant differences in the content of 49 differential metabolites in the tissues of the model group (P < 0.05). Xihuang Pills could significantly call back 17 metabolites such as L-alanine, threonine, indole-3-carboxylic aldehyde, lysine, arginine, alanylleucine, glycyltyrosine, γ-glutamyl leucine, vitamin B3, serine leucine, threonine leucine, isoleucine glutamic acid, γ-glutamyl tyrosine, decanoyl-L-carnitine, uric acid, leucylleucine, S-adenosyl-methionine. Further network analysis and literature research on the key metabolites regulated by Xihuang Pills showed that the AGE-RAGE signaling pathway may be one of the important pathways for Xihuang Pills to improve hyperplasia of mammary glands. STAT3, MAPK1, EGFR, CASP3, CASP8, PRKCA and JUN in the AGE-RAGE signaling pathway may be potential targets for Xihuang Pills to improve hyperplasia of mammary glands. The animal experiment operations involved in this paper follow the provisions of the Animal Ethics Committee of Gansu University of Traditional Chinese Medicine and pass the ethical review of animal experiments (approval number: 2022-705).

Characterization of Salivary Gland Pain: A Review of the Literature / Caracterización del Dolor de Glándulas Salivales: Revisión de la Literatura

SUMMARY: The salivary glands in pathological conditions produce countless different clinical presentations, and due to their complex neuroanatomy, their pain symptoms vary widely. However, in the literature to date, few studies characterize salivary gland pain. The aim of this study was to conduct a literature review concerning the clinical characteristics of pain in various salivary gland pathologies. A literature review was done through a systematic search of scientific articles in the Web of Science (WoS), MEDLINE, Scopus, and Elton B. Stephens Company (EBSCO) databases. The free terms "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", and "pain" were used along with the Boolean operators OR and AND. The search yielded a total of 1896 articles, of which 60 fulfilled the inclusion criteria and were ultimately included in this review. It is described that pain is a nonspecific symptom of a glandular pathology and is characterized mainly by the location of the pain, which is correlated with the anatomical location of the affected salivary gland. Among the painful salivary gland pathologies, we found inflammatory disorders, including infections, obstructions, disorders secondary to hyposalivation; systemic autoimmune diseases; neoplasms, and neuropathic pain disorders. The diagnosis and management of salivary gland pain require knowledge of the causes and mechanisms of the pain, and it is to recognize the signs and symptoms of salivary gland disorders to be able to diagnose and treat them.

Las glándulas salivales en condiciones patológicas producen un sinfín de presentaciones clínicas diferentes, y debido a su compleja neuroanatomía generan variaciones en su sintomatología dolorosa. Sin embargo, en la literatura hasta ahora son escasos los estudios que caracterizan el dolor de glándulas salivales. El objetivo de este estudio fue realizar una revisión de la literatura respecto a las características clínicas del dolor en diversas patologías de glándulas salivales. Se realizó una revisión de la literatura, a través de la búsqueda sistemática de artículos científicos en las bases de datos Web of Science (WoS), MEDLINE, Scopus y Elton B. Stephens Company (EBSCO). A través de los términos libres: "salivary gland", "parotid gland", "submaxillary gland", "sublingual gland", "pain", junto con los operadores booleanos OR y AND. La búsqueda arrojó un total de 1896 artículos, de los cuales 60 cumplieron los criterios de inclusión y fueron finalmente incluidos en esta revisión. Se describe que el dolor es un síntoma poco específico para la patología glandular y está caracterizado principalmente por la localización del dolor, el cual se correlaciona con la ubicación anatómica de la glándula salival afectada. Dentro de las patologías dolorosas de glándulas salivales encontramos los trastornos inflamatorios, incluidas infecciones, obstrucciones, trastornos secundarios a hiposalivación; enfermedades sistémicas autoinmunes; neoplasias y trastornos de dolor neuropático. El diagnóstico y manejo del dolor de glándulas salivales requiere del conocimiento de las causas y mecanismos del dolor, siendo necesario reconocer los signos y síntomas de los trastornos de glándulas salivales para ser capaces de diagnosticarlos y tratarlos.

Importancia del diagnóstico precoz en el carcinoma mucoepidermoide. Relato de caso clínico / Importance of early diagnosis in mucoepidermoid carcinoma. Case report

El carcinoma mucoepidermoide es el tumor maligno más frecuente de las glándulas salivales menores localizándose por lo general en el paladar. El objetivo del presente reporte de caso es evidenciar en la literatura científica la importancia del diagnóstico precoz de carcinomas orales, así como, el rol fundamental que cumple el odontólogo general para identificar, guiar y derivar al paciente a un especialista. Se presenta el caso clínico de un paciente de sexo masculino que acudió a la Facultad de Odontología de la Universidad Nacional de Asunción, quien fue derivado por su odontóloga tras percibir un pequeño pero perceptible cambio en la coloración normal de la mucosa y molestias ocasionales en la zona del paladar duro. Al examen intraoral se observó en el paladar duro, a la altura de los premolares en la hemiarcada izquierda, una lesión nodular ovoidea, color violáceo, de 1cm de diámetro, depresible a la palpación. Se realizó una biopsia incisional para su estudio histopatológico, reportando un carcinoma mucoepidermoide. El diagnóstico precoz de este tipo de patologías es un desafío para el odontólogo general, quien debe orientar al paciente, ante cualquier cambio de la estructura normal de la cavidad bucal, para que acuda a un especialista.

Mucoepidermoid carcinoma is the most frequent malignant tumor of the minor salivary glands, usually located in the palate. The objective of this case report is to demonstrate in the Paraguayan scientific literature the importance of early diagnosis of oral carcinomas as well as the fundamental role of the general dentist in identifying, guiding and referring the patient to the corresponding specialist. The clinical case presented is about a male patient who attended the Faculty of Dentistry of the National University of Asuncion. His dentist referred him after noticing a small but perceptible change in the normal coloration of the mucosa and occasional discomfort in the area of the hard palate. In the intraoral examination, an ovoid nodular lesion, purplish in color, 1cm in diameter, depressible on palpation, observed on the hard palate at the level of the premolars in the left hemiarch. An incisional biopsy performed for histopathological study, reporting a mucoepidermoid carcinoma. Regarding the early diagnosis of this type of pathology, the challenge for the general dentist will continues to be his continuous training in order to be able to successfully guide the patient in seeking care from the right specialist in case of any change in the oral cavity.

Functional and morphological evaluation of the meibomian glands and ocular surface assessment at high altitude

Purpose: To compare the function and morphology of the meibomian glands and the ocular surface of individuals from highland and lowland. Methods: This was a randomized controlled trial. The study was performed with 104 individuals (51 individuals from the highland and 53 individuals from the lowland). Detailed eye examinations comprising tear meniscus height, lipid layer grading, non?invasive Keratograph tear breakup time (NIKBUT), and scoring of the meibomian glands from the upper and lower eyelids of the individuals were performed by Keratograph 5M (OCULUS, Wetzlar, Germany). Symptoms related to dry eye disease were assessed using the Ocular Surface Disease Index (OSDI). Results: In the highland group, tear meniscus height was lower (P = 0.024), lipid layer grade, as well as all the meiboscores were higher (P < 0.05) than that in the lowland group. The OSDI (P = 0.018) and the percentage of dry eye disease were also higher as compared to that of the lowland group (P = 0.032). The first NIKBUT and average NIKBUT did not differ significantly between groups. The frequency of plugged meibomian gland orifices was greater in the lowland group compared to the highland group (P = 0.036). Conclusion: It was observed that dry eye disease was more common in the highland group. The morphological changes of meibomian gland dropout were significant in highlanders as demonstrated objectively with Keratograph 5M. Our study may raise a concern for environmental influences on ocular surface changes

Biometry of the Submandibular Salivary Glands in Indian Population Using Computed Tomography : A Retrospective Study

Objectives : To study the biometric measurements of the submandibular salivary gland in the Indian population using Computed Tomography. Materials and Methods : From the available database, 300 patients who have undergone Computed Tomography without any salivary gland disease, the CT scans were retrospectively evaluated. The CT scans were obtained with TOSHIBA Activion 16 slice CT machine. The antero-posterior, transverse and cranio-caudal dimensions of bilateral submandibular salivary glands were measured in the axial, coronal and sagittal planes. Results : The mean CT measurements of the patients included was 2.0 ± 0.38 cm in Antero-posterior, 2.1 ± 0.31 cm in Transverse and 2.90 ± 0.27 cm in Cranio-caudal dimensions. The average volume of the submandibular gland was 6.68 ± 0.21 cc.

Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

Histogram analysis in the differentiation between adrenal adenomas and pheochromocytomas: the value of a single measurement / Análise por histograma para diferenciação entre adenomas da adrenal e feocromocitomas: o valor de uma medida única

Abstract Objective: To assess the diagnostic accuracy of histogram analysis on unenhanced computed tomography (CT) for differentiating between adrenal adenomas and pheochromocytomas (PCCs). Materials and Methods: We retrospectively identified patients with proven PCCs who had undergone CT examinations between January 2009 and July 2019 at one of two institutions. For each PCC, we selected one or two adenomas diagnosed within two weeks of the date of diagnosis of the PCC. For each lesion, two readers scored the size, determined the mean attenuation, and generated a voxel histogram. The 10th percentile (P10) was obtained from the conventional histogram analysis, as well as being calculated with the following formula: P10 = mean attenuation - (1.282 × standard deviation). The mean attenuation threshold, histogram analysis (observed) P10, and calculated P10 (calcP10) were compared in terms of their diagnostic accuracy. Results: We included 52 adenomas and 29 PCCs. The sensitivity, specificity, and accuracy of the mean attenuation threshold were 75.0%, 100.0%, and 82.5%, respectively, for reader 1, whereas they were 71.5%, 100.0%, and 81.5%, respectively, for reader 2. The sensitivity, specificity, and accuracy of the observed P10 and calcP10 were equal for both readers: 90.4%, 96.5%, and 92.6%, respectively, for reader 1; and 92.3%, 93.1%, and 92.6%, respectively, for reader 2. The increase in sensitivity was significant for both readers (p = 0.009 and p = 0.005, respectively). Conclusion: For differentiating between adenomas and PCCs, the histogram analysis (observed P10 and calcP10) appears to outperform the mean attenuation threshold as a diagnostic criterion.

Resumo Objetivo: Avaliar a acurácia diagnóstica da análise por histograma na tomografia computadorizada (TC) sem contraste para a diferenciação entre adenomas adrenais e feocromocitomas (FCCs). Materiais e Métodos: Identificamos, retrospectivamente, pacientes com diagnóstico de FCC confirmado que foram submetidos a exames de TC entre janeiro de 2009 e julho de 2019 em duas instituições distintas. Para cada FCC, selecionamos um ou dois adenomas diagnosticados em até duas semanas da data do diagnóstico do FCC. Para cada lesão, dois leitores pontuaram o tamanho, determinaram a atenuação média e geraram um histograma com os voxels das imagens. O percentil 10 (P10) foi obtido a partir da análise convencional do histograma, além de ser calculado com a seguinte fórmula: P10 = atenuação média - (1,282 × desvio-padrão). O limiar de atenuação média, o P10 da análise por histograma (P10 observado) e o P10 calculado (P10calc) foram comparados em termos de acurácia diagnóstica. Resultados: Foram incluídos 52 adenomas e 29 FCCs. A sensibilidade, especificidade e acurácia do limiar de atenuação média foram de 75,0%, 100,0% e 82,5% para o leitor 1, respectivamente, e de 71,5%, 100,0% e 81,5% para o leitor 2, respectivamente. A sensibilidade, especificidade e acurácia do P10 observado e do P10calc foram idênticas para os dois leitores: 90,4%, 96,5% e 92,6%, respectivamente, para o leitor 1; e 92,3%, 93,1% e 92,6%, respectivamente, para o leitor 2. O aumento da sensibilidade foi significativo para ambos os leitores (p = 0,009 e p = 0,005, respectivamente). Conclusão: Para a diferenciação entre adenomas e FCCs, a análise por histograma (P10 observado ou P10calc) parece superar o limiar de atenuação média como critério diagnóstico.

Mielolipoma gigante unilateral de la glándula suprarrenal. Reporte de caso

Introducción: Los tumores de la glándula suprarrenal son inusuales y por lo general son hallados de forma incidental por estudios de imágenes. Dentro de este grupo los mielolipomas son uno de los tumores más raros, considerados el 2% de los tumores suprarrenales. Caso Clínico: Presentamos una paciente femenina de 60 años de edad con antecedentes de dolor a tipo cólico de forma esporádica a nivel del hipocondrio derecho. La ecografía abdominal detectó colelitiasis y una masa sugerente de adenoma suprarrenal izquierdo. La tomografía abdominal corroboró el tumor suprarrenal gigante y la litiasis vesicular. Se realizó suprarrenalectomía y colecistectomía convencional sin complicaciones. El diagnóstico histopatológico mostró un mielolipoma suprarrenal y una colecistitis crónica. Discusión: El mielolipoma suprarrenal es infrecuente, la etiología se desconoce, por lo general es asintomático y su hallazgo es incidental, habitualmente son unilaterales, menores a 4cm y la incidencia aumenta con la edad. Conclusiones: Cuando los mielolipomas alcanzan dimensiones mayores de 10cm se recomienda realizar una suprarrenalectomía convencional.

Introduction: Adrenal gland tumors are unusual and are usually found incidentally by imaging studies. Within this group, myelolipomas are one of the rarest tumors, considered 2% of adrenal tumors. Clinical case: We present a 60-year-old female patient with a history of sporadically colicky pain at the level of the right hypochondrium. Abdominal ultrasound revealed cholelithiasis and a mass suggestive of a left adrenal adenoma. Abdominal tomography confirmed a giant adrenal tumor and gallstones. An adrenalectomy and conventional cholecystectomy were performed without complications. The histopathological diagnosis showed an adrenal myelolipoma and chronic cholecystitis. Discussion: Adrenal myelolipoma is infrequent, the etiology is unknown, it is usually asymptomatic and its finding is incidental, they are usually unilateral, smaller than 4cm and the incidence increases with age. Conclusions: When myelolipomas reach dimensions greater than 10cm, conventional adrenalectomy is recommended. In selected cases.

NECROTIZING SIALOMETAPLASIA OF PALATE A RARE CASE REPORT

Necrotizing sialometaplasia (NS) is a rare benign reactive necrotizing in?ammatory process that affects the minor salivary gland and frequently mimics cancer on both a clinical and histopathological level. Case Study : We report the case of a 21-year-old healthy man who had throat pain and non-healing ulcer over soft palate for the past one month, with pain during swallowing.Histopathological analysis and an incisional biopsy were performed on the patient. Necrotizing sialometaplasia was the histologically determined diagnosis. Necrotizing sialometaplasia is a self-limiting disorder of salivary glands mostly affecting the hard palate.The duration of the healing process is usually related to the size of the lesion.The recurrence rate of Necrotizing Sialometaplasia is low.Even a full thickness palatal lesion heals completely within 6 months.

Enfermedad de Fox-Fordyce: reporte de un caso / Fox-Fordyce disease: a case report

Resumen La enfermedad de Fox-Fordyce (EFF) es un trastorno inflamatorio crónicopoco frecuente de las glándulas apocrinas. Afecta comúnmente a mujeres entre los 13-35 años. Su etiopatogenia es multifactorial. Se caracteriza por pápulas foliculares pruriginosas dispuestas en zonas que contienen las glándulas mencionadas. Se presenta el caso clínico de una paciente de 30 años, con pápulas foliculares en axilas compatibles con enfermedad de Fox-Fordyce. El propósito deeste trabajo es presentar una entidad infrecuente y brindar una revisión bibliográfica repasando los diagnósticos diferenciales y las opciones terapéuticas disponibles.

Abstract Fox-Fordyce disease (FFD) is a rare chronic inflammatory disorder of the apocrine glands. It commonly affects women between 13-35 years. Its etiopathogenesis is multifactorial. This disorder is characterized by pruritic follicular papules arranged in areas containing the aforementioned glands. We reporta clinical case of a 30-year-old female patient, with follicular papules on armpits compatible with Fox-Fordyce disease. The purpose of this paper is to report a uncommon entity while providing a bibliographical revision highlighting the differential diagnoses and their available therapeutic options.

Caracterización morfométrica nuclear de glándulas mamarias sanas en mujeres adultas mayores

Introducción: Las glándulas mamarias son órganos que durante las diferentes etapas de la vida en la mujer sufren modificaciones, donde se involucran los procesos de proliferación, diferenciación y apoptosis, bajo el control hormonal. Sin embargo, una vez que cesan dichas influencias hormonales ocurren cambios que llevan a la involución de dicho órgano. Objetivo: Caracterizar el factor de forma, perímetro, área y volumen de los núcleos de las células epiteliales glandulares mamarias. Métodos: Para caracterizar las glándulas mamarias sanas en mujeres de 60 años y más, se realizó un estudio de serie de casos en 14 mujeres fallecidas que no tenían lesiones benignas o malignas del órgano. Todas examinadas por el departamento de Anatomía Patológica del Hospital Provincial Vladimir Ilich Lenin en Holguín, en el período comprendido de septiembre 2018 a septiembre 2019. Para mejor valoración, la muestra de estudio se dividió en dos grupos de edades: de 60-75 años de edad y mayores de 75 años. Resultados: Tanto el factor de forma como el perímetro, área y volumen de los núcleos de las células epiteliales de los conductos mamarios son menores en las mujeres mayores de 75 años. Conclusiones: Existen diferencias notables en los indicadores morfométricos estudiados en ambos grupos de edades. Específicamente el tamaño y la forma de los núcleos de células epiteliales se ven afectados con la edad, lo cual se corresponde con la baja actividad metabólica de las células epiteliales mamarias en esta etapa de la vida.

Introduction: The mammary glands are organs that during the different stages of life in women undergo modifications, where the processes of proliferation, differentiation and apoptosis are involved, under hormonal control. However, once these hormonal influences cease, changes occur that lead to the involution of said organ. Objective: To determine the shape factor, perimeter, area and volume of the nuclei of glandular epithelial cells. Methods: To characterize healthy mammary glands in women aged 60 years and older, a case series study was conducted on 14 deceased women who had no benign or malignant lesions of the organ. All examined by the Department of Pathological Anatomy of the Provincial Hospital V.I. Lenin in Holguín, in the period between September, 2018 - September, 2019. For a better assessment, the study sample was divided into two age groups: from 60 to 75 years of age; age and older than 75 years. Results: Both the shape factor and the perimeter, area and volume of the nuclei of the epithelial cells of the mammary ducts are lower in women older than 75 years. Conclusions: There are notable differences in the morphometric indicators studied. Epithelial cell nuclei are affected with age, which corresponds to the low metabolic activity of mammary epithelial cells at this stage of life.

Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers / Avaliação da superfície ocular e das alterações morfológicas nas glândulas meibomianas através de meibografia sem contato em usuários de cigarros eletrônicos

ABSTRACT Purpose: The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. Methods: The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. Results: The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). Conclusion: Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci­garette smoking.

RESUMO Objetivo: Avaliar a superfície ocular e a morfologia da glândula meibomiana em usuários de cigarros eletrônicos. Métodos: Foram avaliadas através de meibografia Sirius as pálpebras superiores e inferiores de 25 usuários de cigarros eletrônicos do sexo masculino e 25 pacientes não usuários saudáveis, também do sexo masculino. A perda nas glândulas meibomianas foi calculada automaticamente com o módulo de software de imagem de meibografia Phoenix. O resultado foi obtido como perda percentual. O questionário Ocular Surface Disease Index (OSDI), o teste do tempo de ruptura lacrimal e o teste de Schirmer II foram administrados em todos os casos. Resultados: A duração média do uso de cigarros eletrônicos foi de 4,9 ± 0,9 anos (intervalo de 3,4-7 anos). O valor médio do teste de Schirmer II foi de 9,16 ± 2,09 mm no grupo de usuários de cigarros eletrônicos e de 11,20 ± 2,14 mm no grupo controle (p=0,003). O valor médio do teste do tempo de ruptura lacrimal foi de 6,96 ± 2,31 segundos no grupo de usuários de cigarros eletrônicos e 9,84 ± 2,13 segundos no grupo controle (p=0,002). O valor médio do Ocular Surface Disease Index foi de 28,60 ± 6,54 e 15,16 ± 7,23 para os grupos de usuários de cigarros eletrônicos e controle, respectivamente (p<0,001). Na meibografia de Sirius, a perda média para a pálpebra superior foi de 23,08 ± 6,55% para o grupo de usuários de cigarros eletrônicos e 17,60 ± 4,94% para o grupo controle (p=0,002), e a perda média para a pálpebra inferior foi de 27,84 ± 5,98% e 18,44 ± 5,91%, respectivamente (p<0,001). Além disso, foi observada uma correlação positiva significativa entre a taxa de perda na meibografia palpebral superior e inferior com a duração do tabagismo eletrônico, respectivamente de (r=0,348, p<0,013) e (r=0,550, p<0,001). Conclusão: O uso prolongado de cigarros eletrônicos causa danos às glândulas meibomianas. Portanto, esses danos devem ser considerados em distúrbios da superfície ocular devidos ao uso desses dispositivos.

Nevus apocrino puro: una entidad raramente sospechada / Pure apocrine nevus: a rarely suspected entity

Los nevus apocrinos puros son hamartomas de las unidades pilosebáceas caracterizadas por proliferaciones benignas de glándulas apocrinas maduras, la cual es una descripción microscópica realizada en los reportes de patología sin que se nombre el diagnóstico exacto. Considerando además, los diagnósticos diferenciales clínicos y la baja frecuencia de este diagnóstico, presentamos un caso clínico y una revisión del tema

Pure apocrine nevi are hamartomas of the pilosebaceous units characterized by benign proliferations of mature apocrine glands, which is a microscopic description made in pathology reports without the exact diagnosis being named. Considering the clinical differential diagnoses and its low frequency, we present a case report and a review of the literature on this topic

Siringofibroadenoma écrino em paciente tetraplégico por mielite transversa / Eccrine syringofibroadenoma in a patient with quadriplegia following transverse myelitis

O siringofibroadenoma écrino (SFAE) é um tumor benigno raro que se origina das glândulas sudoríparas écrinas. Apresenta predileção pelas extremidades de indivíduos idosos e pode surgir em associação com várias doenças adquiridas ou hereditárias e com afecções cutâneas neoplásicas. Relatamos caso de homem de 48 anos, tetraplégico por mielite transversa há 30 anos, com tumoração plantar rapidamente progressiva de difícil diagnóstico

Eccrine syringofibroadenoma (EFAS) is a rare benign tumor that originates from the eccrine sweat glands. It has a predilection for the extremities of elderly individuals and may arise in association with various acquired or hereditary pathologies and neoplastic skin disorders. We report the case of a 48-year-old man who had been quadriplegic due to transverse myelitis for 30 years, with a rapidly progressive plantar tumor that was difficult to diagnose.