Peripheral ossifying fibroma: A 20-year retrospective study with focus on clinical and morphological features.

BACKGROUND: Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in the gingiva and is characterized by the deposition of dystrophic calcification, cementum-like tissue, and immature and mature bone within the connective tissue. The objective of the present study was to perform a retrospective analysis of clinicopathologic features of POF. MATERIAL AND METHODS: Clinical and histopathological data were obtained from biopsy records and histopathological reports from a Brazilian reference service in Oral Pathology (1999 - 2020). Morphological analysis was performed to evaluate features related to the mesenchymal component, inflammatory infiltrate, ulceration, and mineralized tissue. RESULTS: A total of 270 POFs were diagnosed during the study period. A higher frequency was observed in females (71.9%) between the third (22.9%) and fourth (23.3%) decades of life. The anterior upper gingiva (29.1%) was the most affected region. Mature (86.7%) and immature (52.6%) bone tissue were the most frequent. There was a significant association between immature bone deposition and lesions with size ≤ 1.7 cm (p = 0.041); immature bone and cement-like tissue deposition with an evolution time ≤ 16 months (p < 0.001); deposition of immature bone and mesenchymal hypercellularization (p < 0.001); deposition of dystrophic calcification and the presence of ulceration (p < 0.001). CONCLUSIONS: The clinical characteristics corroborate the findings in the literature. The heterogeneous distribution and quantity of mineralized tissues found in the analyzed cases support the theory that the different mineralized tissues constitute a spectrum of clinical maturation of POF.

Clinicopathologic features of nasopalatine duct cysts: A retrospective study in two Brazilian oral and maxillofacial pathology referral centers.

BACKGROUND: Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast. MATERIAL AND METHODS: A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected. RESULTS: Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells. CONCLUSIONS: The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopathological features with the clinical and radiographic findings to establish a correct diagnosis.

Effect of larger apical size on the quality of preparation in curved canals using reciprocating instruments with different heat thermal treatments.

AIM: To evaluate the influence of larger apical canal enlargement in curved canals using reciprocating systems subjected to various heat treatments. METHODOLOGY: Ninety mandibular premolars with root curvatures ranging from 20° to 30° were selected and scanned by microcomputed tomography (micro-CT) before and after root canal preparation with reciprocating systems (n = 30): Reciproc Blue (RB size 25, .08 taper and size 40, .06 taper; VDW, Munich, Germany), WaveOne Gold (WOG size 25, .07 taper and size 35, .06 taper; Dentsply Sirona, Ballaigues, Switzerland) and ProDesign R (PDR size 25, .06 taper and size 35, .05 taper; Easy Dental Equipment, Belo Horizonte, Brazil). Canal transportation, untouched areas, and apical and total root canal volumes were measured. Statistical analysis was performed with the nonparametric Kruskal-Wallis and Dunn's tests and a significance level set at 5%. RESULTS: The between-group comparison revealed no significant difference in untouched areas, canal transportation, and apical root canal volume among the groups (P > 0.05). However, WOG size 35, .06 taper was associated with a significant increase in the percentage of total canal volume in comparison to the PDR size 35, .05 taper (P < 0.05). The within-group comparison revealed a significant decrease in untouched areas, increase in apical and total root canal volume for all groups when using a larger instrument (P < 0.05). There was no significant difference in transportation among the groups and when a larger apical preparation was created (P > 0.05). CONCLUSIONS: Larger apical enlargement of curved canals was associated with a decrease in untouched areas, an increase in root canal volume and maintenance of canal trajectory. In addition, all systems were safe and provided similar root canal shapes.

Total homocysteine levels in healthy children from the Monterrey metropolitan area, Mexico.

Currently, there are indications for determining hyperhomocysteinemia in adulthood as risk factors for cardiovascular diseases, psychiatric disorders, pregnancy complications, birth defects, cognitive impairment in the elderly, in addition to cancer. If hyperhomocysteinemia is determined from childhood, it may be modulated with the provision of an opportunity for public health intervention. The objective of this descriptive study was to determine total homocysteine (tHcy) levels in healthy children from the Monterrey metropolitan area in Mexico. In a peripheral-blood sample collected from 56 healthy children aged 2-10 years, we determined tHcy concentration by high performance liquid chromatography (HPLC) with fluorescence detection. The geometric mean +/- SD was 9.78 +/- 1.73 micromol/l. tHcys of the children studied were homogeneous by age cohort and gender. Nutritional state was classified by body mass index (BMI). Sixty five percent of children who participated in the study had normal BMI, and 96% of the children belong to the low socioeconomic status. In conclusion, to our knowledge this is the first-ever information on homocysteine (Hcy) prevalence in a population of healthy Mexican children. tHcy concentration was higher than that reported in other populations studies. This preliminary study could constitute the baseline for future public health studies.

[Personality profile among cocaine users]. / Perfil de personalidad en usuarios de cocaína utilizando el Inventario Multifásico de Personalidad.

INTRODUCTION: Due to the psychiatric comorbidity seen among cocaine addicts, it is of clinical interest to know the personality traits associated to the use of this substance. METHODOLOGY: Personality-profile comparative study of cocaine users and multiple-substance users obtained through the Multistage Personality Inventory. The study analyzed a sample of 30 cocaine users and 26 users of various substances who asked for treatment at a specialized institution. RESULTS: Results show the same profile for both groups, with high 8-4-2 scales. According to the Multistage Personality Inventory, this profile corresponds to an antisocial personality disorder with depressive and schizoid traits. CONCLUSIONS: The fact that there is a single profile for different drug users leads us to the hypothesis that there are addictive personality characteristics rather than specific traits related to the use of each substance. These subjects' personality characteristics suggest that the fear to relate to others could make it very difficult to establish a therapeutic link. This, in addition to the acting up tendency seen among users, constitutes a call of alert in terms of their likely abandonment of treatment. Further more, as they take impulses into actions, they build a barrier before words. This could be called acting up, doing instead of saying, which can become an obstacle for the appropriate development of the therapeutic process. The result must consider the size of the sample.

[The father image in male substance users]. / Imagen del padre en varones usuarios de sustancias.

INTRODUCTION: Due to the fact that various research studies have shown that drug users usually have a father with negative characteristics, it is convenient to investigate this phenomenon and take it into consideration in addict treatment efforts. METHODOLOGY: This is a qualitative study that explores the fatherly perception among male substance users. The sample included 25 users who asked for treatment at Youth Integration Center and 25 non-users. Both groups were subjected to projective tests. RESULTS: The father image among substance users emphasizes negative characteristics; in contrast, non-users present a basically positive father perception, considering him as the most valuable family member. CONCLUSIONS: These data show that substance users relate less with the fatherly figure than non-users. They perceive their father as a devaluated member that occupies a secondary place in the family and sometimes does not even have an affective role. The findings of this investigation can be applied in individual psychotherapy, facilitating the revaluation and reflection of the fatherly figure among substance users. It would be convenient to create the necessary conditions to restitute the father role in family therapy and counseling groups for relatives. The findings must consider the size of the sample and limitations of qualitative research methology.

Perfil de personalidad en usuarios de cocaína utilizando el Inventario Multifásico de Personalidad / Personality profile among cocaine users

Introducción. Debido a la comorbilidad psiquiátrica que se observa en adictos a cocaína, es de interés clínico conocer los rasgos de personalidad que caracterizan a los consumidores de esta sustancia. Metodología. Estudio comparativo del perfil de personalidad de usuarios de cocaína y los de varias sustancias obtenido a través del Inventario Multifásico de la Personalidad (MMPI). Se analizó una muestra de 30 sujetos consumidores de cocaína y 26 consumidores de varias sustancias que solicitaron tratamiento en una institución especializada. Resultados. Los resultados muestran el mismo perfil para los dos grupos, con las escalas 8-4-2 altas y de acuerdo con el MMPI, corresponde a un trastorno antisocial de la personalidad, con rasgos depresivos y esquizoides. La interpretación del perfil de personalidad encontrado, de acuerdo con el Inventario Multifásico de la Personalidad es la siguiente: son personas emocionalmente dependientes, por lo cual buscan atención exageradamente, sin embargo les es difícil establecer relaciones cercanas por temor a involucrarse. Presentan rasgos depresivos y con frecuencia conductas de autocastigo. Sus rasgos antisociales y su dificultad para el control de impulsos, hacen que manifiesten oposición a las normas sociales. Conclusiones. El hecho de que haya un mismo perfil para los consumidores de diferentes drogas nos lleva a formular la hipótesis de que existen características de personalidad adictiva, más que rasgos específicos correspondientes al consumo de cada una de las sustancias. El temor a involucrarse podría dificultar el establecimiento de un vínculo terapéutico, lo que aunado con su tendencia a la actuación de impulsos constituyen una llamada de atención sobre su probable abandono del tratamiento. Al llevar sus impulsos a la acción imponen una barrera a la palabra, esto es lo que podría llamarse una actuación (acting out), un hacer en lugar de decir, lo cual se convierte en un obstáculo para el buen desarrollo del proceso terapéutico. Los hallazgos deben considerar las limitaciones de la muestra (AU)

Imagen del padre en varones usuarios de sustancias / The father image in male substance users

Introducción. Debido a que diversas investigaciones han comunicado que los sujetos que abusan de drogas tienen un padre con características negativas es conveniente investigar este fenómeno con la finalidad de tomarlo en cuenta para su tratamiento. Metodología. En este trabajo se presenta un estudio cualitativo exploratorio de la percepción del padre en varones consumidores de sustancias. La muestra del estudio consistió en 25 usuarios que acudieron a Centros de Integración Juvenil para recibir tratamiento y 25 sujetos no consumidores. A los dos grupos se les aplicaron pruebas proyectivas de personalidad. Resultados. Los resultados muestran que los usuarios de sustancias presentan una imagen del padre con mayor énfasis en características negativas; los no usuarios tienen una percepción del padre básicamente con aspectos positivos y lo consideran, con mayor frecuencia, como el integrante más valioso de la familia. Conclusiones. Los datos anteriores indican que los consumidores de sustancias tienen, en comparación con los no consumidores, una menor identificación con el padre y dificultades relacionales con esta figura; lo perciben como un integrante devaluado, que ocupa un lugar secundario en la familia y en algunos casos inclusive sin presencia afectiva en la misma. Los hallazgos de esta investigación se pueden aplicar a la psicoterapia individual, facilitando una reflexión y revaloración de la figura paterna. En los usuarios de drogas, en la terapia familiar, así como en los grupos de orientación a familiares, sería conveniente crear las condiciones para la reubicación del padre en el rol que le corresponde. Los resultados y conclusiones deben considerar las limitaciones que tiene la muestra de una investigación cualitativa (AU)

Hypomagnesemia in critically ill cancer patients: a prospective study of predictive factors.

Hypomagnesemia is the most common electrolyte disturbance seen upon admission to the intensive care unit (ICU). Reliable predictors of its occurrence are not described. The objective of this prospective study was to determine factors predictive of hypomagnesemia upon admission to the ICU. In a single tertiary cancer center, 226 patients with different diagnoses upon entering were studied. Hypomagnesemia was defined by serum levels <1.5 mg/dl. Demographic data, type of cancer, cause of admission, previous history of arrhythmia, cardiovascular disease, renal failure, drug administration (particularly diuretics, antiarrhythmics, chemotherapy and platinum compounds), previous nutrition intake and presence of hypovolemia were recorded for each patient. Blood was collected for determination of serum magnesium, potassium, sodium, calcium, phosphorus, blood urea nitrogen and creatinine levels. Upon admission, 103 (45.6%) patients had hypomagnesemia and 123 (54.4%) had normomagnesemia. A normal dietary habit prior to ICU admission was associated with normal Mg levels (P = 0.007) and higher average levels of serum Mg (P = 0.002). Postoperative patients (N = 182) had lower levels of serum Mg (0.60 +/- 0.14 mmol/l compared with 0.66 +/- 0.17 mmol/l, P = 0.006). A stepwise multiple linear regression disclosed that only normal dietary habits (OR = 0.45; CI = 0.26-0.79) and the fact of being a postoperative patient (OR = 2.42; CI = 1. 17-4.98) were significantly correlated with serum Mg levels (overall model probability = 0.001). These findings should be used to identify patients at risk for such disturbance, even in other critically ill populations.

Hypomagnesemia in critically ill cancer patients: a prospective study of predictive factors

Hypomagnesemia is the most common electrolyte disturbance seen upon admission to the intensive care unit (ICU). Reliable predictors of its occurrence are not described. The objective of this prospective study was to determine factors predictive of hypomagnesemia upon admission to the ICU. In a single tertiary cancer center, 226 patients with different diagnoses upon entering were studied. Hypomagnesemia was defined by serum levels <1.5 mg/dl. Demographic data, type of cancer, cause of admission, previous history of arrhythmia, cardiovascular disease, renal failure, drug administration (particularly diuretics, antiarrhythmics, chemotherapy and platinum compounds), previous nutrition intake and presence of hypovolemia were recorded for each patient. Blood was collected for determination of serum magnesium, potassium, sodium, calcium, phosphorus, blood urea nitrogen and creatinine levels. Upon admission, 103 (45.6 percent) patients had hypomagnesemia and 123 (54.4 percent) had normomagnesemia. A normal dietary habit prior to ICU admission was associated with normal Mg levels (P = 0.007) and higher average levels of serum Mg (P = 0.002). Postoperative patients (N = 182) had lower levels of serum Mg (0.60 ± 0.14 mmol/l compared with 0.66 ± 0.17 mmol/l, P = 0.006). A stepwise multiple linear regression disclosed that only normal dietary habits (OR = 0.45; CI = 0.26-0.79) and the fact of being a postoperative patient (OR = 2.42; CI = 1.17-4.98) were significantly correlated with serum Mg levels (overall model probability = 0.001). These findings should be used to identify patients at risk for such disturbance, even in other critically ill populations

Limitations in distinguishing malignant from benign lesions of the breast by systematic review of mammograms.

Our objective was to assess whether or not a systematic review of mammographic descriptors would result in improved classifications of nonpalpable lesions of the breast and reductions of biopsies for benign conditions. The prelocalization mammograms of 200 consecutive patients who had 231 biopsies were reviewed in random order by four radiologists experienced in mammography. Each reader assessed the presence of 32 specific descriptors regarding masses and calcifications. The following descriptors were highly associated with malignancy: for masses, inhomogeneous density; irregular shape; spiculated borders; and for calcifications, many calcifications; microcalcifications; linear or branching patterns, or both, and high spatial density. For masses, the descriptors highly associated with benignity were homogeneous density, oval shape and sharp or lobulated borders. For calcifications, the descriptors highly associated with benignity were solid, round and irregularly shaped. Readers indicated their over-all rating of each lesion, ranging from definitely benign to definitely malignant. Ratings were compared with the findings of pathologic reports (181 benign to 50 malignant), and receiver operating characteristic analyses were performed. The areas under the curves (A[z]) varied from 0.65 to 0.78. If biopsies had not been performed on those patients who were judged to have most likely benign lesions, one could reduce the number of biopsies for benign conditions by 48 to 69 per cent; however, 18 to 46 per cent of the malignancies would be missed. We conclude that diagnoses based on a systematic review of descriptors are not sufficiently accurate to reduce the number of mammary biopsies.

Non-specific ileojejunitis in Arequipa, Peru.

Non-specific ileojejunitis, characterised by mild to moderate structural changes in the intestinal mucosa and often associated with asymptomatic malabsorption, is known to occur in the tropics and in countries with hot climates. This acquired condition is probably related to environmental factors, and some consider it to be a subclinical form of tropical sprue. Changes in the intestinal mucosa typical of non-specific ileojejunitis were found in 10 indigenous Indians as well as 5 people of Latin stock living in the Southern Peruvian sierra, where tropical sprue has not as yet been demonstrated and which has a temperate climate.