Oral squamous cell carcinoma of tongue: Histological risk assessment. A pilot study.

BACKGROUND: More than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and tobacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue. MATERIAL AND METHODS: Samples from 26 patients with OSCC were analyzed and histological risk pattern of recurrent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption. RESULTS: We found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization. CONCLUSIONS: Based on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas.

Lesiones traumáticas en la mucosa oral de los adultos mayores / Traumatic lesions of oral mucosa in older adults

Dentro de la patología oral asociada con mayor frecuencia al paciente geriátrico nos encontramos con las lesiones con origen traumático. Los cambios fisiológicos que tienen lugar durante el envejecimiento hacen que las estructuras orales sean más susceptibles a la acción de agentes irritantes o agentes traumáticos, por lo que es importante establecer protocolos de prevención y diagnóstico precoz. En este artículo abordaremos las principales lesiones traumáticas que encontramos en el paciente anciano en función del tiempo de evolución, así clasificaremos las lesiones en agudas y crónicas (AU)

Among the oral pathology associated with geriatric patients we found more often we with traumatic injuries. The physiological changes that occurs during aging, makes that oral structures would be more susceptible to the action of irritants or traumatic agents, so it is important to establish different protocols for prevention and early diagnosis. In this paper we will review the major traumatic injuries found in the elderly patient depending on the time of evolution and so we classify the lesions in acute and chronic (AU)

Relación entre la historia reproductiva femenina y la aterosclerosis carotídea / Relationship between female reproductive history and carotid atherosclerosis

OBJETIVO: Los estrógenos han sido implicados en el desarrollo de patología aterosclerótica a nivel de las extremidades inferiores y la aorta abdominal. El estudio de la historia reproductiva de las pacientes con estenosis carotídea puede contribuir al conocimiento de los factores de riesgo de aterosclerosis. El objetivo principal de este estudio fue investigar si existen diferencias en la historia reproductiva entre mujeres con patología oclusiva carotídea y mujeres sanas, así como su influencia en el grado de severidad de la misma. MATERIAL Y MÉTODOS: Se realizó un estudio de casos y controles incluyendo a 153 pacientes con (78) y sin (75) patología oclusiva carotídea. Las pacientes con estenosis de carótida se subdividieron según el estudio mediante eco-Doppler en ligera (< 30%, 16,6%), moderada (30-49%, 16,6%), significativa (50-60%, 12,8%), severa (70-99%, 34,6%) y trombosada (100%, 19,2%). Se utilizó un cuestionario validado de 54 preguntas para obtener información sobre historia reproductiva (edad de menarquia y menopausia, número de hijos, uso de anticonceptivos y terapia hormonal sustitutiva y cirugía ginecológica), comorbilidades (diabetes, dislipidemia, tabaquismo, cardiopatía y enfermedad arterial periférica) y tratamiento farmacológico concomitante. RESULTADOS: Ambos grupos fueron comparables en edad, peso, altura y comorbilidades. Se encontraron diferencias significativas en cuanto al número de hijos (1,4 ± 1 vs. 3,2 ± 2, p = 0,04) y uso de estatinas (92,0 ± 28% vs. 13,3 ± 35%, p = 0,02), siendo mayor en el grupo de mujeres con patología carotídea. La influencia de posibles factores hormonales como la edad de menarquia y menopausia, así como la toma de anticonceptivos orales o sustitutos estrogénicos, no se demostró durante el estudio. No existieron diferencias significativas en la historia reproductiva entre los diferentes grados de estenosis carotídea. CONCLUSIONES: La multiparidad se asocia a un incremento de patología oclusiva carotídea. Este hallazgo sugiere que la maternidad podría comportarse como un factor de riesgo aterosclerótico y debería considerarse al establecer el riesgo cardiovascular en mujeres. El verdadero papel de los estrógenos sobre la patología oclusiva carotídea necesita ser todavía estudiado

OBJECTIVE: Estrogens have been implicated in the development of atherosclerotic disease in the lower limbs and abdominal aorta. The reproductive history study of patients with carotid stenosis may contribute to the understanding of the risk factors for atherosclerosis. The main objective of this study was to investigate whether there are differences in reproductive history between women with carotid occlusive disease and healthy women, and the influence of these differences on its severity. MATERIAL AND METHODS: A case-control study was conducted on 153 patients with (78), and without (75) carotid occlusive disease. Patients with carotid stenosis were sub-divided according to the Doppler ultrasound results, into slight (<30%, 16.6%), moderate (30-49%, 16.6%), significant (50-60%, 12.8%), severe (70-99%, 34.6%), and thrombosed (100%, 19.2%). A validated questionnaire of 54 questions was used to gather information on reproductive history (age at menarche and menopause, number of children, use of contraceptives and hormone replacement therapy, and gynecological surgery), comorbidities (diabetes, dyslipidemia, smoking, coronary artery disease, and peripheral artery disease), and concomitant drug therapy. RESULTS: Both groups were comparable in age, weight, height, and comorbidities. There were significant differences in the number of children (1.4±1 vs 3.2±2, P=0.04) and statin use (92.0±28% vs 13.3±35%, P=0.02), being higher in the group of women with carotid disease. The possible influence of hormonal factors such as age at menarche and menopause, as well as oral contraceptives or estrogen replacement was not demonstrated during the study. No significant differences were found in reproductive history between different degrees of carotid stenosis. CONCLUSIONS: Multiparity is associated with increased carotid occlusive disease. This finding suggests that motherhood might behave as an atherosclerotic risk factor and should be considered when determining cardiovascular risk in women. The real role of estrogen in carotid occlusive disease still needs to be studied