ABSTRACT
Oral squamous cell carcinoma (OSCC) is the most frequent malignant neoplasia of the oral cavity, which largely compromises the patient's life quality. Therefore, the identification of biomarkers for this kind of cancer is essential to provide a better diagnosis and prognosis for patients. Endothelin-1 is a peptide produced mainly by endothelial cells, and might be found in several body fluids, such as saliva, milk, urine, cerebrospinal fluid and plasma. It has been demonstrated that expression of this peptide is increased in a great number of neoplasias, including oral carcinoma. The identification of salivary biomarkers would be a useful tool for scanning and monitoring patients with risk of developing OSCC, as well to early detect recurrence, or the formation of a new primary tumor. In the present study, we have analyzed the levels of endothelin-1 in saliva obtained from patients with OSCC or oral leukoplakia, in comparison to healthy control patients. This study also evaluated the salivary ET-1 levels in patients with complete remission of OSCC. The results revealed no statistical difference in salivary endothelin-1 levels, neither in OSCC nor in oral leukoplakia, even when conditions such as elderly, sex and hypertension were taken into consideration. Although, ET-1 might display an important role in OSCC, its levels in saliva do not seem to be a good marker of neoplasias grade or malignant transformation.
Subject(s)
Biomarkers, Tumor/analysis , Carcinoma, Squamous Cell/metabolism , Endothelin-1/analysis , Leukoplakia, Oral/metabolism , Mouth Neoplasms/metabolism , Saliva/chemistry , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
Oral squamous cell carcinoma (OSCC) is one of the most common malignancies recognized nowadays, and represents a public health problem. Its early detection is the better alternative to provide a good quality of life for the patients. During the last years, several studies have identified potential biomarkers of OSCC progression and prognosis. Endothelins and their receptors are involved in several pathophysiological conditions and in various cancer types. The present review article discusses whether the endothelin system would represent a biomarker for OSCC.
Subject(s)
Biomarkers, Tumor/metabolism , Carcinoma, Squamous Cell/metabolism , Endothelins/metabolism , Mouth Neoplasms/metabolism , Receptors, Endothelin/metabolism , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Early Detection of Cancer , Endothelins/genetics , Female , Gene Expression Regulation, Neoplastic/genetics , Humans , Male , Mouth Neoplasms/genetics , Mouth Neoplasms/pathology , Prognosis , Receptors, Endothelin/geneticsABSTRACT
Oral myiasis is a rare disease in humans associated with poor oral hygiene, suppurative oral lesions, alcoholism and senility, among other conditions. A case of oral myiasis in a 34-year-old white male with advanced periodontal disease and neurologic deficit is reported. Treatment consisted of manual removal of the larvae, one by one, with the help of clinical forceps and subsequent management of the periodontal disease.
Subject(s)
Mouth Diseases/parasitology , Myiasis/therapy , Adult , Humans , Male , Mouth Breathing/complications , Myiasis/etiology , Open Bite/complications , Oxygen/administration & dosage , Periodontal Diseases/complications , Water/chemistryABSTRACT
Paracoccidioidomicose Revisão da LiteraturaParacoccidioidomycosis Literature ReviewO presente estudo tem por objetivo apresentar uma revisão da literatura sobre a paracoccidioidomicose, abordando aspectos clínicos importantes da doença. Foram consultados artigos indexados no Medline e livros-texto sobre o tema, ambos publicados no período de 1990 a 2004. A paracoccidioidomicose é uma doença sistêmica, endêmica, causada pelo fungo dimórfico Paracoccidioides brasiliensis. Embora a via primária de infecção seja a pulmonar, pela inalação de esporos ou partículas do fungo, vários sítios anatômicos podem ser acometidos pela disseminação linfoematogênica, inclusive a mucosa oral. A via primária de infecção da paracoccidioidomicose é pulmonar, mas a doença é, freqüentemente, diagnosticada a partir de manifestações orais. A abordagem clínica de pacientes portadores de lesões ulceradas crônicas de mucosa oral deve, portanto, considerar a paracoccidioidomicose como possibilidade diagnóstica.
Subject(s)
Humans , Male , Female , Mycoses , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapyABSTRACT
OBJECTIVES: p63, a p53 homologue, may be associated with tumorigenesis in epithelial tissues through its inhibition of p53 transactivation functions. We sought to determine the pattern and levels of p63 expression in oral dysplasias and carcinomas using standard immunohistochemical staining. We also assessed and compared expression of p53 and a cell proliferation marker in these lesions. STUDY DESIGN: This retrospective cross-sectional survey (n=67) included hyperkeratosis (10), mild dysplasia (9), moderate dysplasia (11), severe dysplasia/in situ carcinoma (10), squamous cell carcinoma (SCC) (22 [9 well differentiated, 7 moderately differentiated, 6 poor differentiated]), and normal mucosa (5). Serial sections were stained immunohistochemically with antibodies to p63 (4A4 recognizing all p63 isotypes), p53 (DO-7), and Ki-67 (MIB-1) proteins. In preinvasive lesions, both the percentage of positive cells and staining patterns (negative, basal, suprabasal) were assessed. In oral SCCs, the percentage of positive cells was assessed. Statistical analysis was done using the Tukey-Kramer multiple comparisons test. RESULTS: A suprabasal p63 staining pattern was evident in keratinocyte nuclei in the entire range of noninvasive lesions studied, including normal mucosa. Most nuclei in invasive SCCs stained positive. When all grades of dysplasia were combined, the percent of p63 positive cells was significantly greater than hyperkeratosis (P < .01), and well-differentiated SCC (P < .001). Moderately differentiated SCC had statistically significant more positive cells than well-differentiated SSC (P < .01). Comparison of serial sections showed different p63 staining patterns compared to p53 or Ki-67 staining patterns. CONCLUSIONS: We conclude that p63 is expressed in oral carcinomas and dysplasias, as determined by immunohistochemical staining with a primary antibody to all isotypes. Neither staining pattern nor percentage of stained cells could be used to differentiate the lesions studied. The statistically significant differences found between some groups are not likely to be of diagnostic value. p63 is not coexpressed with p53 expression or Ki-67 suggesting functional independence. When antibodies to the p63 isotypes become available, oral dysplasias and carcinomas should be reassessed.
Subject(s)
Carcinoma, Squamous Cell/pathology , Genes, Tumor Suppressor/physiology , Mouth Neoplasms/pathology , Phosphoproteins/analysis , Trans-Activators/analysis , Carcinoma in Situ/pathology , Cell Nucleus/ultrastructure , Cross-Sectional Studies , DNA-Binding Proteins , Humans , Immunohistochemistry , Keratinocytes/pathology , Ki-67 Antigen/analysis , Leukoplakia, Oral/pathology , Mouth Mucosa/pathology , Neoplasm Invasiveness , Precancerous Conditions/pathology , Protein Isoforms/analysis , Retrospective Studies , Transcription Factors , Tumor Suppressor Protein p53/analysis , Tumor Suppressor ProteinsABSTRACT
A hipoplasia do esmalte é uma alteração do esmalte dental, decorrente da ação de diferentes fatores etiológicos durante o período de formação desse. Dentre os possíveis fatores etiológicos, merecem destaque as alterações sistêmicas presentes em crianças infectadas pelo HIV. O objetivo deste trabalho foi estudar a freqüência da hipoplasia do esmalte em crianças infectadas pelo HIV e a provável relação desta patologia dental com a classificação da AIDS pediátrica. A amostra foi composta por 156 crianças brasileiras e 42 crianças norte-americanas, de zero a treze anos de idade, infectadas pelo HIV. A metodologia incluiu o preechimento de uma ficha individual, o exame clínico odontológico buscando a presença de dentes com anomalia dental do tipo hipoplasia do esmalte e a revisão dos prontuários médicos das crianças. Na amostra estudada, 24 crianças (12,12%) apresentaram hipoplasia do esmalte, sendo 17 brasileiras e 7 norte-americanas. A freqüência de crianças com hipoplasia do esmalte na amostra estudada foi considerada baixa. A distribuição das 24 crianças com hipoplasia do esmalte, de acordo com a classificação da AIDS pediátrica foi: 12 (50%) na categoria clínica C, 8 (33,33%) na categoria B e 4 (16,67%) na categoria A. A maioria das crianças com hipoplasia do esmalte encontrava-se na categoria C da AIDS pediátrica, considerada a mais grave.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Dental Enamel , Dental Enamel Hypoplasia , HIV , Early Diagnosis , HIV Infections/complications , Acquired Immunodeficiency Syndrome/complicationsABSTRACT
O presente artigo tem por objetivo apresentar uma revisão da literatura sobre as terapêuticas disponíveis para o tratamento da candidíase bucal. Foram consultados livros e artigos científicos enfoque no tratamento da candidíase, publicados entre 1990 e 2003. Os agentes antifúngicos empregados no tratamento da candidíase bucal dividem-se em poliênicos (anfotericina B e nistatina), imidazólicos (cetoconazol, clotrimazol e miconazol) e triazólicos (fluconazol e o itraconazol). Outros azóis foram introduzidos no mercado recentemente (econazol, butoconazol, tioconazol, terconazol e voriconazol). Além desses, ravuconazol e posaconazol encontram-se em fase de testes, portanto seus efeitos clínicosainda estão integralmente disponíveis. Identificar a melhor alternativa terapêutica para o tratamento da candidíase bucal é um desafio, devendo-se avaliar o estado de saúde do paciente, seu fluxo salivar, risco de cárie, número de recidivas da candíase, interações medicamentosas, alternativas disponíveis no mercado e o acesso aos medicamentos por parte do paciente. Ainda, o profissional não pode negligenciar a necessidade de eliminação ou controle dos fatores predisponentes, conduta importante para o sucesso do tratamento.
Subject(s)
Humans , Male , Female , Antifungal Agents , Mouth/injuries , Candidiasis, Oral , Mouth DiseasesABSTRACT
OBJECTIVES: This study had two objectives: (1) to investigate the socioeconomic and cultural characteristics of HIV-infected children and their families in relation to the presence of oral manifestations of AIDS and (2) to identify the most frequent oral manifestations of AIDS in the sample of children studied. METHODS: The sample consisted of a total of 184 children - both boys and girls - from 0 to 13 years old. The children were receiving care at two hospitals in the city of Porto Alegre, Brazil (the Hospital de Clínicas de Porto Alegre and the Hospital São Lucas da Pontifícia Universidade Católica), and at Stony Brook University Hospital, which is in the state of New York, United States. Data were analyzed using the chisquare test, Student's t test, and analysis of variance. RESULTS: Of the 184 patients, 117 of them (63.59%) were receiving care at the Hospital de Clínicas de Porto Alegre, 26 (14.13%) at the Hospital São Lucas, and 41 (22.28%) at Stony Brook University Hospital. In the Brazilian sample (the two hospitals in Porto Alegre) 42.66% of the children were living with their natural parents (mostly with the mother), while in the United States 56.10% of the children were living with foster families. Concerning income, 39.86% of the Brazilian families had a monthly income ranging from US$ 180 to US$ 450, and 33.57% had no income or did not provide information. With the United States sample, we were not allowed to ask about income, but all the families were classified by the social workers as having a monthly income below US$ 1 000. HIV was acquired through vertical transmission by 97.20% of the Brazilian children and by 97.56% of the children in the United States sample. Oral manifestations were more frequent in the Brazilian children (72.73%) than in the children in the United States sample (53.66%) (P = 0.01). CONCLUSIONS: The frequency of oral manifestations in the samples in both Brazil and the United States was influenced by socioeconomic and cultural conditions, family structure and income, access to information concerning AIDS, and adherence to treatment.
Subject(s)
HIV Infections/epidemiology , Mouth Diseases/epidemiology , AIDS-Related Opportunistic Infections/epidemiology , Adolescent , Brazil/epidemiology , Child , Child, Preschool , Comorbidity , Culture , Female , HIV Infections/transmission , Hospitals, University/statistics & numerical data , Humans , Income , Infant , Infant, Newborn , Infectious Disease Transmission, Vertical , Male , New York/epidemiology , Socioeconomic FactorsABSTRACT
OBJETIVO: Investigar as características socioeconômicas e culturais de crianças infectadas pelo HIV e de suas famílias, relacionando-as com a presença de manifestaçöes estomatológicas da AIDS, e identificar as manifestaçöes estomatológicas mais freqüentes na amostra estudada. MÉTODO: A amostra foi composta por 184 crianças de ambos os sexos, com idade entre 0 e 13 anos, atendidas no Hospital de Clínicas de Porto Alegre e Hospital Säo Lucas da Pontifícia Universidade Católica, em Porto Alegre, Brasil, e no hospital universitário da Universidade do Estado de Nova Iorque em Stony Brook, Estado de Nova Iorque, Estados Unidos. Os dados foram analisados pelos testes do qui-quadrado, t de Student e análise de variância. RESULTADOS: Dos 184 pacientes, 63,59 por cento eram do Hospital de Clínicas de Porto Alegre; 22,28 por cento do hospital de Stony Brook; e 14,13 por cento do Hospital Säo Lucas. Na amostra brasileira, 42,66 por cento das crianças residiam com os pais naturais (principalmente com a mäe), enquanto que nos Estados Unidos 56,10 por cento das crianças moravam com pais adotivos. Em relaçäo à renda, 39,86 por cento das famílias no Brasil ganhavam entre 180 e 450 dólares mensais; 33,57 por cento näo tinham renda ou näo forneceram seus dados. Nos Estados Unidos, a pergunta sobre renda näo foi autorizada, mas todas as famílias foram classificadas pelos assistentes sociais do hospital como tendo renda abaixo de 1 000 dólares. O HIV foi adquirido por transmissäo vertical em 97,20 por cento dos casos no Brasil e 97,56 por cento nos Estados Unidos. A freqüência das manifestaçöes estomatológicas foi maior nas crianças brasileiras (72,73 por cento) do que nas norte-americanas (53,66 por cento) (P = 0,01). CONCLUSÖES: As condiçöes socioeconômicas e culturais, estrutura e renda familiar, acesso a informaçäo sobre AIDS e a adesäo aos esquemas terapêuticos influenciaram a freqüência das manifestaçöes estomatológicas nas duas amostras.
Objectives. This study had two objectives: (1) to investigate the socioeconomic and cultural characteristics of HIV-infected children and their families in relation to the presence of oral manifestations of AIDS and (2) to identify the most frequent oral manifestations of AIDS in the sample of children studied. Methods. The sample consisted of a total of 184 childrenboth boys and girls from 0 to 13 years old. The children were receiving care at two hospitals in the city of Porto Alegre, Brazil (the Hospital de Clínicas de Porto Alegre and the Hospital São Lucas da Pontifícia Universidade Católica), and at Stony Brook University Hospital, which is in the state of New York, United States. Data were analyzed using the chisquare test, Student's t test, and analysis of variance. Results. Of the 184 patients, 117 of them (63.59%) were receiving care at the Hospital de Clínicas de Porto Alegre, 26 (14.13%) at the Hospital São Lucas, and 41 (22.28%) at Stony Brook University Hospital. In the Brazilian sample (the two hospitals in Porto Alegre) 42.66% of the children were living with their natural parents (mostly with the mother), while in the United States 56.10% of the children were living with foster families. Concerning income, 39.86% of the Brazilian families had a monthly income ranging from US$ 180 to US$ 450, and 33.57% had no income or did not provide information. With the United States sample, we were not allowed to ask about income, but all the families were classified by the social workers as having a monthly income below US$ 1 000. HIV was acquired through vertical transmission by 97.20% of the Brazilian children and by 97.56% of the children in the United States sample. Oral manifestations were more frequent in the Brazilian children (72.73%) than in the children in the United States sample (53.66%) (P = 0.01). Conclusions. The frequency of oral manifestations in the samples in both Brazil and the United States was influenced by socioeconomic and cultural conditions, family structure and income, access to information concerning AIDS, and adherence to treatment
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , HIV Infections/epidemiology , Mouth Diseases/epidemiology , Infectious Disease Transmission, Vertical , AIDS-Related Opportunistic Infections/epidemiology , Brazil/epidemiology , Comorbidity , Culture , HIV Infections/transmission , Hospitals, University/statistics & numerical data , Income , New York/epidemiology , Socioeconomic FactorsABSTRACT
Foi feito um estudo de 54 casos de Paracoccidioidomi cose oral no Serviço de Estomatologia e Prevençäo do Câncer Bucomaxilofacial do Hospital Säo Lucas no período de janeiro de 1976 a junho de 1997. Foram analisados em relaçäo à idade, sexo, profissäo, cidade de origem, hábitos, presença de lesäo pulmonar, tipo de lesäo oral e sítios mais atingidos. Observou-se que os homens säo mais atingidos que as mulheres, com maior incidência na faixa etária dos 30 aos 60 anos. A profissäo de agricultor foi a mais encontrada, sendo a maioria dos pacientes estudados proveniente de cidades localizadas na regiäo norte do Estado, àrea que apresenta clima, solo e umidade favoráveis ao desenvolvimento do fungo. O hábito de fumar foi relatado por dois terços dos pacientes, sendo muitos deles também etilistas. As lesöes orais, presentes em todos os casos, apresentaram-se como ulceraçöes moriformes ou como úlceras vegetantes, as quais foram observadas em vários sítios da boca. Metade dos pacientes avaliados aprsentaram evidências radiográficas de lesöes pulmonares
Subject(s)
Humans , ParacoccidioidomycosisABSTRACT
Este artigo descreve o Fibroma Ossificante e o Granuloma Periférico de Células Gigantes, realizando um estudo comparativo e demonstrando um caso clínico-cirúrgico