Clinicopathological Features of Buccal Squamous Cell Carcinoma with Focus on Patients Who Never Smoke and Never Drink.

Introduction Oral carcinoma has been reported at a substantial proportion in patients who never smoke and never drink. However, the proportion may vary by subsite and ethnicity. Objective We aimed to determine the clinicopathological features of buccal squamous cell carcinoma (SCC) in a Japanese population. Methods We retrospectively analyzed the records of patients diagnosed with buccal SCC at our institution from September 2002 to November 2015. We reviewed the gender, age, tumor status, treatment, smoking, alcohol drinking, multiple primary cancers, and prognosis of the patients. The overall and cause-specific survival rates were calculated, and the effects of clinicopathological variables were assessed by univariate analysis. Furthermore, the cause of death was evaluated. Results Among the 63 patients (men: 38; women: 25) included in the present study, 29 (46.0%) never smoked or drank. Women were almost 5 years older than men ( p = 0.014). The number of women in the group who never smoked or drank was disproportionately higher than that of those in the smoker or drinker groups ( p < 0.001). In total, 29 patients (46.0%) had 59 multiple primary cancers, including 26 oral cancers. Surgeries and radiotherapy were performed in 57 (90.5%) and 6 (9.5%) cases, respectively. The 5-year overall survival and disease-specific survival rates were 74.6 and 78.8%, respectively. Conclusion Our study confirms that buccal SCC may develop in older adult Japanese patients, especially in women who have never smoked or drank. These patients could be at risk for second primary malignancy.

Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Objetivo: Las comunicaciones bucosinusales y buco- nasales son condiciones patológicas que se caracterizan por la presencia de una solución de continuidad entre la cavidad bucal y el seno maxilar o la cavidad nasal respectivamente. Una vez que se ha instalado una comunicación es deseable ce- rrar este defecto, evitando así la infección del seno maxilar y posibles dificultades en la deglución, fonación y masticación. Se han propuesto diferentes tratamientos para su resolución, algunos no quirúrgicos y otros quirúrgicos. Los quirúrgicos pueden realizarse desplazando tejidos locales, regionales o injertando. El presente trabajo tiene como objetivo presentar situaciones clínicas de comunicaciones bucosinusales y buco- nasales con diferentes etiologías y sus distintos tratamientos según tamaño y ubicación del defecto. Casos clínicos: Se identificaron pacientes que asistie- ron al Servicio de Cirugía Maxilofacial del Hospital Piñero presentando cuatro comunicaciones bucosinusales agudas y crónicas y una comunicación buconasal crónica. Los casos analizados fueron tratados de manera quirúrgica utilizando di- versos colgajos según tamaño y ubicación del defecto (AU)

Aim: Oroantral and oronasal communications are patho- logical conditions characterized by the presence of a solu- tion of continuity between the oral cavity and the maxillary sinus or nasal cavity respectively. Once a communication has been installed, it is desirable to close this defect, thus avoid- ing infection of the maxillary sinus and possible difficulties in swallowing, phonation, and mastication. Different treatments have been proposed for its resolution, some non-surgical and others surgical. Surgical procedures can be performed by dis- placing local or regional tissue or by grafting. The aim of this case report is to present clinical situations of oral sinus and oral nasal communication with different etiologies and their different treatments according to the size and location of the defect. Clinical cases: A group of patients who attended the Maxillofacial Surgery Service of Piñero Hospital presenting four acute and chronic oral sinus and one oronasal communi- cations were identified. The analyzed cases were treated sur- gically using different flaps according to the size and location of the defect (AU)

Buccal mucosa graft vaginoplasty: A viable option demonstrated step-by-step.

INTRODUCTION: Persistent cloaca, defined as confluence of the rectum, the vagina and the urethra into a single common channel, has an estimated incidence of 1/50,000 live births. We describe the buccal mucosa graft vaginoplasty for a 11 year old female with cloaca, who underwent at the age of 11 months a Peña repair. We performed the vaginoplasty after the onset of uterine pain due to the beginning of menstruation. MATERIAL AND METHODS: We accessed the lower lip for superficial dissection to harvest the graft. The donor site has been kept with as much submucosal fat as possible to avoid damage to the buccinatoria muscles. A second graft was further obtained from the cheek. Both grafts were submitted to multiple small sections to produce a mesh graft and increase its size. A arciform incision anterior to the anal canal and posterior to the urethra was performed followed by consecutive dissection with eletrocautery to gain profundity. The mesh-graft was placed over the neovaginal cavity and sutured with 4.0 PDS monofilament suture used to suture and then quilt the graft in place. The vaginal capacity was confirmed by ease of a two-digit insertion. Haemostasis was confirmed before the insertion of a soft vaginal mold. The patient remained with an indwelling urinary catheter. The mold was equivalent to 24Fr and had 13 cm of profundity and Foley tube were removed after 14 days postoperatively. RESULTS: Patient had an excellent postoperative course and had been instructed to perform vaginal dilatation every 3 h during the day. Current follow up is 10 months. DISCUSSION: Buccal mucosal grafting has advantages over the use of keratinized skin flaps and intestinal flaps. Buccal mucosa is ideal for female genital reconstruction, given its color, texture, lack of hair and mild mucous production. In our particular case, we connected the neovagina after two months of adequate healing to the native 1/3 through laparoscopic approach. CONCLUSIONS: BMG vaginoplasty is a viable alternative to treat females with cloaca at adolescence.

Genetic instability in farmers using pesticides: A study in Brazil with analysis combining alkaline comet and micronucleus assays.

The use of pesticides to prevent and control pests also increases food production. Pesticides are widely used by contemporary farmers, especially in Brazil, where the economy is based on agriculture. The objective of this study was to evaluate the genotoxic potential of pesticide use in rural workers in Maringá, Paraná, Brazil. DNA damage in whole blood cells was measured by the comet assay, while the frequency of cell types, abnormalities, and nuclear damage was estimated using the buccal micronucleus cytome assay. Samples of buccal mucosa were collected from 50 male volunteers (27 not exposed to pesticides and 23 occupationally exposed to pesticides). Among them, 44 volunteered for blood sampling (24 unexposed and 20 exposed). In the comet assay, the exposed farmers had a higher damage index than non-exposed ones. There were also statistically significant differences between the groups in the buccal micronucleus cytome assay. Farmers exhibited an increase in basal cell numbers, and cytogenetic alterations, represented by condensed chromatin and karyolitic cells. Comparisons between cell morphologies and epidemiological factors indicated an increased number of condensed chromatin and karyolitic cells in individuals who were responsible for preparation and transportation of pesticides to agricultural machines. Thus, the participants in this study who were exposed to pesticides were more sensitive to genetic damage, and thereby, more susceptible to diseases resulting from such damage. These results demonstrated that health policies should be developed for pesticide-exposed farmers to better mitigate risks and damage to their health.

Oral follicular lymphoma: a clinicopathologic and molecular study.

Follicular lymphoma is a hematolymphoid neoplasm that originates from germinal center B cells. It is made up of a combination of small cleaved centrocytes and a varying quantity of larger non-cleaved centroblasts to describe the clinical, microscopic, immunohistochemical, and molecular features of oral follicular lymphomas. Follicular lymphomas affecting the oral cavity were retrieved from pathology files. Immunohistochemistry was performed to confirm the diagnosis, and fluorescence in situ hybridization (FISH) was employed to detect rearrangements in BCL2, BCL6, and MYC genes. Clinical and follow-up data were obtained from the patient's medical and pathology files. Twenty cases were obtained. There was an equal sex distribution (10 males: 10 females) and a mean age of 60.9 years (range: 10-83 years-old). Lesions presented as asymptomatic swellings, usually in the palate (10 cases) and the buccal mucosa (7 cases). Five patients presented with concomitant nodal involvement. Microscopic evaluation depicted the follicular growth pattern with diffuse areas in six cases. Grades 1 and 2 follicular lymphomas represented 12 cases, while grade 3A neoplasms accounted for other 8 cases. Two cases showed rearrangements in MYC, BCL2, and BCL6 genes, while single BCL2 translocation was found in eight cases. Two cases had no translocation. Three patients deceased and the 2-year overall survival achieved 88%. Follicular lymphoma affecting the oral cavity is uncommon, usually affects the palate as a non-ulcerated swelling and the presence of a systemic disease most always be ruled out.

Clinicopathological Features of Buccal Squamous Cell Carcinoma with Focus on Patients Who Never Smoke and Never Drink

Abstract Introduction Oral carcinoma has been reported at a substantial proportion in patients who never smoke and never drink. However, the proportion may vary by subsite and ethnicity. Objective We aimed to determine the clinicopathological features of buccal squamous cell carcinoma (SCC) in a Japanese population. Methods We retrospectively analyzed the records of patients diagnosed with buccal SCC at our institution from September 2002 to November 2015. We reviewed the gender, age, tumor status, treatment, smoking, alcohol drinking, multiple primary cancers, and prognosis of the patients. The overall and cause-specific survival rates were calculated, and the effects of clinicopathological variables were assessed by univariate analysis. Furthermore, the cause of death was evaluated. Results Among the 63 patients (men: 38; women: 25) included in the present study, 29 (46.0%) never smoked or drank. Women were almost 5 years older than men (p = 0.014). The number of women in the group who never smoked or drank was disproportionately higher than that of those in the smoker or drinker groups (p < 0.001). In total, 29 patients (46.0%) had 59 multiple primary cancers, including 26 oral cancers. Surgeries and radiotherapy were performed in 57 (90.5%) and 6 (9.5%) cases, respectively. The 5-year overall survival and disease-specific survival rates were 74.6 and 78.8%, respectively. Conclusion Our study confirms that buccal SCC may develop in older adult Japanese patients, especially in women who have never smoked or drank. These patients could be at risk for second primary malignancy.

Genotoxic Biomonitoring in Children Living near the El Fraile Mine Tailings in Northern Guerrero State, Mexico.

A genotoxic study was conducted with 101 elementary school children (56 girls and 45 boys) in the 6-7, 8-9, and 10-12 age ranges from El Fraile rural community, which is located beside the El Fraile mine tailings in Taxco of Alarcon City, in northern Guerrero State, Mexico. For this, we used the alkaline comet assay in exfoliated buccal mucosa cells, scoring three genotoxic parameters: tail intensity, tail moment, and tail length. Additionally, we detected oxidative DNA damage through urinary 8-OHdG levels by enzyme-linked immunosorbent assay. We also evaluated a control group consisting of 101 children in the same age ranges from Chilpancingo City, Guerrero, who had never lived near mining zones. Genotoxic results showed that there was a significant increase in three genotoxic parameters and urinary 8-OHdG levels in the exposed children group compared with the control group. Analysis of MANOVA revealed that boys aged 8 and 9 years had higher DNA damage than girls from the same exposure group, and Spearman's analysis identified a positive correlation between DNA damage and sex and age. This study provides the first valuable genotoxic data in children living in areas with environmental pollution.

APOL1 genotyping via buccal mucosa cell samples to establish risk of kidney disease.

Two alleles (G1 and G2) of the apolipoprotein 1 gene (APOL1) predispose people of African descent to developing or accelerating the course of certain types of kidney disease. Population studies to determine the frequency of the G1 and G2 alleles are important to inform resource allocation by public health authorities. Traditionally, APOL1 genotyping is carried out in blood samples. However, sample collection, transport, and storage is cumbersome. Here we compared APOL1 genotyping in blood and buccal mucosa cell samples obtained from 23 individuals. Alleles G0 (wild), G1, and G2, as well as genotypes G0/G0, G0/G1, G1/G1, G0/G2, G1/G2, and G2/G2 were detected using both blood and buccal mucosa cells with 100% coincidence. Our data indicate that buccal mucosa cell samples may represent a suitable alternative to blood samples for APOL1 genotyping in the field.

Parámetros histomorfométricos de la mucosa bucal en pacientes portadores de leucoplasia con displasia epitelial / Histomorphometric Parameters of the Buccal Mucosa in Patients with Leukoplakia and Epithelial Dysplasia

RESUMEN Fundamento la leucoplasia es la lesión potencialmente maligna más frecuente en las membranas mucosas de la boca y se puede presentar con diferentes grados de displasia epitelial. El estudio histológico de esta lesión unido a la medición de parámetros morfométricos y estereológicos, permite la mejor comprensión de procesos tanto fisiológicos como patológicos. Objetivo: caracterizar los parámetros histomorfométricos de la mucosa bucal en pacientes portadores de leucoplasia bucal según grado de displasia epitelial. Método: se realizó un estudio de serie de casos, con el objeto de determinar indicadores morfométricos, de lesiones leucoplásicas de la mucosa oral en biopsias de pacientes atendidos en los Servicios de Anatomía Patológica y Maxilofacial del Hospital General Universitario Dr. Gustavo Aldereguía Lima, de la provincia Cienfuegos. La muestra se obtuvo por muestreo intencionado, la cual quedó constituida por 30 láminas histológicas (biopsias), distribuidas en tres grupos de diez láminas por cada grado de displasia epitelial. La variable de estudio fue la caracterización morfométrica de la leucoplasia de la mucosa oral con displasia. Se aplicó estadística descriptiva e inferencial. Resultados: predominaron tres parámetros en la clasificación de la displasia: alteración de los clavos interpapilares, hiperplasia y pérdida de la polaridad de las células basales. Se constató presencia de ortoparaqueratosis, epitelios hiperplásicos e infiltrado inflamatorio del corion, en más de la mitad de los casos. Hubo significación estadística en las relaciones que se establecieron entre la altura o profundidad de las papilas y la densidad relativa de células según grado de displasia epitelial, al aplicar la estadística inferencial. Conclusiones: predominaron tres parámetros en la clasificación de la displasia. Se constató presencia de ortoparaqueratosis, epitelios hiperplásicos e infiltrado inflamatorio del corion, en más de la mitad de los casos.

ABSTRACT Background: leukoplakia is the most frequent potentially malignant lesion in the mucous membranes of the mouth and can present with different degrees of epithelial dysplasia. The histological study of this lesion, together with the measurement of morphometric and stereological parameters, allows a better understanding of both physiological and pathological processes. Objective: to characterize the histomorphometric parameters of the oral mucosa in patients with oral leukoplakia according to the degree of epithelial dysplasia. Method: a case series study was carried out in order to determine morphometric indicators of leukoplastic lesions of the oral mucosa in biopsies of patients treated at the Pathology and Maxillofacial Anatomy services of the Dr. Gustavo Aldereguía Lima General University Hospital, in Cienfuegos province. The sample was obtained by intentional sampling, which was made up of 30 histological slides (biopsies), distributed in three groups of ten slides for each degree of epithelial dysplasia. The study variable was the morphometric characterization of oral mucosal leukoplakia with dysplasia. Descriptive and inferential statistics were applied. Results: three parameters prevailed in the classification of dysplasia: alteration of the interpapillary nails, hyperplasia and loss of polarity of the basal cells. The presence of orthoparakeratosis, hyperplastic epithelia and inflammatory infiltrate of the chorion was confirmed in more than half of the cases. There was statistical significance in the relationships established between the height or depth of the papillae and the relative density of cells according to the degree of epithelial dysplasia, when applying inferential statistics. Conclusions: three parameters predominated in the classification of dysplasia. The presence of orthoparakeratosis, hyperplastic epithelia and inflammatory infiltrate of the chorion was confirmed in more than half of the cases.

The Fagerström and AUDIT Tests as Probable Screening Tools in Oral Cancer and Their Correlation with CYP1A1, GSTM1, GSTP1, and GSTT1 Gene Expression.

BACKGROUND: Cancer is currently a major public health problem worldwide, with a marked increase of about 70% in the number of expected diagnosed cases over the next two decades. The amount of tobacco and alcohol consumed is calculated based on the subjective information provided by the user. Tobacco exposure can be assessed using the Fagerström Test for Cigarette Dependence (FTCD) and alcohol consumption by the Alcohol Use Disorder Identification Test (AUDIT). MATERIALS AND METHODS: Forty-eight subjects answered the Fagerström, and AUDIT tests and we studied them as likely screening tools for oral cancer and their correlation with the expression of CYP1A1, GSTM1, GSTP1, and GSTT1 genes by the RT-qPCR method. RESULTS: There were significant differences in the AUDIT score and CYP1A1 expression between cancer and control groups. Participants in advanced stages, whether due to tumor size or regional metastasis, showed significant differences in the duration of tobacco use, FTCD, AUDIT score, and CYP1A1 expression when compared to patients in early stages. Among subjects without cancer, we found a significant correlation between participant age and GSTP1 expression. Furthermore, the expression of GSTP1 was significantly correlated with the number of cigarettes smoked per day, duration of tobacco use, and FTCD. CONCLUSIONS: Questionnaires designed to evaluate the degree of tobacco and alcohol exposure and dependence combined with gene expression tests can be useful to assess the risk of developing oral cancer. Furthermore, raising the awareness of individuals regarding their degree of dependence and encouraging them to participate in cessation programs are important educational measures for the prevention of tobacco-related malignancies.

A buccal mucosa ulcer as the first sign of tuberculosis.

Tuberculosis (TB) is an infectious disease caused mostly by Mycobacterium tuberculosis. Oral lesions caused by this disease are not common, and most of them represent secondary involvement of the initial pulmonary focus. Therefore, the discovery of lung tuberculosis because of the investigation of oral lesions is rare. This paper reports a case of a 61-year-old male patient who presented with a painfully ulcerated lesion in labial commissure and buccal mucosa, without any comorbidities or symptoms associated. An incisional biopsy was performed, and histopathology showed a chronic granulomatous lesion extending to involve the underlying muscle. Based on these findings, investigation for tuberculosis was suggested. Chest radiography displayed excavated macronodular lesions suggestive of an inflammatory-infectious/granulomatous process of bronchogenic dissemination. The search for acid-alcohol-resistant bacillus in sputum was positive. After using drug therapy for tuberculosis for 3 months, there was a total regression of the oral lesions, in addition to weight recovery in the period. Thus, in patients with isolated oral mucosa lesions, we must consider the possibility of oral manifestation of systemic diseases, even without typical clinical signs and symptoms.

Micronucleus in exfoliated buccal cells of crack users: systematic review and meta-analysis / Micronúcleos en células bucales exfoliadas en consumidores de crack: una revisión sistemática y meta-análisis

Abstract This research aimed to conduct a systematic review and metanalysis to compare the frequency of cell damage in crack users and nonusers, through Micronucleous (MN) test in buccal mucosa cells. A comprehensive search was carried out on MEDLINE via PubMeb, Web of Science, LILACS and the grey literature without restrictions. It was included case-control studies that report the frequency of micronuclei in the oral mucosa of adult crack users and nonusers. A review protocol was registered with PROSPERO (CRD42018115672), and conducted in accordance with the PRISMA guidelines for the report of this systematic review. Furthermore, study quality was evaluated using an adapted Newcastle-Ottawa Scale for cross-sectional studies.The original search yielded 27 references, after eligibility criteriaonly five articles were included. The number of micronuclei was higher in crack users compared to nonusers. Also, secondary outcomes: binucleated cells, nuclear buds, pyknosis, karyorrhexis and karyolysis had higher prevalence in crack users.Crack use is associated with genotoxic and mutagenic effects because there is a higher frequency of micronuclei in exfoliated cells of crack users. In addition, MN test proved to be a goodbiomarker to assess the mutagenic impact of crack use in oral epithelium.

Resumen Esta investigación tuvo como objetivo realizar una revisión sistemática y un meta-análisis para comparar la frecuencia de daño celular en usuarios de crack y sin crack, a través de la prueba de micronúcleos (MN) en células de la mucosa bucal. Se realizó una búsqueda exhaustiva en MEDLINE a través de PubMeb, Web of Science, LILACS y la literatura gris sin restricciones. Se incluyeron estudios de casos y controles que informaron la frecuencia de micronúcleos en la mucosa oral de usuarios adultos de crack y sin crack. Se registró un protocolo de revisión con PROSPERO (CRD42018115672), y se realizó de acuerdo con las pautas de PRISMA para el informe de esta revisión sistemática. Además, la calidad del estudio se evaluó mediante una escala Newcastle-Ottawa adaptada para estudios transversales. La búsqueda original arrojó 27 referencias, después de los criterios de elegibilidad se incluyeron un total de cinco artículos. El número de micronúcleos fue mayor en los usuarios de crack en compa ración con los usuarios sin crack. Además, los resultados secundarios de células binucleadas, yemas nucleares, picnosis, cario- rrexis y cariólisis tuvieron una mayor prevalencia en los usuarios de crack. El uso de crack se asocia con efectos genotóxicos y mutagénicos porque hay una mayor frecuencia de micronúcleos en las células exfoliadas de los usuarios de crack. Además, la prueba de MN demostró ser un buen biomarcador para evaluar el impacto mutagénico del uso de crack en el epitelio oral.

Genetic Alterations in Patients with Two Clinical Phenotypes of Multiple Sclerosis.

The etiology of multiple sclerosis (MS) is still not known, but the interaction of genetic, immunological, and environmental factors seem to be involved. This study aimed to investigate genetic alterations and the vitamin D status in patients with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS). A total of 53 patients (29 RRMS; 24 SPMS) and 25 healthy subjects were recruited to evaluate the micronucleated cell (MNC) frequency and nuclear abnormalities in the buccal mucosa, gene expression profiling in mononuclear cells, and plasmatic vitamin D concentration in the blood. Results showed a higher frequency of cells with karyorrhexis (SPMS) and lower frequencies of nuclear pyknosis (RRMS and SPMS) and karyolysis (SPMS) in patients with MS. Significant increase in the frequency of MNC was detected in the buccal mucosa of RRMS and SPMS patients. HIF1A, IL13, IL18, MYC, and TNF were differentially expressed in MS patients, and APP was overexpressed in cells of RRMS compared to SPMS patients. No relationship was observed between vitamin D level and the differentially expressed genes. In conclusion, the cytogenetic alterations in the buccal mucosa can be important indicators of genetic instability and degenerative processes in patients with MS. Furthermore, our data introduced novel biomarkers associated with the molecular pathogenesis of MS.

Lipoma em região pterigomandibular: relato de caso / Lipoma in the pterygomandibular region: Case report

O lipoma é um tumor benigno de crescimento lento, assintomático, com consistência amolecida. Clinicamente, apresenta-se como massa nodular, pedunculada ou séssil, de aspecto gelatinoso com superfície lisa recoberta por mucosa bucal saudável. Apesar de comum em outras partes do corpo, esse tumor raramente acomete a cavidade bucal. Seu tratamento consiste na excisão cirúrgica, e apresenta raras recidivas, devido à presença de uma pseudocápsula que separa a lesão dos tecidos circunvizinhos. Objetivo: este trabalho objetiva relatar o caso clínico de um paciente com lipoma em região peterigomandibular, tratado com sucesso por excisão cirúrgica. Relato de caso: paciente masculino, de 51 anos, relatou aparecimento de aumento de volume assintomático em região posterior da cavidade bucal, com evolução de aproximadamente 8 meses. Foi realizada biópsia excisional da lesão sob anestesia local, sem complicações. A suspeita diagnóstica de lipoma foi confirmada por meio de laudo histopatológico. Paciente encontra-se no vigésimo mês de pós-operatório, sem recidiva da lesão. Conclusão: por ser raro na região maxilofacial, o tumor, quando acomete a mucosa bucal, deve ser relatado na literatura. No caso descrito, a biópsia excisional, realizada em âmbito ambulatorial, mostrou-se eficaz no tratamento do lipoma em região peterigomandibular.

Lipoma is a slow-growing, asymptomatic benign tumor with soft consistency. Clinically, they present as a pedunculated or sessile nodular mass, with a gelatinous aspect with a smooth surface covered by a healthy oral mucosa. Although common in other parts of the body, this tumor rarely affects the oral cavity. Its treatment consists of surgical excision and rare recurrences due to the presence of a pseudocapsule that separates the lesion from the surrounding tissues. Objective: this paper aims to report the clinical case of a patient with pterigomandibular lipoma, successfully treated by surgical excision. Case report: a 51-year-old male patient reported asymptomatic swelling in the posterior region of the oral cavity, with an evolution of approximately 8 months. An excisional biopsy of the lesion was performed under local anesthesia without complications. The diagnostic suspicion of lipoma was confirmed by the histopathological report. Patient is in the twentieth postoperative month, with no recurrence of the lesion. Conclusion: because it is rare in the maxillofacial region, the tumor when it affects the oral mucosa should be reported in the literature. In the case here described, outpatient excisional biopsy proved to be effective in the treatment of lipoma in the pterigomandibular region.

In vivo evaluation of the genotoxicity and oxidative damage in individuals exposed to 10% hydrogen peroxide whitening strips.

OBJECTIVE: This study assessed the impact of 10% hydrogen peroxide whitening strip exposure on the genotoxicity and oxidative damage by means of the buccal micronucleus cytome assay by counting nuclear abnormalities (NAs) in buccal mucosa and attached gingiva cells and by analyzing in whole saliva the molecule 8-hydroxy-2'-deoxyguanosine (8-OHdG). MATERIALS AND METHODS: The study was conducted on 113 subjects divided into two groups: group 1 or control (n = 53), non-whitening strip exposed, and group 2 (n = 60), whitening strip exposed (Crest® 3D Whitestrips® premium plus, 10% hydrogen peroxide). Oral epithelial cells and whole saliva samples were taken at the beginning and 30 days later for group 1 and immediately before bleaching and 15 and 30 days after the end of the bleaching for group 2. RESULTS: An increased frequency of NAs (p < 0.05) and higher levels of 8-OHdG (p < 0.05) were observed after bleaching exposure. Also, a positive correlation exists between oxidative stress produced by hydrogen peroxide and micronuclei was found. CONCLUSION: Individuals exposed to 10% hydrogen peroxide whitening strips exhibit NAs increased in oral epithelial cells and 8-OHdG in saliva, which is directed related to nuclear and oxidative DNA damage, respectively. CLINICAL SIGNIFICANCE: Hydrogen peroxide is the active agent of tooth whitening and this compound induced DNA damage. Individuals exposed to whitening strips with 10% hydrogen peroxide exhibit increased genotoxic and oxidative damage. Therefore, self-application of bleaching agents should be handled carefully since it could be a risk to human health.

Biopsia de glándula salival menor en el diagnóstico confirmatorio del Síndrome de Sjögren y Amiloidosis / Minor salivary gland biopsy in the confirmatory diagnosis of Sjögren's Syndrome and Amyloidosis

INTRODUCCIÓN. El trabajo trata de dos enfermedades con la descripción histopatológica del tejido glandular, que nos ayudará a identificar y a corroborar el diagnóstico del Síndrome de Sjögren y la Amiloidosis, que a pesar de ser de un mismo tejido ductal, tienen características histopatológicas muy diferentes. OBJETIVO. Demostrar el uso de la biopsia de glándula salival menor en diagnósticos confirmatorios de patologías autoinmunes como son: el Síndrome de Sjögren y Amiloidosis, que al ser dos entidades distintas, tienen una misma estructura de afectación. CASO CLÍNICO. Se estudió dos placas histológicas, de una paciente con manifestaciones clínicas de Síndrome de Sjögren y de un paciente con Amiloidosis; se realizó la toma de biopsia de la glándula salival menor y su respectiva histopatología, lo que permitió identificar de forma microscópica las dos entidades. DISCUSIÓN. Abordar la diferente etiología, técnicas y exámenes complementarios en el diagnóstico de estas enfermedades, y el tratamiento, sin descuidar el grado de sensibilidad y especificidad de cada tipo de biopsia y el debate de cuál es el método ideal y eficaz. RESULTADOS. En cuanto a las características de biopsias de glándulas salivales menores que siguieron su patrón histopatológico de las dos enfermedades, Síndrome de Sjögren y Amiloidosis, con la modificación de tejido glandular y asi demostrando la utilidad de la técnica en el diagnostico confirmatorio. CONCLUSIÓN. El uso de la técnica, biopsia de glándula salival menor, fue un método de diagnóstico confirmatorio complementario a estudios de imagenología y laboratorio clínico.

INTRODUCTION. The work deals with two diseases with the histopathological description of glandular tissue, which will help us identify and corroborate the diagnosis of Sjögren's Syndrome and Amyloidosis, which, despite being from the same ductal tissue, have very different histopathological characteristics. OBJECTIVE. To demonstrate the use of minor salivary gland biopsy in confirmatory diagnoses of autoimmune pathologies such as: Sjögren's Syndrome and Amyloidosis, which, being two distinct entities, have the same structure of affectation. CLINICAL CASE. Two histological plates were studied, of a patient with clinical manifestations of Sjögren's Syndrome and of a patient with Amyloidosis; The biopsy of the minor salivary gland and its respective histopathology were performed, which allowed the two entities to be identified microscopically. DISCUSSION. To address the different etiology, techniques and complementary examinations in the diagnosis of these diseases, and treatment, without neglecting the degree of sensitivity and specificity of each type of biopsy and the debate of which is the ideal and effective method. RESULTS As for the characteristics of minor salivary gland biopsies that followed histopathological pattern of the two diseases, Sjögren's Syndrome and Amyloidosis, with the modification of glandular tissue and thus demonstrating the usefulness of the technique in the confirmatory diagnosis. CONCLUSION. The use of the technique, minor salivary gland biopsy, was a confirmatory diagnostic method complementary to imaging and clinical laboratory studies.

Frecuencia y caracterización de Staphylococcus spp. en la mucosa bucal de pacientes diabéticos y no diabéticos / Frequency and characterization of Staphylococcus spp. in the buccal mucosa of diabetic and non-di

Antecedentes: Dentro de la gran diversidad de microorganismos en la microbiota oral, el género Staphylococcus es causante de una gran variedad de infecciones, desde leves hasta diseminadas que pueden causar la muerte. Los portadores de estas bacterias tienen más riesgo de presentar infecciones por estas mismas. Un grupo vulnerable de sufrir infecciones por estos microorganismos son los pacientes diabéticos por sus características sistémicas propias de la enfermedad, deterioro inmunológico y locales bucales, por lo que es importante conocer si son portadoras de este grupo de bacterias. Objetivo: Determinar la frecuencia de colonización por Staphylococcus spp. en aislamientos obtenidos de la mucosa bucal de pacientes diabéticos y sin diabetes. Material y métodos: Se tomó un raspado superficial de la mucosa bucal de personas diabéticas y sin diabetes para cultivo y análisis microbiológico. Se sembró en agar sal manitol y los aislados se identificaron por galerías API Staph. La concentración de glucosa se determinó con equipo Accu-Chek. El análisis fue descriptivo, las diferencias y asociaciones se investigaron con χ2 y T Student. Se consideró estadísticamente significativo cuando el valor de p < 0.05. Resultados: La colonización por Staphylococcus spp. total fue de 73.7%, no hubo diferencia significativa entre diabéticos y no diabéticos (p = 0.946). S. epidermidis se identificó en 69% y S. aureus en 17.6%, sin diferencia entre ambos grupos con p = 0.556 y p = 0.428 respectivamente. Setenta y seis por ciento de los pacientes portadores de prótesis bucales estaban colonizados con Staphylococcus spp. Conclusiones: No se encontró que los pacientes diabéticos tuvieran porcentajes significativamente mayores de colonización por Staphylococcus spp. a pesar de sus condiciones particulares inmunológicas, glucemia anormal y disminución de flujo salival en la cavidad bucal (AU)

Background: Within the great diversity of microorganisms in the buccal microbiota, the genus Staphylococcus is the cause of a great variety of infections ranging from mild to disseminated, which can cause death. The carriers of these bacteria are more at risk of developing infections by themselves. A vulnerable group to suffer infections by these microorganisms are diabetic patients due to their systemic characteristics of the disease, immunological deterioration and local buccal, so it is important to know if they are carriers of this group of bacteria. Objective: The objective was determined the frequency of colonization by Staphylococcus spp. in isolates obtained from the oral mucosa of diabetic and without diabetes patients. Material and methods: A superficial scraping of the buccal mucosa of diabetic and without diabetes people was taken for culture and microbiological analysis. It was seeded in sal manitol agar and the isolates were identified by API Staph galleries. The glucose concentration was determined with Accu-Chek equipment. The analysis was descriptive, differences and associations were investigated with χ2 and Student T. It was considered statistically significant when the value of p < 0.05. Results: Total colonization by Staphylococcus spp. was 73.7%, there was no significant difference between diabetics and nondiabetics (p = 0.946). S. epidermidis was identified in 69% and S. aureus in 17.6%, without difference between both groups with p = 0.556 and p = 0.428 respectively. 76% of patients with oral prostheses were colonized with Staphylococcus spp. Conclusions: Diabetic patients were not found to have significantly higher rates of colonization by Staphylococcus spp. despite their particular immunological conditions, abnormal glycemia and decreased salivary flow in the oral cavity (AU)

Workers of São Paulo city, Brazil, exposed to air pollution: Assessment of genotoxicity.

Air pollution affects all major urban centers, particularly megacities with populations greater than 10 million people. Vehicular and industrial emissions are among the most important sources of air pollutants in these cities. Air pollution composition, dose, and time of exposure can cause differential effects on human health. We have evaluated the genotoxic effects of air pollution (PM2.5 and NO2) on São Paulo city workers. Fifty-seven male individuals, 28-66 years old, with occupational exposure to air pollution, participated in this study; all worked daily outdoor shifts in São Paulo. Participants were recruited from three occupations: traffic controllers (n = 18); taxi drivers (n = 21); and workers at the Forestry Institute (n = 18). These workers were classified into two groups based on their workplace locations: Downtown Group (DT): traffic controllers and taxi drivers; Outskirts of Town Group (OT): workers at the Forestry Institute. Individual samplers of air pollution (Harvard air impactor) were used to collect PM2.5 and NO2 pollutants. Genotoxicity analysis (micronucleus test) was performed on buccal mucosa epithelial cells and peripheral blood lymphocytes. PM2.5 concentrations were significantly different between the groups (DT = 32.92 µg m-3, OT = 25.77 µg m-3; p = 0.03); however, no difference was observed in NO2 concentrations. Micronucleus frequencies in both buccal mucosa (DT = 2.78%, OT = 1.16%; p < 0.0001) and in peripheral lymphocytes (DT = 1.51%, OT = 0.73%; p < 0.0001) were significantly different between the groups. We observed a direct correlation between the individual dose of PM2.5 and micronucleus frequency in the buccal mucosa (p = 0.0021). Our results indicate that workers in the most urban areas of São Paulo are exposed to higher concentrations of PM2.5 and showed higher micronucleus frequencies in both buccal mucosa and lymphocytes.

What Is the Best Way to Prepare A Buccal Mucosa Graft for Urethroplasty? A Histology-Based Preliminary Report.

PURPOSE: To evaluate the histological characteristics of buccal mucosa samples prepared using different dissection techniques. METHODS: The buccal mucosae harvested from 9 men submitted to a substitution urethroplasty were used in this study. Biopsy specimens of buccal mucosae were grouped according to the macroscopic appearance after dissection: Group 1 - yellowish appearance (minimal dissection), Group 2 - whitish appearance (more aggressive dissection), and Group 3 - translucent appearance (ultra-aggressive dissection). The biopsy specimens were evaluated using histomorphometric techniques. The thicknesses of the graft, epithelium, and sub-epithelial connective tissue were compared. RESULTS: The samples from Group 3 and Groups 2 and 3 presented lower total and lower sub-epithelial connective tissue thickness, respectively, when compared with Group 1. The epithelial thickness was not affected by the dissection method. Muscular and adipose tissues were present in 77 and 55% of samples from Group 1, respectively, whereas these were observed in 44 and 22% of samples from Group 2 respectively. The muscular tissue was observed in 11% of the cases, and the adipose tissue was not observed in samples prepared with ultra-aggressive dissection. CONCLUSION: We conclude that an intermediate graft dissection (whitish appearance, as performed in Group 2) presents the best balance between subepithelial connective tissue preservation and adipose and muscle tissue removal.

Is circumferential urethral mobilization an overdo? A prospective outcome analysis of dorsal onlay and dorso - lateral onlay BMGU for anterior urethral strictures

ABSTRACT Introduction For dorsal onlay graft placement, unilateral urethral mobilization is less invasive than standard circumferential urethral mobilization. Apart from success in terms of patency of urethra, other issues like sexual function, overall quality of life and patient satisfaction remain important issues while comparing outcomes of urethroplasty. Aim To prospectively compare the objective as well as subjective outcomes of two approaches. Materials and Methods Between July 2011 and January 2015, 136 adult males having anterior urethral stricture with urethral lumen ≥ 6 Fr. were prospectively assigned between two groups by alternate randomization. Operative time, complications, success rate (no obstructive symptoms, no need of any postoperative intervention, Q max > 15mL/sec), sexual functions (using Brief Male Sexual Function Inventory) were compared. Results Baseline parameters were similar in both groups (68 in each group). Overall success rate was similar in both groups (89 % and 91 % respectively). Improvement in total LUTS scores was similar in groups. Changes in overall health status (VAS and EQ 5D) was equal in both groups. Erectile function score was significantly decreased in DO than DL group while ejaculatory function and sexual desire remained stable after urethroplasty in both groups. Conclusions In anterior urethral stricture buccal mucosa graft provides satisfactory results as onlay technique. No technique whether dorsolateral and dorsal techniques is superior to other. Dorsolateral technique needs minimal urethral mobilization and should be preferred whenever feasible.