Predictive value of CDKN2A/p16INK4a expression in the malignant transformation of oral potentially malignant disorders: Systematic review and meta-analysis.

BACKGROUND: Management of oral potentially malignant disorders (OPMDs) is still challenging. Despite the diagnostic ascertainment by bioptic examination, this method is poorly informative of the prognosis and subsequent malignant transformation. Prognosis is based on histological findings by grading of dysplasia. Immunohistochemical expression of p16INK4a has been investigated in different studies, with controversial results. In this scenario, we systematically revised the current evidence about p16INK4a immunohistochemical expression and the risk of malignization of OPMDs. MATERIAL AND METHODS: After a proper set of keywords combination, 5 databases were accessed and screened to select eligible studies. The protocol was previously registered on PROSPERO (Protocol ID: CRD42022355931). Data were obtained directly from the primary studies as a measure to determine the relationship between CDKN2A/P16INK4a expression and the malignant transformation of OPMDs. Heterogeneity and publication bias were investigated by different tools, such as Cochran's Q test, Galbraith plot and Egger and Begg Mazumdar's rank tests. RESULTS: Meta-analysis revealed a twofold increased risk to malignant development (RR = 2.01, 95% CI = 1.36-2.96 - I2 = 0%). Subgroup analysis did not highlight any relevant heterogeneity. Galbraith plot showed that no individual study could be considered as an important outlier. CONCLUSION: Pooled analysis showed that p16INK4a assessment may arise adjunct tool to dysplasia grading, leading to an optimized determination of the potential progression to cancer of OPMDs. The p16INK4a overexpression analysis by immunohistochemistry techniques has a multitude of virtues that may facilitate its incorporation in the day-to-day prognostic study of OPMDs.

Linfoma primario de base de cráneo presentándose como oftalmoplejia aguda / Primary skull base lynphoma presenting as acute ophtalmoplegia

Primary Skull base lymphoma (PSBL) represents a rare manifestation of extranodal lymphoma. Aggressive non-Hodgkin´s lymphoma such as diffuse large B-cell lymphoma, constitute the most commonly encountered subtype of PBSL. We report the case of a 70-year-oldwoman with acute diplopia and ptosis of the right eye. Neurological examination showed palsy of right III, IV and VI cranial nerves. Brain imaging studies showed a lesion showed invading the floor of the sella turcica, both cavernous sinuses, the clivus and part of the sphenoid sinus. The patient underwent endonasal endoscopic resection of the lesion. The histological diagnosis was diffuse large B-cell lymphoma. No systemic disease was found on staging the patient. (AU)

El linfoma primario de base de cráneo (LPBC) representa una variante poco frecuente del linfoma extranodal. Los linfomas no-Hodgkin agresivos, tales como el linfoma difuso de células grandes B son el subtipo más frecuente que se presentan como LPBC. Describimos el caso de una paciente mujer de 70 años que acude a nuestro centro con una clínica aguda de diplopía y posterior ptosis del ojo derecho. En la exploración neurológica se constató parálisis de III, IV y VI pares derechos. Los estudios de imagen cerebral mostraron una lesión que invadía el suelo de la silla turca, ambos senos cavernosos, el clivus y parte del seno esfenoidal. Se realizó una exéresis endoscópica endonasal de la lesión. El examen histológico de la lesión fue compatible con un linfoma difuso de células grandes B. No se constató enfermedad sistémica en los estudios de extensión. (AU)

Overexpression of E-Cadherin Is a Favorable Prognostic Biomarker in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Oral squamous cell carcinoma (OSCC) is characterized by poor survival, mostly due to local invasion, loco-regional recurrence, and metastasis. Given that the weakening of cell-to-cell adhesion is a feature associated with the migration and invasion of cancer cells, different studies have explored the prognostic utility of cell adhesion molecules such as E-cadherin (E-cad). This study aims to summarize current evidence in a meta-analysis, focusing on the prognostic role of E-cad in OSCC. To find studies meeting inclusion criteria, Scopus, Web of Science, EMBASE, Medline, and OpenGrey databases were systematically assessed and screened. The selection process led to 25 studies, which were considered eligible for inclusion in the meta-analysis, representing a sample of 2553 patients. E-cad overexpression was strongly associated with longer overall survival (OS) with Hazard Ratio (HR) = 0.41 95% confidence interval (95% CI) (0.32-0.54); p < 0.001 and disease-free survival with HR 0.47 95% CI (0.37-0.61); p < 0.001. In terms of OS, patients with tongue cancer experienced better survivability when expressing E-cad with HR 0.28 95% CI (0.19-0.43); p < 0.001. Globally, our findings indicate the prognostic role of the immunohistochemical assessment of E-cad in OSCC and its expression might acquire a different role based on the oral cavity subsites.

Oral Chronic Hyperplastic Candidiasis and Its Potential Risk of Malignant Transformation: A Systematic Review and Prevalence Meta-Analysis.

Chronic hyperplastic candidiasis (CHC) is a prototypical oral lesion caused by chronic Candida infection. A major controversy surrounding CHC is whether this oral lesion owns malignant transformation (MT) potential. The aim of the present study was to evaluate current evidence on the MT of CHC and to determine the variables which have the greatest influence on cancer development. Bibliographical searches included PubMed, Embase, Web of Science, Scopus and LILACS. The cohort studies and case series used to investigate the MT of CHC were deemed suitable for inclusion. The quality of the enrolled studies was measured by the Joanna Briggs Institute scale. Moreover, we undertook subgroup analyses, assessed small study effects, and conducted sensitivity analyses. From 338 studies, nine were finally included for qualitative/quantitative analysis. The overall MT rate for CHC across all studies was 12.1% (95% confidential interval, 4.1-19.8%). Subgroup analysis showed that the MT rate increased when pooled analysis was restricted to poor quality studies. It remains complex to affirm whether CHC is an individual and oral, potentially malignant disorder according to the retrieved evidence. Prospective cohort studies to define the natural history of CHC and a consensus statement to clarify a proper set of diagnostic criteria are strongly needed. PROSPERO ID: CRD42022319572.

Self-reported depression and anxiety among COPD patients. A case-control study.

BACKGROUND: Anxiety and depression are the most prevalent mental disorders worldwide. However, the exact mechanisms linking chronic obstructive pulmonary disease (COPD) with depression and anxiety have not been identified. OBJECTIVES: To compare self-reported depression and anxiety among patients diagnosed with COPD in relation to healthy controls. DESIGN AND SETTING: Case control study at a public hospital institution in Spain. METHODS: We designed a case-control study. Patients were recruited using a consecutive sampling method from a single institution. Two groups were created: COPD and healthy controls. Data on medical history and demographic background were collected from the medical records. Self-reported depression levels were assessed using Beck's depression inventory (BDI). Self-reported anxiety was measured using the State-trait anxiety inventory (STAI). RESULTS: Fifty-two patients with COPD and fifty healthy patients were included in this study. BDI scores were higher for COPD patients (10.23 ± 6.26) than in the control group (5.2 ± 6.56). STAI-state scores were higher for COPD patients (41.85 ± 12.55) than for controls (34.88 ± 9.25). STAI-trait scores were higher for COPD patients (41.42 ± 10.01) than for controls (34.62 ± 9.19). CONCLUSIONS: This study showed that there were higher levels of depression and anxiety among COPD patients than among healthy controls.

Self-reported depression and anxiety among COPD patients. A case-control study

Abstract BACKGROUND: Anxiety and depression are the most prevalent mental disorders worldwide. However, the exact mechanisms linking chronic obstructive pulmonary disease (COPD) with depression and anxiety have not been identified. OBJECTIVES: To compare self-reported depression and anxiety among patients diagnosed with COPD in relation to healthy controls. DESIGN AND SETTING: Case control study at a public hospital institution in Spain. METHODS: We designed a case-control study. Patients were recruited using a consecutive sampling method from a single institution. Two groups were created: COPD and healthy controls. Data on medical history and demographic background were collected from the medical records. Self-reported depression levels were assessed using Beck's depression inventory (BDI). Self-reported anxiety was measured using the State-trait anxiety inventory (STAI). RESULTS: Fifty-two patients with COPD and fifty healthy patients were included in this study. BDI scores were higher for COPD patients (10.23 ± 6.26) than in the control group (5.2 ± 6.56). STAI-state scores were higher for COPD patients (41.85 ± 12.55) than for controls (34.88 ± 9.25). STAI-trait scores were higher for COPD patients (41.42 ± 10.01) than for controls (34.62 ± 9.19). CONCLUSIONS: This study showed that there were higher levels of depression and anxiety among COPD patients than among healthy controls.

Riesgo de necrosis avascular tras osteotomía de la cabeza del primer metatarsiano / No disponible

La Necrosis Avascular (NAV) de la primera cabezametatarsal representa una entidad relativamentepoco frecuente. Muchos autores defienden que suaparición puede ser espontánea1,2, pero con frecuenciase asocia a la cirugía del hallux valgus, yen especial a la osteotomía distal tipo Chevron oAustin3-7.Algunos autores, para mejorar la alineación del primerradio, además de realizar una osteotomía distalde la 1º cabeza metatarsal recomiendan la liberaciónlateral de partes blandas. Aunque diferentes estudiosestablecen que este procedimiento es seguro, escierto también que puede incrementar el riesgo denecrosis avascular de la 1ª cabeza metatarsal.En este artículo haremos un repaso de la anatomía,en lo que a su parte vascular se refiere, de la 1ª cabezametatarsal, de la etiología de la necrosis avascular,discutiendo la prevalencia de NAV después de realizarosteotomías metatarsales dístales intentandorealizar una aproximación al diagnóstico de lapatología y a las distintas opciones de tratamientoexistentes(AU)

Avascular Necrosis (NAV) of the first metatarsalhead represents a pathological condition relativelyless frequent. Many authors defend that its appearancecan be spontaneous1,2, but is frequently associatedto hallux valgus surgery, and in special to thedistal osteotomy type Chevron or Austin3-7.Some authors, to improve the alignment of the firstray, besides making a distal osteotomy of the firstmetatarsal head recommend the lateral release ofsoft tissue. Although different studies establishthat this procedure is safe, is also certain that it canincrease the risk of avascular necrosis of the firstmetatarsal head.In this article we will review the vascular anatomy,of the first metatarsal head, and the aetiology of theavascular necrosis, discussing the prevalence of NAVafter making distal metatarsal osteotomies trying tomake an approach to the diagnosis of the pathologyand the different existing options of treatment(AU)

La enfermedad de Sever / No disponible

Se denomina enfermedad de Sever, apofisitis posteriordel calcáneo u osteocondritis calcánea a la inflamacióne irritación del cartílago de crecimiento delhueso calcáneo que cursa con dolor localizado en eltalón. Existen diversos factores que condicionan sudesarrollo, tales como la edad, el exceso deportivo, laretracción de la musculatura posterior de la pierna oun calzado inadecuado. No obstante, con la colocaciónde una pieza elevadora de talón así como conreposo físico durante 2-3 semanas y terapia antiinflamatoria,se resuelven la mayoría de los casos consultadosen la bibliografía. Así mismo, se hace necesariala planificación deportiva anual de los niñospara evitar la aparición de esta patología(AU)

The Sever’s disease, posterior apophysitis of thecalcaneus or calcaneous osteocondritis is theinflammation and irritation of the cartilage of growthof the calcaneus bone that attends with pain locatedin the heel. There are many factors contributing toits development, such as the age, the sport exercise,the retraction of the posterior muscles of the leg orinadequate footwear. However, with the treatmentof a heel lift as well as with physical, resting during2-3 weeks and anti-inflammatory therapy, most ofthe cases consulted in the bibliography are resolved.Also, the annual sport planning with childrenbecomes necessary to avoid this pathology(AU)

Abordaje quirúrgico de la exostosis retrocalcánea / Surgical approach of the retrocalcaneal exotosis

El dolor posterior del talón representa una patología relativamente común que se asocia a la calcificación tanto del cuerpo del tendón como de su inserción. Clínicamente los pacientes presentan eritema, y edema en la inserción del tendón de Aquiles. La zona posterior del talón se presenta sensible a la presión, y el dolor puede ir acompañado de una bursitis localizada. Las alternativas al tratamiento conservador suelen ser limitadas y poco eficaces. El tratamiento quirúrgico está indicado cuando el tratamiento conservador fracasa y el paciente tiene dificultades para realizar sus actividades diarias. En el presente artículo presentamos la revisión de 2 técnicas quirúrgicas para el abordaje de la exostosis retrocalcánea y para la solución de la patología tendinosa asociada

The posterior heel pain represents a relatively common pathology that it is associated with the calcification of the body of the tendon as well as its insertion. Clinically, the patients show eritema, and edema in the insertion of the Aquilles tendon. The posterior aspect of the heel appears too tender to the digital pressure, and the pain can go accompanied of a located bursitis. The alternatives to the conservative treatment usually are limited and not to much effective. The surgical treatment is indicated when the conservative treatment fails and the patients have difficulties to make their daily activities. In the present article we present the review of 2 surgical techniques to approach the retrocalcaneal exostosis and for the solution of the associated tendinopathy