Immunoexpression of VEGFR-3, but not the immunoexpression of VEGF-C or lymphatic density, is correlated with metastasis in lower lip squamous cell carcinoma.

The purpose of this study was to evaluate the immunoexpression of vascular endothelial growth factor C (VEGF-C) and VEGF receptor 3 (VEGFR-3) and their correlation with intratumoural lymphatic density (ILD) and peritumoural lymphatic density (PLD) in metastatic and non-metastatic lower lip squamous cell carcinoma (LLSCC). Twenty-five LLSCC with regional nodal metastasis and 25 LLSCC without metastasis were selected. The percentages of VEGF-C and VEGFR-3 staining in each tumour core and at the deep invasive front were assessed. PLD and ILD were determined using anti-podoplanin antibody. Immunohistochemical findings were correlated with nodal metastasis, clinical staging, local recurrence, clinical outcome, and histological grade. Cytoplasmic immunoexpression of VEGFR-3 in the tumour core was associated with metastasis (P=0.009), patient death (P=0.008), and histological grade (P<0.005). PLD, ILD, and VEGF-C expression showed no significant associations with clinicopathological parameters (P>0.05). PLD and ILD were not significantly correlated with the immunoexpression of VEGF-C or VEGFR-3 (P>0.05). There was a significant positive correlation between PLD and ILD (P=0.004), and between cytoplasmic immunoreactivity of VEGF-C and VEGFR-3 (P=0.011). These results suggest an important role for VEGFR-3 in the progression of LLSCC, and highlight the possible influence of its expression on the prognosis of these tumours. ILD and PLD may not be associated with lymph node metastasis in LLSCC.

Heart rate variability during 6-min walk test in adults aged 40 years and older.

We evaluated age- and sex-dependent differences in heart rate variability (HRV) during the 6-min walk test (6MWT) in healthy adults. We also evaluated the intensity of the 6MWT based on HRV. 78 participants aged 40-49, 50-59, 60-69, and ≥ 70 years (42 females; 36 men) performed the 6MWT. Heart rate and HRV were monitored 1 min at rest and during the last 2-min of the test. The root mean square (RMSSD), instantaneous beat-to-beat variability (SD1), and long-term standard deviation (SD2) of RR intervals were calculated. The SD1 <3 ms at the end of the 6MWT was defined as high-intensity exercise. Despite the significantly higher peak values of heart rate observed for women, we did not find sex- and age-related differences in HRV during the 6MWT. The ROC curve identified percentage of maximum heart rate >67% as the best cut-point for prediction of high-intensity exercise with 94% of sensitivity and 65% of specificity (area under the curve=0.804). We may conclude that autonomic modulation of heart rate during exercise was not dependent of age and sex. The HRV assessment during walking enables a valid estimation of exercise intensity in adults. We may therefore suggest the use of 6MWT for assessing exercise capacity and for prescribing exercises in adults aged 40 yrs and older.

Proteína C-reactiva ultrasensible en pacientes con y sinperiodontitis crónica severa generalizada / Ultra-sensible C-reactive protein in patients with and without chronic severe generalized periodontitis

Introducción: La proteína C-reactiva ultrasensible (PCR-US) constituye un mediador inflamatorio utilizado como predictor del riesgo cardiovascular que viene siendo investigado como factor indicativo de la relación entre enfermedades cardiovasculares y periodontales. Este trabajo tuvo como objetivo comparar los niveles séricos de proteína C-reactiva entre pacientes con y sin periodontitiscrónica severa generalizada. Material y métodos: Se realizó un estudio seccional, utilizando una muestra de 60 pacientes, siendo29 participantes con enfermedad periodontal (Grupo I) y 31 sin enfermedad (Grupo II). Como criterios de inclusión fueron seleccionados pacientes con diagnóstico de periodontitis crónica severa generalizada. La investigación constó de dos etapas, clínica y bioquímica. La clínica consistió en el examen periodontal y la bioquímica en la recogida de sangre para determinación de los niveles de PCR-US y un hemograma. Resultados: El grupo con enfermedad periodontal presentó una media de 0,36 mg/dl, mientras el sin enfermedad de 0,17 mg/dl (p=0,061). El riesgo cardiovascular para el grupo I fue clasificado como alto para 27,6% de los participantes y bajo para 72,4%. En el grupo II, 6,45% presentaban alto riesgo y 93,5% bajo riesgo, siendo esa relación estadísticamente significativa obtenida por el test de Fisher (p=0,042), presentando uno OR=5,33; IC95% (1,02-27,4). Las variables interventores investigadas no presentaron asociación estadísticamente significativa con los niveles de PCR-US. Conclusión: EL estudio indicó que pacientes portadores de periodontitis crónica severa generalizada no presentaron niveles séricos de PCR-US estadísticamente diferente de los pacientes sin enfermedad. La periodontitis actuó como factor asociado para la elevación de los niveles de la PCR-US, aunque con frágil asociación (AU)

Introduction: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. This work had the purpose of compare sericlevels of C-reactive protein between patients with and without chronic severe generalized periodontitis. Material and methods: A cross-sectional study was realized using a sample with 60 patients, being29 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II). As inclusion criteria were selected patients with diagnosis of chronic severe generalized periodontitis. The research consisted of two stages, clinc and biochemical. The stage was constituted of periodontal examination and the biochemist stage, of the blood collection for determination hsCRP levels and a hemogram. Results: Periodontal disease group presented a average of 0,36 mg/dL, while the group without disease presented 0,17 mg/Dl (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high riske 93,5% low risk, being this relation significant statistically gotten for Fisher’s Test (p = 0,042)presenting OR = 5,33; IC = 95% (1,02–27,4). The independents variables researched do not presented significant statistically association with the levels of hsCRP. Conclusion: The study indicated that despite of carriers patients of periodontal diseases do not present differents seric levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP levels elevation (AU)