Association between Epstein-Barr Virus and Oral Carcinoma: A Systematic Review with Meta-Analysis.

The purpose of this meta-analysis is to evaluate the association of Epstein-Barr virus (EBV) with oral squamous cell carcinoma (OSCC). We searched the electronic scientific databases of PubMed and Scopus and included a total of 53 studies that were published from 1990 to 2019. The analysis yielded a 45.37% (95% confidence interval [CI]: 38.90-51.84; p < 0.001) overall pooled prevalence of EBV. Studies that used the applied methods of in situ hybridization, polymerase chain reaction, immunology, or RNA microarray showed the following pooled prevalence: 46.08%, 40.32, 54.97%, and 74.89%, respectively. EBV-infected individuals have a 2.5 higher risk for developing OSCC (odds ratio: 2.57; 95% CI: 1.23% to 5.36%; p < 0.001). The present meta-analysis supports the hypothesis of EBV association with OSCC, pointing to this virus as a risk factor for neoplasia. Our findings also suggest that EBV latent transcripts (latent membrane protein 1, EBV nuclear antigen 1 and 2, and EBV-encoded small RNAs) have an important role in this process. Furthermore, novel advancements could arise from large and standardized studies that are constructed to probe for other latent gene expression, eliminate confounding factors (tobacco, alcohol, and high-risk human papillomavirus infection), and define the relationship between EBV and oral carcinomas.

Manifestação clínica de peritonite em pacientes que vivem com insuficiência renal crônica / Clinical signs of peritonitis in patients living with chronic renal failure

INTRODUÇÃO: A diálise peritoneal é uma alternativa segura e eficaz no tratamento de pacientes com insuficiência renal crônica terminal. Desde a introdução da diálise peritoneal, a peritonite tem sido a principal complicação dessa técnica. OBJETIVO: Analisar a frequência da peritonite num centro de hemodiálise, situado no sertão da Paraíba, de 2005 a 2010. MÉTODOS: Realizou-se a análise retrospectiva dos prontuários de 25 pacientes em diálise peritoneal na referida clínica de diálise. RESULTADOS: A população foi predominantemente masculina (76%), de cor branca (80%), com idade média de 65,88 anos. O diabetes mellitus foi a doença de base mais frequente (36%), seguida de hipertensão arterial sistêmica (32%), glomerulopatias (12%), entre outras (20%). Apenas um paciente iniciou a terapia renal substitutiva por diálise peritoneal. Em 92% dos casos, o motivo de conversão para diálise peritoneal foi a exaustão de acesso vascular para hemodiálise. A média do tempo em diálise foi de 26,4 meses. A frequência geral de peritonite foi 88%. Do total, três estavam em tratamento, dois (8%) receberam alta, três (12%) foram transferidos para hemodiálise e 17 (68%) evoluíram a óbito. CONCLUSÃO: A minoria dos pacientes não apresentou peritonite. O modo inadequado da escolha de pacientes para diálise peritoneal e a falha na realização da técnica estão associados a maiores chances de ocorrência de peritonite. O estudo permitiu caracterizar uma população em diálise peritoneal ambulatorial contínua, possibilitando melhor planejamento do cuidado para evitar infecções.

INTRODUCTION: Peritoneal dialysis is a safe and effective alternative treatment for patients with terminal chronic renal failure. Since the introduction of peritoneal dialysis, peritonitis has been the main complication of this technique. OBJECTIVE: To analyze the frequency of peritonitis in a hemodialysis center, located in the countryside of Paraíba, in Brazil, from 2005 to 2010. METHODS: A retrospective analysis of medical records from 25 peritoneal dialysis patients in the clinic for dialysis was carried out. RESULTS: The population was predominantly male (76%), white (80%), with a mean age of 65.88 years-old. Diabetes mellitus was the most frequent basis disease (36%), followed by systemic arterial hypertension (32%), glomerulopathies (12%), among others (20%). Only one patient started on renal replacement therapy for peritoneal dialysis. In 92% of the cases, the reason of conversion for peritoneal dialysis was exhaustion of vascular access for hemodialysis. The average time on dialysis was 26.4 months. The general frequency of peritonitis was 88%. Of all, three patients were under treatment, two (8%) were discharged, three (12%) were transferred to hemodialysis, and 17 (68%) died. CONCLUSION: The minor part of the patients did not present peritonitis during the period. The inappropriate way of patients' choice for dialysis peritoneal and the flaw in the accomplishment of the technique are associated with larger chances of peritonitis occurrence. The study characterized a population in continuous ambulatory peritoneal dialysis, enabling better planning of care to avoid infections.