Oral squamous cell carcinoma arising from areas of Graft-versus-host disease: A systematic review.

BACKGROUND: Graft-versus-host disease (GVHD) is an immune system reaction that occurs in patients with a history of hematopoietic stem cell transplantation (HSCT), in which the grafted donor's cells attack those of the host. The objective of this systematic review was to present a study on oral squamous cell carcinoma (OSSC) that developed from GVHD areas in patients undergoing HSCT. MATERIAL AND METHODS: An electronic search was conducted in the databases PUBMED, WEB OF SCIENCE, SCOPUS, MEDLINE and SCIENCE DIRECT, according to PRISMA guidelines. RESULTS: Of the 1582 results, 23 articles were included, resulting in 81 cases. The most common underlying disease for performing the transplant was Myeloid Leukemia (55.6%). The mean age was 39 years, with a predilection for males (64.2%). The tongue was the site of GVHD that most frequently underwent transformation to SCC (59.3%). The average time between transplantation and the development of GVHD was of approximately of 8 months, while the average period of development between transplantation and the development of OSCC was of approximately of 111 months. The most common treatment to GVHD was cyclosporine associated with corticosteroids. CONCLUSIONS: OSCCs arising from areas of GVHD present a different evolution from conventional oral carcinomas, since they affect younger patients, smoking and alcohol are not important etiological factors and finally because they present good prognosis, but further studies with larger number cases followed are needed to confirm our findings.

Immuno-oncology in head and neck squamous cell carcinoma - a narrative review

Immuno-oncology studies the immune system in cancer. In recent decades, immunotherapy has shown a good response to the treatment of various locally advanced and metastatic cancers. The main mechanisms of action include stimulation of the patient's own immune system to enhance immune responses acting in tumor escape pathways. This review examined the literature related to immune system mechanisms in head and neck squamous cell carcinoma (HNSCC) and their application in immunotherapy using biomarkers. The PUBMED, LILACS, MEDLINE, WHOLIS, and SCIELO databases were searched using the terms squamous cell carcinoma, head and neck, immuno-oncology, immunotherapy, and immunology. The main drugs currently available for clinical use in patients diagnosed with HNSCC include pembrolizumab and nivolumab, both classified as check-point inhibitors. These immunobiological agents improve patient survival and quality of life. Many authors and clinical trials point out that the recommendation of these agents is linked to the dose of PD-L1 (ligand expressed primarily by tumor cells), which proved to be an unreliable biomarker in the patient selection. Recommendation of immunotherapy depends on reliable biomarkers that must be identified in order to achieve good therapeutic results.

Precisely dating the Frasnian-Famennian boundary: implications for the cause of the Late Devonian mass extinction.

The Frasnian-Famennian boundary records one of the most catastrophic mass extinctions of the Phanerozoic Eon. Several possible causes for this extinction have been suggested, including extra-terrestrial impacts and large-scale volcanism. However, linking the extinction with these potential causes is hindered by the lack of precise dating of either the extinction or volcanic/impact events. In this study, a bentonite layer in uppermost-Frasnian sediments from Steinbruch Schmidt (Germany) is re-analysed using CA-ID-TIMS U-Pb zircon geochronology in order to constrain the date of the Frasnian-Famennian extinction. A new age of 372.36 ± 0.053 Ma is determined for this bentonite, confirming a date no older than 372.4 Ma for the Frasnian-Famennian boundary, which can be further constrained to 371.93-371.78 Ma using a pre-existing Late Devonian age model. This age is consistent with previous dates, but is significantly more precise. When compared with published ages of the Siljan impact crater and basalts produced by large-scale volcanism, there is no apparent correlation between the extinction and either phenomenon, not clearly supporting them as a direct cause for the Frasnian-Famennian event. This result highlights an urgent need for further Late Devonian geochronological and chemostratigraphic work to better understand the cause(s) of this extinction.

Helminth extracts inhibit eosinophilic inflammation in a murine model of allergic rhinitis

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Efficacy of cognitive behavioral therapy in reducing psychiatric symptoms in patients with implantable cardioverter defibrillator: an integrative review

This article is a systematic review of the available literature on the benefits that cognitive behavioral therapy (CBT) offers patients with implanted cardioverter defibrillators (ICDs) and confirms its effectiveness. After receiving the device, some patients fear that it will malfunction, or they remain in a constant state of tension due to sudden electrical discharges and develop symptoms of anxiety and depression. A search with the key words “anxiety”, “depression”, “implantable cardioverter”, “cognitive behavioral therapy” and “psychotherapy” was carried out. The search was conducted in early January 2013. Sources for the search were ISI Web of Knowledge, PubMed, and PsycINFO. A total of 224 articles were retrieved: 155 from PubMed, 69 from ISI Web of Knowledge. Of these, 16 were written in a foreign language and 47 were duplicates, leaving 161 references for analysis of the abstracts. A total of 19 articles were eliminated after analysis of the abstracts, 13 were eliminated after full-text reading, and 11 articles were selected for the review. The collection of articles for literature review covered studies conducted over a period of 13 years (1998-2011), and, according to methodological design, there were 1 cross-sectional study, 1 prospective observational study, 2 clinical trials, 4 case-control studies, and 3 case studies. The criterion used for selection of the 11 articles was the effectiveness of the intervention of CBT to decrease anxiety and depression in patients with ICD, expressed as a ratio. The research indicated that CBT has been effective in the treatment of ICD patients with depressive and anxiety symptoms. Research also showed that young women represented a risk group, for which further study is needed. Because the number of references on this theme was small, further studies should be carried out.

Spatial patterns of a tropical tree species growing under an eucalyptus plantation in South-East Brazil / Padrões espaciais de uma espécie arbórea tropical crescendo sob o dossel de um plantio de eucalipto no Sudeste brasileiro

The objectives of this study were to evaluate the influence of propagules source and the implication of tree size class on the spatial pattern of Xylopia brasiliensis Spreng. individuals growing under the canopy of an experimental plantation of eucalyptus. To this end, all individuals of Xylopia brasiliensis with diameter at soil height (dsh) > 1 cm were mapped in the understory of a 3.16 ha Eucalyptus spp. and Corymbia spp. plantation, located in the municipality of Lavras, SE Brazil. The largest nearby mature tree of X. brasiliensis was considered as the propagules source. Linear regressions were used to assess the influence of the distance of propagules source on the population parameters (density, basal area and height). The spatial pattern of trees was assessed through the Ripley K function. The overall pattern showed that the propagules source distance had strong influence over spatial distribution of trees, mainly the small ones, indicating that the closer the distance from the propagules source, the higher the tree density and the lower the mean tree height. The population showed different spatial distribution patterns according to the spatial scale and diameter class considered. While small trees tended to be aggregated up to around 80 m, the largest individuals were randomly distributed in the area. A plausible explanation for observed patterns might be limited seed rain and intra-population competition.

Os objetivos deste estudo foram avaliar a influência da fonte de propágulo e a implicação de diferentes classes de tamanho sobre o padrão de distribuição espacial de indivíduos de Xylopia brasiliensis Spreng. crescendo sob o dossel de um plantio experimental de eucalipto. Para isso, todos os indivíduos de X. brasiliensis com diâmetro à altura do solo (das) > 1 cm foram mapeados em uma área de 3,16 ha no sub-bosque de um plantio de Eucalyptus ssp. e Corymbia spp., localizado no município de Lavras, MG. O maior e mais próximo indivíduo reprodutivo de X. brasiliensis foi considerado como fonte de propágulos. Foram utilizadas regressões lineares para avaliar a influência da fonte de propágulos sobre parâmetro populacionais (densidade, área basal e altura). O padrão de distribuição espacial das árvores foi avaliado por meio da função K de Ripley. O padrão geral demonstrou que a distância da fonte de propágulo teve forte influência sobre a distribuição espacial das árvores, principalmente as menores, indicando que quanto mais próximo à fonte de propágulos, maior a densidade e menor a altura das árvores. A população demonstrou diferentes distribuições espaciais de acordo com a escala analisada. Enquanto árvores menores tenderam a estar agregadas até uma escala de 80 m, os maiores indivíduos estavam aleatoriamente distribuídos na área. Uma explicação plausível para os padrões observados poderia ser a limitação espacial da chuva de sementes e a competição intraespecífica.

Bone markers after total body irradiation in childhood.

Total body irradiation (TBI) can cause short stature because of decreased growth hormone (GH) and skeletal abnormalities. To evaluate the plasma concentrations of markers of bone formation (osteocalcin and procollagen type 1 amino-terminal propeptide, P1NP) and resorption (carboxy-terminal telopeptide, CTX), in patients (n=65) who had been given TBI at 6.6+/-0.4 years were evaluated at 9.8+/-0.4 years. Patients given single 10 Gy or fractionated 12 Gy TBI had similar characteristics, except that plasma insulin-like growth factor (IGF-1) was lower in those given a single 10 Gy. Seven had lower osteocalcin and two had higher CTX than controls. Bone markers (as zs) were positively correlated (osteocalcin with P1NP, rho=0.42, P=0.0007; osteocalcin with CTX, rho=0.3, P<0.02), but not P1NP with CTX. Plasma osteocalcin and CTX were also positively correlated with plasma IGF-1, but not with growth rate during the first year on GH (n=28). Adult height was -2.5+/-0.2 s.d.s. (n=49). Those irradiated when young (P=0.0002) or given single TBI lost more height between TBI and adult height. Most TBI patients had normal bone formation and resorption markers. Thus, impaired bone turnover is probably not the cause of their short stature and poor response to GH.

Final height and gonad function after total body irradiation during childhood.

Short stature and gonad failure can be a side effect of total body irradiation (TBI). The purpose of the study was to evaluate the factors influencing final height and gonad function after TBI. Fifty young adults given TBI during childhood were included. Twenty-seven had been treated with growth hormone (GH). Those given single 10 Grays (Gy) or fractionated 12 Gy TBI had similar characteristics, GH peaks, final heights and gonad function. After the end of GH treatment, 11/20 patients evaluated had GH peak >10 microg/l. Final height was <-2s.d. in 29 (58%). The height loss between TBI and final height (2.4+/-1.1 s.d.) was greater in those who were younger when irradiated (P<0.0001). When the GH-treated and -untreated patients were analyzed separately, this loss was correlated with the age at TBI at 4-8 years for the GH-treated and at 6-8 years for the untreated. Boys showed negative correlations between testicular volume and plasma follicle-stimulating hormone (FSH, P=0.0008) and between plasma FSH and inhibin B (P=0.005) concentrations. We concluded that the indications for GH treatment should be mainly based on the age at irradiation, taking into account the GH peak. The plasma FSH and inhibin B concentrations may predict sperm function.

[Central precocious puberty in girls: prediction of the etiology]. / Pubertés précoces centrales des filles: prédiction de l'étiologie.

Precocious puberty (PP) is defined in girls by the occurrence of pubertal development before the age of 8. This development raises 3 questions: 1) Is it abnormal puberty or variant of the normal? 2) If abnormal puberty, is it of central, hypothalamic-pituitary, or peripheral, ovarian or adrenal origin? 3) If central, is it idiopathic or due to a lesion, and is there indication to treat it? The PP in a girl with no previous medical history is usually of central and idiopathic origin. However, isolated central PP may reveal a CNS lesion, particularly an optic glioma with its risk of blindness. Two independent predictors of CNS lesion are the age at PP onset of less than 6 years old, and increased plasma estradiol concentration. The selection of the girls for neuroradiological imaging should be based on these two parameters. However, neuroradiological imaging remains necessary until the prospective confirmation of their predictive value.

The coronary circulation of the pig heart: comparison with the human heart

Over the last decades, the pig has been chosenas a feasible animal organ donor for the humanspecies, namely regarding heart transplantation.This has led to the development of transgenicpigs with the goal of avoiding the rejectioncaused by xenotransplantation. It istherefore pertinent to characterize in detail thevascular anatomy of the pig heart and compareit with that of humans. In this study, 23 heartsfrom domestic pigs were subjected to two differentanatomical techniques (resin vascularcasting and injection/dissection with contrastsuspension) in order to visualize their coronarycirculation. After defining the arterial distributionand anastomoses of the branches of thecoronary arteries of the pig, these features werecompared with well-established descriptions ofthe coronary circulation in human hearts. Themain contributions of this work are: (i) newfeatures of the coronary vessels of the pig heartare documented; (ii) there is close resemblancein the architecture of the coronary arteries betweenthe pig and humans; (iii) the frequencyof anatomical variation in the arrangement ofthe coronary arteries is lower in the pig than inhumans (AU)

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Detailed arrangement of the bronchial arteries in the Wistar rat: a study using vascular injection and scanning electron microscopy / Disposición detallada de las arterias bronquiales en la rata wistar: estudio que emplea la inyección vascular y microscopía electrónica de barrido

We have used vascular castings, light microscopy coupled with tracers, and scanning electron microscopy to define the detailed anatomy of the bronchial arteries in the Wistar rat, a rodent often used in experimental research on lung disorders; namely in those that involve vascular alterations. We found that there are two bronchial arteries in the Wistar rat and that they have a cranial origin, either from the subclavian arteries or from their primary branches. The left bronchial artery was always originated from the internal thoracic artery, ran between the thoracic aorta and the left cranial vena cava and offered branches to the thymus, trachea and esophagus. The right bronchial artery was of variable origin, and was located between the right cranial vena cava and the trachea; it gave off branches to the right cranial vena cava, phrenic nerve, trachea, esophagus and, seldomly, to the mediastinic-pericardial pleura, myocardium and caudal vena cava. In more than half of the rats, there were anastomoses between the bronchial and pulmonary arteries. The histological organization of rat bronchial arteries was different from those of humans, suggesting that there are differences in the resistance to blood flow between the two species. Scanning electron microscopy revealed that the bronchial arteries formed two plexuses surrounding the intrapulmonary airways and also supplied the vasa vasorum of pulmonary arteries and veins. We conclude that there are important differences in the arrangement and structure between bronchial arteries in humans and rats and that this should be taken into account whenever data from experimental studies are to be extended to human (AU)

Hemos usado piezas vasculares, microscopía óptica acoplada con trazadores y microscopía electrónica de barrido para definir la anatomía detallada de las arterias bronquiales en la rata Wistar, un roedor frecuentemente empleado en la investigación experimental sobre disfunciones pulmonares; es decir, en aquellas que implican alteraciones vasculares. Observamos que existen dos arterias bronquiales en la rata Wistar y que son de origen craneal, bien de las arterias subclavias o de sus ramas primarias. La arteria bronquial izquierda siempre se originaba a partir de la arteria torácica interna, recorría una trayectoria entre la aorta torácica y la vena cava craneal izquierda, y mandaba ramas al timo, a la tráquea y al esófago. La arteria bronquial derecha era de origen variable y estaba localizada entre la vena cava craneal derecha y la tráquea; emitía ramas hacia la vena cava craneal derecha, el nervio frénico, la tráquea, el esófago y, aunque raras veces, a la pleura mediastínica-pericardial, el miocardio y la vena cava caudal. En más de la mitad de los animales, se apreciaron anastomosis entre las arterias bronquiales y las pulmonares. La organización histológica de las arterias bronquiales de la rata difería de la de los humanos, sugiriendo que existen diferencias en la resistencia al flujo sanguíneo entre las dos especies. La microscopía electrónica de barrido reveló que las arterias bronquiales forman dos plexos que rodeaban a las vías aéreas intrapulmonares, y también suministraban los vasa vasorum de las arterias y venas pulmonares. Se deduce que existen diferencias importantes en disposición y estructura entre las arterias bronquiales en los humanos y en las ratas y que esto ha de tenerse en cuenta cuando han de extenderse datos procedentes de las ratas a los humanos. (AU)

Primórdios da velha Faculdade de Medicina e Cirurgia de Säo Paulo / The origin of the old Faculdade de Medicina e Cirurgia de Säo Paulo

Conferência proferida no 70º aniversário da Faculdade de Medicina da Universidade de Säo Paulo, a 15 de dezembro de 1982, reunindo, de forma sintética, numa só exposiçäo, os trabalhos esparsos publicados sobre a história da Faculdade de Medicina e Cirurgia de Säo Paulo, no septuagésimo aniversário da sua fundaçäo.(MAM)