Prevalence and screening of active tuberculosis in a prison in the South of Brazil.

SETTING: Tuberculosis (TB) remains a challenge in Brazil, particularly among prison inmates. OBJECTIVE: To assess TB prevalence by active case finding in a public prison in southern Brazil. DESIGN: Prison inmates were screened for TB using the presence of cough and chest X-ray (CXR) from October 2014 to August 2016. Presence of cough, irrespective of duration, and abnormal CXRs were further investigated using laboratory tests. RESULTS: Of 10 326 inmates screened, 196 had confirmed TB (1898/100 000 inmates screened). At the first screening, 1759 inmates presented with cough only, 16 of whom had TB; among those with only abnormal CXR (n = 1273), 92 had TB. Xpert was positive in 155 patients, and negative in 15; these results were confirmed using culture. The remaining 26 patients did not undergo Xpert testing and were confirmed using microscopy (27%), culture (42%) or both (31%). CONCLUSION: The combined use of symptom screening (cough) and CXR was much more effective in maximising TB yield than using either method alone. If patients presenting with cough alone had not been investigated, 10% of TB patients would have been missed; if those with abnormal CXR but no cough had not been investigated, 51% of TB patients would have been missed. We detected high TB prevalence in this prison by using active case finding.

How detrimental are seed galls to their hosts? Plant performance, germination, developmental instability and tolerance to herbivory in Inga laurina, a leguminous tree.

Gall inducers use these structures as shelters and sources of nutrition. Consequently, they cause multiple physiological changes in host plants. We studied the impact caused by seed coat galls of a braconid wasp on the performance of fruits, seeds and seedlings of tree Inga laurina. We tested whether these seed galls are 'nutrient sinks' with respect to the fruit/seed of host plant, and so constrain the reproductive ability and reduce seedling longevity. We measured the influence of such galls on the secondary compounds, fruit and seed parameters, seed viability and germination and seedling performance. Inga laurina has indehiscent legumes with polyembryonic seeds surrounded by a fleshy sarcotesta rich in sugars. The galls formed inside the seed coat and galled tissues presented higher phenol concentrations, around 7-fold that of ungalled tissues. Galls caused a significant reduction in parameters such as fruit and seed size, seed weight and the number of embryos. Fluctuating asymmetry (a stress indicator) was 31% higher in leaves of galled seed plants in comparison to ungalled seed plants. However, the negative effects on fruit and seed parameters were not sufficient to reduce seed germination (except the synchronization index) or seedling performance (except leaf area and chlorophyll content). We attributed these results to the ability of I. laurina to tolerate gall attack on seeds without a marked influence on seedling performance. Moreover, because of the intensity of seed galling on host plant, we suggest that polyembryony may play a role in I. laurina reproduction increasing tolerance to seed damage.

Accuracy assessment of the axial images obtained from cone beam computed tomography.

OBJECTIVE: The aim of this study was to evaluate accuracy of linear measurements assessed from axial tomograms and the influence of the use of different protocols in two cone beam CT (CBCT) units. METHODS: A cylinder object consisting of Nylon® (Day Brazil, Sao Paulo, Brazil) with radiopaque markers was radiographically examined applying different protocols from NewTom 3G(TM) (Quantitative Radiology s.r.l, Verona, Veneto, Italy) and i-CAT(TM) (Imaging Sciences International, Hatfield, PA) units. Horizontal (A-B) and vertical (C-D) distances were assessed from axial tomograms and measured using a digital calliper that provided the gold standard for actual values. RESULTS: There were differences when considering acquisition protocols to each CBCT unit. Concerning all analysed protocols from i-CAT(TM) and Newtom 3G(TM), both A-B and C-D distances presented underestimated values. Measurements of the axial images obtained from NewTom 3G(TM) (6 inch 0.16 mm and 9 inch 0.25 mm) were similar to the ones obtained from i-CAT(TM) (13 cm 20 s 0.3 mm, 13 cm 20 s 0.4 mm and 13 cm 40 s 0.25 mm). CONCLUSION: The use of different protocols from CBCT machines influences linear measurements assessed from axial images. Linear distances were underestimated in both equipments. Our findings suggest that the best protocol for the i-CAT(TM) is 13 cm 20 s 0.3 mm and for the NewTom 3G(TM), the use of 6 inch or 9 inch is recommended.

Substance P regulates the expression of matrix metalloproteinases and tissue inhibitors of metalloproteinase in cultured human gingival fibroblasts.

BACKGROUND AND OBJECTIVE: Substance P may play a role in the pathogenesis of periodontal disease; however, its mechanisms of modulation are not clear. This study evaluated the effect of two concentrations of Substance P on the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in cultured human gingival fibroblasts. MATERIAL AND METHODS: Fibroblasts were stimulated for 48 h with 10(-4) or 10(-9) m Substance P; untreated fibroblasts served as controls. The expression of MMP-1, -2, -3, -7 and -11 and of TIMP-1 and -2 was evaluated using real-time polymerase chain reaction and western blotting. RESULTS: There was a significant, concentration-dependent stimulatory effect of Substance P on MMP-1, -2, -3 and -7 and TIMP-2 gene expression (p < 0.05), and a probable effect on MMP-11 (p = 0.06). At the higher concentration (10(-4) m Substance P), MMP-1, -2, -3, -7 and -11 and TIMP-2 showed the greatest up-regulation; at the lower concentration (10(-9) m Substance P), MMP-1, -3 and -7 and TIMP-2 exhibited diminished up-regulation, with MMP-2 and -11 showing down-regulation (p < 0.05). Expression of TIMP-1 was not affected by Substance P (p > 0.05). Western blotting confirmed that Substance P up-regulated MMP-1, -2, -3 and -11 and TIMP-2. MMP-1, -3 and -11 and TIMP-2 showed greater up-regulation at the higher Substance P concentration and diminished up-regulation at the lower concentration. MMP-2 was up-regulated to a similar degree at both Substance P concentrations. CONCLUSION: In gingival fibroblast cells, Substance P at the higher concentration (10(-4) m) induced greater up-regulation of MMP-1, -3 and -11 and TIMP-2 expression, but at the lower concentration (10(-9) m) induced diminished up-regulation, which may represent a mechanism for modulating periodontal breakdown.

Idiopathic bone cavity: a clinical, radiographic, and histological study.

The aim of the present study was to evaluate the clinical, radiographic and histological characteristics of idiopathic bone cavities from the Oral Pathology archives at Universidade Federal de Minas Gerais. Forty-three cases were retrieved. Age, sex, some radiographic variables and morphological variables measured of the connective tissue, were studied. The results showed the men who developed cavities tended to be younger than women (median 16 years (range 11-48) compared with 18 (12-64)). Radiographically rounded lesions that were single, unilocular, and small were more common in younger patients. While rounded cavities occurred mainly in the anterior region, cavities with interdental scalloping occurred in the posterior area. The median age of the patients with thin connective tissue on the wall of the bony cavity was lower than that of those with a thicker lining. In conclusion, the present study shows that there is a significant relation between age and sex, radiographic and histological variables. These findings may contribute to the diagnosis of idiopathic bone cavities.

Cytokeratins in epithelia of odontogenic neoplasms.

Neoplasms and tumours related to the odontogenic apparatus may be composed only of epithelial tissue or epithelial tissue associated with odontogenic ectomesenchyme. The immunohistochemical detection of different cytokeratins (CKs) polypeptides and vimentin has made it easier to explain the histogenesis of many epithelial diseases. The present study aimed to describe the immunohistochemical expression of cytokeratins 7, 8, 10, 13, 14, 18, 19 and vimentin in the epithelial components of the dental germ and of five types of odontogenic tumours. The results were compared and histogenesis discussed. All cells of the dental germ were positive for CK14, except for the preameloblasts and secreting ameloblasts, in which CK14 was gradually replaced by CK19. CK7 was especially expressed in the cells of the Hertwig root sheath and the stellate reticulum. The dental lamina was the only structure to express CK13. The reduced epithelium of the enamel organ contained CK14 and occasionally CK13. Cells similar to the stellate reticulum, present in the ameloblastoma and in the ameloblastic fibroma, were positive for CK13, which indicates a nature other than that of the stellate reticulum of the normal dental germ. The expression of CK14 and the ultrastructural aspects of the adenomatoid odontogenic tumour probably indicated its origin in the reduced dental epithelium. Calcifying odontogenic epithelial tumour is thought to be composed of primordial cells due to the expression of vimentin. Odontomas exhibited an immunohistochemical profile similar to that of the dental germ. In conclusion, the typical IF of odontogenic epithelium was CK14, while CK8, 10 and 18 were absent. Cytokeratins 13 and 19 labelled squamous differentiation or epithelial cells near the surface epithelium, and CK7 had variable expression.

Salivary duct carcinoma: cytokeratin 14 as a marker of in-situ intraductal growth.

AIMS: The aim of this study was to determine the immunoprofile of salivary duct carcinoma and to differentiate intraductal growth from invasive growth. METHODS AND RESULTS: We applied a panel of antibodies (cytokeratins 7, 8, 13, 14, 19, vimentin and alpha-smooth muscle actin) in five cases of salivary duct carcinoma. This panel is currently used for identification of different components of salivary gland tumours in our laboratory. All tumour cells were positive for cytokeratins 7 and 8. Few neoplastic structures expressed cytokeratin 14 in cells surrounding tumour islands. CONCLUSION: The finding of cytokeratin 14 was important to confirm the in-situ intraductal growth, which probably characterizes this low-grade neoplasm.

Severe oral manifestations of chronic graft-vs.-host disease.

BACKGROUND: Graft-vs.-host-disease, or GVHD, is the main cause of morbidity in patients who have received bone marrow transplants. Chronic GVHD, or cGVHD, occurs 100 days or more after the transplant procedure and may take the form of various oral manifestations. CASE DESCRIPTION: A 23-year-old woman received an allogeneic bone marrow transplant. Although prophylactic therapy was provided, the patient developed cGVHD. Appropriate therapy was initiated, and it received a good clinical response at all sites affected by cGVHD, except in the oral cavity. The patient received complete symptomatic relief through revised systemic therapy, improved oral hygiene, use of topical medications and a monitored diet. CLINICAL IMPLICATIONS: Effective intervention by dentists is an important part of increasing treatment effectiveness and improving quality of life in patients who received bone marrow transplants.

Immunohistochemical aspects of basal cell adenoma and canalicular adenoma of salivary glands.

Basal cell adenoma is a benign epithelial neoplasm with a uniform histologic appearance dominated by basaloid cells. Those cells may be distributed in various arrangements as solid, trabecular, tubular and membranous. Canalicular adenoma is also a benign neoplasm composed by columnar cells arranged in branching and interconnecting cords of single or double cell thick rows. There is some disagreement among investigators about whether canalicular adenoma should be included within the basal cell adenoma histologic spectrum. In the present study we compared the expression of cytokeratins (CK), vimentin and muscle-specific actin, utilizing immunohistochemical technique, in three cases diagnosed as basal cell adenomas predominantly of the solid type, and three cases of canalicular adenomas. The results obtained showed a distinct immunoprofile for both neoplasms. Solid areas of basal cell adenomas did not stain for any of the tested antibodies; only when there was tubular differentiation, those structures expressed CKs 7, 8, 14, and 19 in luminal cells and vimentin in non-luminal cells. On the other hand, canalicular adenomas strongly expressed CKs 7 and 13. The panel of antibodies utilized supports the separation of the two entities.

Application of immunohistochemistry to the diagnosis of salivary gland tumors.

A panel of antibodies composed of the cytokeratins (CKs), vimentin, and actin was applied to 114 minor salivary gland tumors to evaluate its diagnostic value. The results revealed that luminal cells of intercalated duct-like structures, such as those seen in pleomorphic adenoma, basal cell adenoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma, expressed CKs 7, 8, 14, and 19. The outer cells of these structures exhibited vimentin or vimentin plus muscle-specific actin, but rarely CK14, which is seen particularly in pleomorphic adenoma, in the tubular type of basal cell adenoma, and seldom in the tubular type of adenoid cystic carcinoma. Modified myoepithelial cells of pleomorphic adenoma and myoepithelioma exhibited a variable immunoprofile. CKs 7 and 8 were also observed in acinar cell adenocarcinoma and polymorphous low-grade adenocarcinoma with vimentin in the latter. CK13 was expressed only by canalicular adenoma and mucoepidermoid carcinoma cells. This study showed that the panel of antibodies employed is effective in distinguishing among salivary gland tumors.

Immunohistochemical Mdm2 expression in minor salivary gland tumours and its relationship to p53 gene status.

Mdm2 protein is a cellular regulator of p53 protein activity. Minor salivary gland tumours were investigated for immunohistochemical expression of Mdm2 protein and for p53 gene status. Formalin-fixed sections were submitted to monoclonal antibody anti-Mdm2 through use of the streptavidin-biotin method. Nuclear immunoreactivity was scored 1 (0-25% nuclei positive), 2 (26-50%), 3 (51-75%) and 4 (> 75%). The scores found were: PLGA = 1-4; ACC = 3 and 4; ACA = 2 and 4; PA = 3. Genomic DNA of p53 gene exons 5-8 was examined by polymerase chain reaction and no alterations were detected. The strong immunohistochemical Mdm2 expression may represent an alternative mechanism to the development of salivary gland tumours.

Basal cell adenocarcinoma of the palate with squamous metaplasia.

Basal cell adenocarcinoma is a rare salivary gland tumour, especially in minor glands. The clinical, histological, and immunohistochemical features of a case involving the palate are described. Formalin fixed, paraffin embedded sections of the tumour were examined in haematoxylin and eosin (H&E) sections and also using immunostaining for cytokeratins 7, 8, 13, 14, 18, 19, vimentin, muscle specific actin (HHF35), and laminin. H&E sections showed that the tumour was composed mainly of basaloid cells and a striking feature was the presence of squamous metaplasia. Neural invasion was also conspicuous. Immunohistochemical reactions indicated that cytokeratin 14 was expressed by all tumour cells and vimentin by all cells except those in the areas of squamous metaplasia. The remaining cytokeratins and actin were present in some of the tumour cells, while laminin showed discreet positivity around cell arrangements. The foci of squamous metaplasia and the immunohistochemical findings are helpful in distinguishing basal cell adenocarcinoma from other salivary gland tumours which show basaloid cells.

Diagnosis of HIV infection using saliva samples: comparative study between adults and children.

The use of saliva samples to detect the anti-HIV antibody has been described recently as an interesting alternative in relation to blood samples. We have analyzed 172 saliva samples from HIV positive and negative patients assisted at CASP, 108 of them adults and 64 children, in order to assess the specificity and sensitivity of the GACELISA test. A specificity was found of 85% and 80% respectively for the adult and children groups and sensitivity of 97.7% and 100% respectively for the adult and children groups. The statistical analysis revealed no differences in specificity and in sensitivity between these groups. We concluded that GACELISA test is useful for children.

PCNA/AgNOR and Ki-67/AgNOR double staining in oral squamous cell carcinoma.

This study was performed on oral squamous cell carcinomas (OSCC) in order to investigate the relation between the number of interphase silver-stained nucleolar organizer regions (AgNORs) and the immunolabeling of proliferation-associated markers, using antibodies to Ki-67 and proliferating cell nuclear antigen (PCNA). Fifteen consecutive cases of oral squamous cell carcinoma were used and a double staining technique was performed in order to quantify the number of NORs in PCNA-positive and -negative cells as well as in Ki-67-positive and -negative cells. Our results showed a higher mean number of AgNORs in PCNA- and Ki-67-positive cells than in PCNA- and Ki-67-negative cells. We concluded that there is an association between cell proliferation and AgNOR score in OSCC.

Nickel determination in saline matrices by ICP-AES after sorption on Amberlite XAD-2 loaded with PAN.

In the present paper, a solid phase extraction system for separation and preconcentration of nickel (ng g(-1)) in saline matrices is proposed. It is based on the adsorption of nickel(II) ions onto an Amberlite XAD-2 resin loaded with 1-(2-pyridylazo)-2-naphthol (PAN) reagent. Parameters such as the pH effect on the nickel extraction, the effect of flow rate and sample volume on the extraction, the sorption capacity of the loaded resin, the nickel desorption from the resin and the analytical characteristics of the procedure were studied. The results demonstrate that nickel(II) ions, in the concentration range 0.10-275 microg l(-1), and pH 6.0-11.5, contained in a sample volume of 25-250 ml, can be extracted by using 1 g Amberlite XAD-2 resin loaded with PAN reagent. The adsorbed nickel was eluted from the resin by using 5 ml 1 M hydrochloric acid solution. The extractor system has a sorption capacity of 1.87 mumol nickel per g of Amberlite XAD-2 resin loaded with PAN. The precision of the method, evaluated as the R.S.D. obtained after analyzing a series of seven replicates, was 3.9% for nickel in a concentration of 0.20 microg ml(-1). The proposed procedure was used for nickel determination in alkaline salts of analytical grade and table salt, using an inductively coupled plasma atomic emission spectroscopy technique (ICP-AES). The standard addition technique was used and the recoveries obtained revealed that the proposed procedure shows good accuracy.

Proliferative activity in peripheral ossifying fibroma and ossifying fibroma.

A proliferative activity study analysing morphometric and quantitative aspects of nucleolar organizer regions (NORs) and proliferating cell nuclear antigen (PCNA) expression was conducted in 10 cases of peripheral ossifying fibroma (POF) and 10 cases of ossifying fibroma (OF). For NOR identification, the silver staining technique (AgNOR technique) was used. PCNA expression was determined by immunohistochemical staining using the PC10 antibody. The AgNOR analysis for the two lesions showed a profile characteristic of benign lesions. OF showed higher AgNOR number and PCNA expression than POF. Our results suggest increased proliferative activity in OF compared with POF.

p53 In biopsies of oral squamous cell carcinoma. A comparative study with a malignancy grading system.

The relationship between the histological grading of malignancy and p53 protein expression was studied in 40 biopsies of oral squamous cell carcinomas. An immunohistochemical analysis was carried out using the streptavidin method preceded by a treatment with citric acid in a microwave oven. All cases were classified according to the histological malignancy grading system proposed by Anneroth et al. (Scandinavian Journal of Dental Research 1987, 95, 229-249). The expression of p53 was found in 62.5% of the carcinomas studied. Positivity of p53 staining showed a correlation with the histological grade of malignancy and with the degree of keratinisation, nuclear polymorphism and number of mitoses.

Immunohistochemical study of linear gingival erythema from HIV-positive patients.

Severe forms of periodontal disease are frequent in patients with acquired immunodeficiency syndrome (AIDS). Linear gingival erythema (LGE) is a progressive disease described in HIV-positive patients and is considered to be an early stage of necrotizing periodontitis. Although clinical and microbiological differences are reported in LGE and non-specific gingivitis (NSG), a comparative immunopathological approach of both has not been performed yet. The purpose of this study was to compare relative populations of T-lymphocytes, B-lymphocytes, neutrophils, macrophages and IgG bearing plasma cells in gingival biopsies from sites exhibiting LGE and from sites exhibiting NSG. A biotin-streptavidin amplified system was used for identification of the following antigens: CD3 (T-lymphocytes), CD20 (B-lymphocytes), elastase (neutrophils), CD68 (macrophages) and IgG (plasma cell's secretors of IgG). The results have demonstrated decrease proportions of T-lymphocytes, macrophages and high percentage of neutrophils and IgG bearing plasma cells in LGE. In contrast with NSG, many neutrophils cells in LGE were found inside oral gingival epithelium. Our results highlight the idea that progressive periodontal disease is not only characterized by increased tissue inflammation, but, in addition, by significant changes in the proportion of specific inflammatory cells. The high number of neutrophils along the gingival epithelium is probably associated with the severe gingival necrosis reported in AIDS patients.

Minor salivary gland tumours. A retrospective study of 164 cases in a Brazilian population.

One hundred and sixty-four cases of intraoral salivary gland tumours retrieved from the files of the Surgical Oral Pathology laboratory of the University of São Paulo (Brazil), between 1970 and 1993, were studied. Of these, 164 tumours, 62% were classified as benign and 38% malignant. The palate was the main site of occurrence of the tumours followed by the buccal mucosa and upper lip. There was a slight predominance for female patients, with a female to male ratio of 1.3:1. The mean age for benign tumours was 39.9 years (40.8 for females, and 39.7 for males). For malignant tumours the mean age was 43.5 years (42.6 for females and 44.7 for males). Pleomorphic adenoma was the most common of the benign tumours, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma were the most common malignant tumours. In general, benign tumours presented as an asymptomatic nodule. On the other hand, pain, ulceration and radiographic changes were more frequently associated with malignant lesions.