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Metástase é o crescimento de células cancerígenas em sítios distantes do órgão de onde se originaram, e a sua ocorrência indica um prognóstico ruim. Em cavidade oral são raras. Podem ocorrer nos tecidos moles, nos maxilares ou em ambos, e são de expressiva importância clínica, pois indicam um estágio disseminado de um câncer, e podem ser o único sintoma de uma malignidade subjacente ainda não diagnosticada. Desse modo, é essencial que o cirurgião-dentista esteja familiarizado com o aspecto clínico e achados radiográficos mais associados a essa patologia. O objetivo desta revisão narrativa de literatura é compilar os principais aspectos sobre as metástases orais para a atuação do clínico. A patogenia das metástases para a cavidade oral é complexa e não totalmente compreendida. Os sítios primários mais frequentes são o câncer de mama, para as metástases nos ossos maxilares; e o câncer de pulmão, para os depósitos nos tecidos moles orais. As regiões orais mais acometidas são a área posterior de mandíbula e a gengiva. As metástases em osso são mais prevalentes do que em tecidos moles. De maneira geral, os homens são mais acometidos, especialmente na quinta a sétima década de vida, e o aspecto clínico das metástases é variável, lembrando lesões inflamatórias ou hiperplásicas, mas com crescimento rápido. Os achados radiográficos são inespecíficos, e podem apresentar características como osso "roído por traças" e aumento irregular dos espaços da membrana periodontal. Conclui-se com essa revisão que é fundamental que o cirurgião-dentista conheça e inclua lesões metastáticas no diagnóstico diferencial das patologias orais, tendo em vista o seu grau elevado de relevância clínica.
Metastasis is the growth of cancer cells in sites distant from the organ from which they originated, and its occurrence indicates a poor prognosis. In the oral cavity they are rare. They can occur in the soft tissues, jaws or both, and are of significant clinical importance, as they indicate a disseminated stage of cancer, and may be the only symptom of an underlying malignancy that has not yet been diagnosed. Therefore, it is essential that the dental surgeon is familiar with the clinical aspect and radiographic findings most associated with this pathology. The aim of this narrative literature review is to compile the main aspects about oral metastases for the clinician's work. The pathogenesis of metastases to the oral cavity is complex and not fully understood. The most frequent primary sites are breast cancer, for metastases in the jaw bones; and lung cancer, for deposits in oral soft tissues. The most affected oral regions are the posterior area of the jaw and the gingival tissue. Metastases in bone are more prevalent than in soft tissues. In general, men are more affected, especially in the fifth to seventh decade of life, and the clinical appearance of metastases is variable, resembling inflammatory or hyperplastic lesions, but with rapid growth. Radiographic findings are nonspecific and may present characteristics such as "moth-eaten" bone and irregular increase in periodontal membrane spaces. This review concludes that it is essential for the dentist to know and include metastatic lesions in the differential diagnosis of oral pathologies, given their high degree of clinical relevance.
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Patologia Bucal , Neoplasias Bucais , Diagnóstico Diferencial , Metástase NeoplásicaRESUMO
Introduction: The incidence of breast cancer has risen in Chile, along with the complexity of diagnosis. For accurate diagnosis, it is necessary to complement the morphology assessed with hematoxylin and eosin with additional techniques to evaluate specific tumor markers. Evaluating the impact on costs, time, and productivity of automated techniques integrated with digital pathology solutions is crucial. Objectives: To estimate the impact on costs, time, and productivity of incorporating the automation of the HER2 in situ hybridization technique combined with integrative digital pathology (IDP) in breast cancer diagnosis in a Chilean public provider versus a manual technique. Methods: This economic evaluation adopted a health economics multi-method approach. A decision model was developed to represent the current manual fluorescence in situ hybridization (FISH) scenario versus an automated dual in situ hybridization (DISH) plus IDP in breast cancer diagnosis. Business process management (BPM) methodology was applied for capturing working time and latencies, in combination with a time-driven activity-based costing (TDABC) methodology for estimating direct, total, and average cost (2023 USD) for both scenarios for the following vectors: Human resources, supplies, and equipment, sorted by pre-analytical, analytical, and post-analytical phases. Indirect costs (2023 USD) were also retrieved. Both BPM and TDABC served to estimate labor productivity. Results: In the baseline scenario based on manual FISH, the turnaround time (TAT) was estimated at 1259â¯min, at an average total cost of $265.67, considering direct and indirect costs for all phases. An average of 20.5 FISH reports were submitted per pathologist monthly during the baseline. The automated DISH plus IDP scenario consumed 203â¯min per biopsy, at an average total cost of $231.08, considering direct and indirect costs for all phases; it also showed an average of 22.8 submitted reports per pathologist monthly. This represents a decrease of 13.02% in average total costs, an 83.86% decrease in TAT, and an average labor productivity increase of 11.29%. Conclusions: The incorporation of automated DISH plus IDP in the pathology department of this public provider has resulted in reductions in the time required to perform the in situ hybridization technique, a decrease in total costs, and increased productivity. Particular attention should be given to adopting new technologies to accelerate processing times and workflow.
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Southern right whales (Eubalaena australis) are mysticete cetaceans commonly observed in the coastal waters of Brazil, particularly in Santa Catarina State. There is limited understanding of the causes of calf mortality in this species, particularly concerning infectious diseases. We report a case of omphalophlebitis caused by Streptococcus equi subsp. zooepidemicus (S. zooepidemicus) that led to septicemia in a Southern right whale calf. Gross examination revealed an incompletely healed umbilicus with fibrin deposition and amorphous yellow material present in the lumen of the umbilical vein on the cut surface. The main histopathological findings showed fibrinosuppurative omphalophlebitis with numerous coccoid basophilic bacterial aggregates. These aggregates were also observed in the lamina propria, submucosa, and muscular layers of the small intestine and uterus, as well as in the interstitium of the kidneys and within blood vessels of the skin, skeletal muscle, heart, and ovaries. Tissue samples taken from the umbilicus and uterus were inoculated on 5% sheep blood agar and MacConkey agar. Small, transparent colonies that exhibited complete hemolysis were identified on blood agar. Gram staining revealed the presence of Gram-positive cocci arranged in chains. The bacterial isolate was analyzed using the MALDI-TOF technique, which confirmed its identity as S. zooepidemicus. The presence of S. equi antigen in the extra-umbilical aggregates was confirmed through immunohistochemistry. These findings underscore the significance of streptococcal infections in cetaceans and contribute valuable data regarding calf mortality in baleen whales. Furthermore, we provide new insights into the understanding of marine ecosystem health markers.
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Infecções Estreptocócicas , Streptococcus equi , Animais , Infecções Estreptocócicas/veterinária , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/patologia , Streptococcus equi/isolamento & purificação , Baleias/microbiologia , Sepse/veterinária , Sepse/microbiologia , Sepse/patologia , Feminino , BrasilRESUMO
Fibrous dysplasia (FD) is a benign tumor condition in which normal bone is replaced by structurally deficient fibrous lamellar bone. It represents approximately 5-7% of benign bone tumors and occurs in two presentations: monostotic, which is the most common, and polyostotic. The proximal femur is one of the most common locations for benign tumors, including FD. Fractures in pathological terrain are often the first symptom. In the context of a proximal femur fracture with a benign tumor, the indications for carrying out a total femoral resection are: multiple lesions in the femur or primary diaphyseal tumors, lesions that extend proximally and distally to exceed the epimetaphyseal junction area, and those that do not allow the joint to be adequately preserved. Currently, proximal or total femoral resection is considered a good therapeutic option to carry out endoprosthetic replacement using modular megaprosthetic systems. We present the case of a 27-year-old male patient, who came to the emergency department with a basicervical fracture of the right femur in Garden II Pauwells III AO 31B2.3r pathological terrain, after presenting a low-energy injury mechanism characterized by axial loading with rotational component of the right hip. This patient has a history of intralesional resection, application of bone graft and prophylactic fixation using unspecified osteosynthesis material in the pertrochanteric region 20 years ago; the biopsy would later show DF; the osteosynthesis material was subsequently removed one year later. Due to the characteristics of the fracture and as a definitive and curative therapeutic method, it was decided to carry out wide resection of the proximal femur and total hip arthroplasty with a modular prosthesis with cerclage placement, as well as taking an excisional biopsy that would later corroborate that it was the same FD treated in childhood.
La displasia fibrosa (DF) es una condición tumoral benigna en la que el hueso normal es reemplazado por hueso laminar fibro-óseo estructuralmente deficiente. Representa aproximadamente 5-7% de los tumores benignos óseos y ocurre en dos presentaciones: monostótica, que es la más frecuente, y poliostótica. El fémur proximal es una de las localizaciones más comunes de tumores benignos, incluida la DF. Las fracturas en terreno patológico son en muchas ocasiones el primer síntoma. En el contexto de fractura de fémur proximal con tumoración benigna, las indicaciones para llevar a cabo una resección femoral total son: múltiples lesiones en fémur o tumores diafisarios primarios, lesiones que se extienden por proximal y distal hasta sobrepasar la zona de unión epimetafisaria y aquellos que no permiten preservar la articulación de manera adecuada. Actualmente se considera como una buena opción terapéutica la resección femoral proximal o total para llevar a cabo un reemplazo endoprotésico mediante sistemas megaprotésicos modulares. Presentamos el caso de un paciente masculino de 27 años, quien acude a servicio de urgencias con una fractura basicervical de fémur derecho en terreno patológico Garden II Pauwells III AO 31B2.3r, posterior a presentar mecanismo de lesión de baja energía caracterizado por carga axial con componente rotacional de la cadera derecha. Dicho paciente cuenta con el antecedente de resección intralesional, aplicación de injerto óseo y fijación profiláctica mediante material de osteosíntesis no especificado en región pertrocantérea 20 años atrás; la toma de biopsia más tarde arrojaría DF; un año después se llevó a cabo retiro del material de osteosíntesis. Debido a las características de la fractura y como método terapéutico definitivo y curativo, se decide llevar a cabo resección amplia de fémur proximal y artroplastía total de cadera con prótesis modular con colocación de cerclaje, así como toma de biopsia escisional que más tarde corroboraría que se trataba de la misma DF tratada en la infancia.
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Artroplastia de Quadril , Fraturas do Fêmur , Displasia Fibrosa Óssea , Humanos , Masculino , Artroplastia de Quadril/métodos , Displasia Fibrosa Óssea/cirurgia , Displasia Fibrosa Óssea/complicações , Fraturas do Fêmur/cirurgia , Fraturas do Fêmur/etiologia , Adulto , Fraturas Espontâneas/cirurgia , Fraturas Espontâneas/etiologiaRESUMO
Pomacea canaliculata is a highly successful invasive snail that shapes freshwater communities in both native and invaded habitats. We studied its digenean parasites from three freshwater bodies in its native distribution area in Buenos Aires Province, Argentina. An integrated approach was used to determine and describe the larval stages of digenean, including morphological, molecular, and histopathology analyses. We provide the first record of P. canaliculata as the first intermediate host of Stomylotrema vicarium (Stomylotrematidae), two species of the family Phaneropsolidae, and one species of the family Cyclocoelidae. This is also the first record of a species of the family Cyclocoelidae parasitizing snails of the genus Pomacea, with the apple snail acting as both the first and second intermediate host. The digestive gland was identified as the target organ of infection for all species. Stomylotrema vicarium and Phaneropsolidae gen. et sp. 2 alter the structure of the gonads, causing indirect parasitic castration, and, through mechanical compression, destroying also the digestive gland. Adequate knowledge of the identity and dynamics of the parasites affecting P. canaliculata in its native range and the damage they cause is key to explaining the success of this invasive species. The lack of parasite records in invaded areas supports the "enemy release" hypothesis, which could explain the apple snail's success in these environments. Parasitic castration reduces the reproductive potential of hosts, limiting the expansion and competition of invasive species, making it crucial to understand these impacts for their conservation and control.
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A osteonecrose dos maxilares induzida por medicamentos (MRONJ) caracteriza-se por exposição óssea ou osso que pode ser sondado através de fístula intra ou extraoral, em região maxilofacial, e que não cicatriza dentro de oito semanas. A MRONJ é uma condição rara e debilitante que pode causar dor, disfagia e odor desagradável na cavidade oral, afetando pacientes com histórico ou sob uso contínuo de terapia antirreabsortiva, isolada ou associada a imunomoduladores ou drogas antiangiogênicas, mas sem histórico de radioterapia nos maxilares. O objetivo desta revisão narrativa de literatura é compilar os principais aspectos sobre a etiopatogenia da MRONJ e as opções terapêuticas disponíveis. A etiologia da MRONJ é multifatorial, complexa, e não está totalmente compreendida, não havendo um tratamento definitivo, mas diversas modalidades terapêuticas que visam o controle da dor e da progressão da osteonecrose. Conclui-se com essa revisão que o entendimento da etiopatogenia da MRONJ pelo cirurgião-dentista lhe permite adotar medidas preventivas, bem como o conhecimento das modalidades terapêuticas disponíveis lhe possibilita oferecer o manejo adequado para seu paciente, conforme o estágio da doença.
Medication-related osteonecrosis of the jaw (MRONJ) is characterized by exposed bone or bone that can be probed through an intra or extraoral fistula, in the maxillofacial region, which does not heal within eight weeks. MRONJ is a rare and debilitating condition that can cause pain, dysphagia and unpleasant odor in the oral cavity, affecting patients with a history or continuous use of antiresorptive therapy, alone or associated with immunomodulators or antiangiogenic drugs, but without a history of radiotherapy to the jaws. The aim of this narrative literature review is to compile the main aspects about the etiopathogenesis of MRONJ and the available therapeutic options. The etiology of MRONJ is multifactorial, complex, and is not fully understood, with no definitive treatment, but several therapeutic modalities that aim to control pain and the progression of osteonecrosis. It is concluded from this review that the understanding of the etiopathogenesis of MRONJ by the dental surgeon allows him to adopt preventive measures, as well as the knowledge of the therapeutic modalities available allows him to offer the appropriate management for his patient, depending on the stage of the disease.
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Osteonecrose , Patologia Bucal , Terapêutica , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Ácido Zoledrônico , Arcada OsseodentáriaRESUMO
This review explores the current understanding and management of penile squamous cell carcinoma, emphasizing recent advances in molecular pathology and treatment strategies. The article discusses the importance of human papillomavirus status in tumor classification and prognosis, highlighting the 2022 WHO classification. The article underscores the need for a multidisciplinary approach to penile cancer management and identifies areas for future research, including refining molecular classification systems and developing predictive biomarkers. It concludes by emphasizing the rapid evolution of penile cancer management and the potential for more personalized treatment strategies.
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Biomarcadores Tumorais , Carcinoma de Células Escamosas , Infecções por Papillomavirus , Neoplasias Penianas , Humanos , Neoplasias Penianas/patologia , Neoplasias Penianas/classificação , Neoplasias Penianas/genética , Neoplasias Penianas/diagnóstico , Masculino , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/classificação , Carcinoma de Células Escamosas/diagnóstico , Biomarcadores Tumorais/genética , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/diagnóstico , Prognóstico , Patologia Molecular/métodosRESUMO
INTRODUCTION: Solitary fibrous tumor (SFT) is a fibroblastic neoplasm of uncertain biological origin that is rare in the tongue. CASE REPORT: A 42-year-old woman presented with a painless, submucosal nodule in the tongue. Based on the clinical hypothesis of benign mesenchymal neoplasia, the lesion was excised, and the specimen was submitted for histopathological analysis. Microscopically, a proliferation of spindle cells with a patternless arrangement was observed, separated by dilated and angulated vascular spaces. Immunohistochemical analysis revealed positivity for CD34, CD99, Bcl-2, Ki-67 (< 5%), and negativity for S-100. Additionally, the tumor cells showed a positive nuclear reaction for STAT6. The diagnosis was a solitary fibrous tumor. CONCLUSIONS: This report presents a case of SFT in the tongue, emphasizing its clinicopathological, microscopic, and immunohistochemical features.
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Tumores Fibrosos Solitários , Neoplasias da Língua , Humanos , Tumores Fibrosos Solitários/patologia , Feminino , Adulto , Neoplasias da Língua/patologia , Biomarcadores Tumorais/análiseRESUMO
Manatees are semi-social animals, with the mother-calf relationship being considered long-lasting for the species. However, some events lead to the separation of this pair. Orphaned manatee calves can be adopted by other females of the same species. However, if this does not happen and a healthy calf strand is rescued, immediate release represents the best option for the individual. But when immediate release becomes unviable, the animals are taken to rehabilitation centers and can die from various causes. A newborn Antillean manatee was rescued in the north of Brazil, and the attempt at immediate release was unsuccessful; three months later, the animal died. At necropsy, it was observed that the brain was soft and friable, collapsing when placed on a surface, with the corpus callosum region able to be ruptured easily and the cerebral hemispheres lying flaccid. The analysis of serial sections of the brain showed dilated lateral ventricles and a reduction in white matter, making it possible to affirm the presence of congenital hydrocephalus, the main factor that may have led to the abandonment of the offspring.
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Small cell osteosarcoma (SCOS) is a rare variant of conventional osteosarcoma, characterized by tumor cells of small size and uniform morphology, which can lead to diagnostic confusion with other small cell tumors, requiring a detailed diagnostic approach. The manifestation in a child adds a degree of complexity, as the management of malignant tumours in paediatric patients requires specific considerations to minimize the long-term side effects of oncological treatment and preserve the structural and functional development of the orofacial region. This report concerns an 8-year-old female patient referred to the Oral and Maxillofacial Surgery outpatient clinic with progressive swelling in the right maxillofacial region, initially asymptomatic, but progressing to pain and difficulty chewing. A cone beam computed tomography scan was requested and an incisional biopsy was carried out for histopathological and immunohistochemical analysis, which confirmed the pathological entity. The lesion was then completely resected with a safety margin and the affected area removed to restore functionality and aesthetics. The surgical specimen was sent for further histopathological analysis, which confirmed the diagnosis of SCOS. Detailed immunohistochemical analysis was crucial to the diagnosis, and a comprehensive surgical approach was indicated given the aggressive behavior of the lesion. This report emphasizes the importance of an integrated multidisciplinary approach, combining oncology, pathology and oral and maxillofacial surgery.
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Neoplasias Maxilares , Osteossarcoma , Humanos , Feminino , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Osteossarcoma/diagnóstico , Criança , Neoplasias Maxilares/patologia , Neoplasias Maxilares/cirurgia , Neoplasias Maxilares/diagnóstico , Tomografia Computadorizada de Feixe Cônico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/cirurgiaRESUMO
Objective: Understanding the relationship between genetic structure and the molecular changes involved in endometrial cancer (EC) provides an opportunity to personalize treatments and incorporate targeted therapies. Method: We compared cytogenetic and molecular features observed in tumoral and adjacent healthy tissue endometrium samples in EC patients. Results: Non-clonal chromosome aberrations (NCCAs) frequently in patients with EC, especially in 10,15,17,22, X chromosomes and were monitored in 73.7%, clonal chromosomal alterations were observed in 26.3% of the patients. Down POLE gene expression in 42.1%, up p53gene expression in 57.9%, PTEN down-regulation in 47.3%, down ARID1A gene expression in 42.1%, PIK3CA up-regulation was observed in 68% of patients. Conclusion: The up-regulation of tumor suppressor genes in our study shows that not only these genes are involved but also different pathways and factors play a role in tumorigenesis. Furthermore, an increased number of NCCAs shows an essential role in the development of ECs.
Objetivo: Comprender la relación entre la estructura genética y los cambios moleculares involucrados en el cáncer de endometrio brinda la oportunidad de personalizar los tratamientos e incorporar terapias dirigidas. Método: Comparamos las características citogenéticas y moleculares observadas en muestras de endometrio de tejido sano tumoral y adyacente en pacientes con cáncer de endometrio. Resultados: Las aberraciones cromosómicas no clonales (NCCA) son frecuentes en pacientes con cáncer de endometrio, especialmente en los cromosomas 10, 15, 17, 22, X y fueron monitoreadas en el 73,7%; se observaron alteraciones cromosómicas clonales en el 26,3% de las pacientes. Disminución de la expresión del gen POLE en el 42,1 %, aumento de la expresión del gen p53 en el 57,9%, disminución de la regulación de PTEN en el 47,3 %, disminución de la expresión del gen ARID1A en el 42,1%, aumento de la expresión de PIK3CA en el 68% de los pacientes. Conclusión: La regulación positiva de los genes supresores de tumores en nuestro estudio muestra que no solo estos genes están involucrados, sino que diferentes vías y factores juegan un papel en la tumorigénesis. Además, un mayor número de NCCA muestra un papel esencial en el desarrollo de cánceres de endometrio.
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BACKGROUND: Eccrine porocarcinoma (EPC) is a rare cutaneous neoplasm, commonly arising from its benign counterpart, eccrine poroma (EP), but potential unrevealed clinicopathological differences between them are not well understood. OBJECTIVES: This study aimed to identify clinicopathological features of EP and EPC and describe the factors that may be associated with the malignant transformation of EP by comparing the two groups. METHODS: A total of 37 cases of EP and 22 cases of EPC diagnosed between January 2017 and June 2023 were retrospectively reviewed, and the clinical and histopathological characteristics were compared using statistical methods. RESULTS: Clinical and histopathologic data such as age, gender, site, clinical presentation, and histopathologic characteristics were collected. The EPC group was more common in older patients, with more cases located in exposed areas, and the patients with EPC had larger lesions with a higher incidence of ulceration. Histopathological features showed significant differences in tumor architecture, ulceration, squamous differentiation, spindle cell changes, central necrosis, and diffuse inflammatory infiltration between the two groups. STUDY LIMITATIONS: This study has limitations due to a small number of cases with potential experimental bias. CONCLUSION: The clinicopathological features of EP and EPC were compared in this study and the results may assist clinicians in diagnosis and management of these tumors by helping to identify potential factors associated with the malignant transformation of EP.
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PURPOSE: This report aims to present an interdisciplinary approach to diagnosing and treating a case of Common Variable Immunodeficiency (CVID), an inborn error of immunity, resulting in successive complications following a third molar extraction procedure. CASE PRESENTATION: The patient, a 37-year-old Caucasian female, sought a specialist for the extraction of an impacted lower third molar associated with dentigerous cyst. Due to the possibility of mandibular fracture, a bone fixation system was used in the region. However, she experienced recurrent infections following the procedure despite various treatments and hospitalizations, and these infections could not be explained by any factors. The diagnosis of CVID was established through exclusionary factors, low immunoglobulin levels, and comprehensive allergy assessments by an immunologist. Resolution of the patient's condition and discharge were achieved only after removing the fixation system and implementing monthly immunoglobulin infusions. CONCLUSION: CVID is often diagnosed late, resulting in significant economic, social, and health burdens, including recurrent hospitalizations, allergies, and increased risk of malignancy. This case underscores the importance of considering CVID in patients presenting with unexplained recurrent infections following oral and maxillofacial surgeries. Additionally, it highlights the necessity of a multidisciplinary approach for effectively managing patients with CVID.
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Imunodeficiência de Variável Comum , Dente Serotino , Extração Dentária , Humanos , Imunodeficiência de Variável Comum/complicações , Imunodeficiência de Variável Comum/diagnóstico , Feminino , Adulto , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Dente Impactado/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/etiologiaRESUMO
BACKGROUND: Despite recent advancements, women still encounter significant challenges in various fields, including dentistry. However, the increasing interest in female participation in science acknowledges its fundamental role in the advancement of knowledge. This study aims to assess indicators of women's involvement in Brazilian research in the areas of Oral Pathology and Oral Medicine. METHODS: This cross-sectional study evaluated 197 professionals affiliated with the Brazilian Society of Stomatology and Oral Pathology in 2023. Data were collected from publicly available Lattes curriculum and organized into three sets of information: researcher profile, scientific production and human resources formation. Both the data from the researcher's entire career and from the last 5 years (2019-2023) were assessed separately. Descriptive analyses of categorical variables were performed, while the Mann-Whitney test was employed to compare the numerical variables regarding researchers' gender. RESULTS: Of 197 professionals, 117 (59.4%) were female. Although there was no significant difference in scientific production between genders, men had more publications, received approximately twice as many citations, and exhibited higher H-index values compared to women. Notably, women surpassed men in undergraduate student supervision, while men predominated in supervising master's and PhD students. CONCLUSIONS: This study highlighted the relevance of female participation in Oral Pathology and Oral Medicine research in Brazil. However, disparities persist regarding women participation, especially in scientific article citations and postgraduate students' supervision.
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Glanders is a zoonotic disease of equids caused by the bacterium Burkholderia mallei, responsible for considerable economic loss. This study aimed to describe the clinical manifestations, pathological findings, and also bacteriological and molecular methods for agent detection in naturally infected animals (16 adult horses and one fetus) detected by serological survey from three glanders outbreaks. Of the 16 horses, 6 (37.5%) did not show clinical signs. After necropsy,samples of organs, lymph nodes, lesions and secretions were collectedfor histopathology, bacterial isolation, and PCR. The clinical and gross alterations mainly comprised nasal and respiratory forms in the three outbreaks, and less of the cutaneous form. All tested animals were positive by PCR (100%, n=17) on at least one sample. Of 121 samples analyzed 8.2% (10/121) isolated B. mallei and 41.3% (50/121) were polymerase chain reaction (PCR) positive. This work highlights the importance of combining diagnostic techniques, such as histopathology microbiological culture and PCR,to confirm cases and characterize the morbidity of glanders as well as considering seropositive animals without glanders clinical signs as potential carrier animals affecting disease control programmes.
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Hybrid carcinomas (HC) are the association of two or more malignant neoplasms arising within the same topographical area. The present study is a systematic review of HC of the salivary glands. This study aimed to assess HC clinicopathological features and molecular profile. Observational studies, case series, and case reports were included. PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched until June 2024. A total of 18 articles including 34 patients were included. HC of the salivary glands is presented as a painless mass affecting mainly the parotid gland of adults with a preference for male patients. Histologically, adenoid cystic carcinoma and epithelial-myoepithelial carcinoma were the most prevalent association, being surgical excision with radiotherapy the most common treatment. The most aggressive component, even when representing only a small proportion of the tumor, should guide the patient's treatment. Further molecular studies are necessary to determine if HC are distinct entities or biologically identical to the individual neoplasms. In conclusion, this systematic review may contribute to a better understanding of this rare lesion, their biological behavior, treatments employed, and the outcome of these patients.
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PREMISE: The soils in lowland tropics are teeming with microbial life, which can impact plant community structure and diversity through plant-soil feedbacks. While bacteria and fungi have been the focus of most studies in the tropics, oomycetes may have an outsized effect on seed and seedling health and survival, given their affinity for moister, warmer environments. METHODS: We assessed the diversity and pathogenicity of oomycete species present in a lowland tropical forest in Panama. We used a culture-dependent leaf-baiting assay and culture-independent soil DNA metabarcoding methods to quantify zoospore abundance and species diversity. A subset of the isolates from the baiting assay were used to evaluate pathogenicity and symptom severity on seedlings of three tree species. RESULTS: Oomycetes were ubiquitous and common members of the soil microbial community in lowland tropical forests, and zoospore abundance was far greater compared to similar studies from temperate and mediterranean forests. The various oomycete species also varied in the ability to infect host plants. Species of Pythium were more virulent, while species of Phytopythium caused less severe symptoms but were more diverse and commonly isolated from the soil. Finally, we found that individual hosts accumulated a distinct oomycete community and was the only factor that had an effect on community structure. CONCLUSIONS: Collectively, these findings demonstrate that oomycetes are ubiquitous, host-generalist pathogens and saprophytes, that can impact seed and seedling survival in lowland tropical forests.
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Florestas , Oomicetos , Plântula , Sementes , Microbiologia do Solo , Clima Tropical , Plântula/microbiologia , Sementes/microbiologia , Oomicetos/fisiologia , Oomicetos/patogenicidade , Panamá , Doenças das Plantas/microbiologiaRESUMO
Background: Breast cancer occupies first place in mortality by neoplasms in women in Mexico; mammography screening (MS) interpreted by BI-RADS (Breast Imaging-Reporting and Data System), allows suspicion of malignancy, which will be confirmed when having the histopathological result (HPR). Objective: o evaluate whether suspicious findings for breast cancer in MS are associated with malignant HPR in women aged ≥ 40 years. Material and methods: Observational, analytical, cross-sectional, prolective study. Patients aged ≥ 40 years, with MS with BI-RADS 4a, 4b, 4c and 5, and RHP of sample obtained by Trucut, excisional or ultrasound-guided biopsy were analyzed. Sociodemographic, anthropometric, clinical variables, BI-RADS classification and HPR variables were recorded. Results: 148 patients were included, median age 53 years; these were stratified into BI-RADS 4a, BI-RADS 4b, BI-RADS 4c and BI-RADS 5. Suspicious findings of malignancy due to MS were associated with HPR. MS BI-RADS 4c, palpable lesion and late menopause were identified as risk factors for malignant HPR; as well as MS BI-RADS 5 and palpable lesión. Conclusion: MS with suspicious findings of malignancy is associated with the malignant HPR obtained by biopsy.
Introducción: el cáncer de mama ocupa el primer lugar en mortalidad por neoplasias en mujeres en México; el tamizaje mastográfico (TM) interpretado mediante BI-RADS (Breast Imaging-Reporting and Data System) permite sospechar de malignidad, la cual se confirmará al contar con el resultado histopatológico (RHP). Objetivo: evaluar si los hallazgos sospechosos de cáncer de mama en el TM se asocian al RHP maligno en mujeres de edad ≥ 40 años. Material y métodos: estudio observacional, analítico, transversal, prolectivo. Se analizaron pacientes de edad ≥ 40 años, con TM con BI-RADS 4a, 4b, 4c y 5, y, RHP de muestra obtenida mediante biopsia Trucut, excisional o guiada por ultrasonido. Se registraron variables sociodemográficas, antropométricas, clínicas, clasificación BI-RADS y RHP. Resultados: se incluyeron 148 pacientes, mediana de edad de 53 años; se estratificaron en BI-RADS 4a, BI-RADS 4b, BI-RADS 4c y BI-RADS 5. Los hallazgos sospechosos de malignidad por TM se asociaron con el RHP. Se identificaron como factores de riesgo para RHP maligno, TM BI-RADS 4c, lesión palpable y menopausia tardía; así como, TM BI-RADS 5 y lesión palpable. Conclusión: el TM con hallazgos sospechosos de malignidad se asocia con el RHP maligno obtenido por biopsia.
Assuntos
Neoplasias da Mama , Mamografia , Humanos , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico , Adulto , Idoso , Estudos Prospectivos , México , Biópsia , Fatores de RiscoRESUMO
BACKGROUND: In voice clinics, vocal effort is a prevalent complaint, with around 25% of clinicians citing it as the primary issue. AIM: This study had two objectives. First, it sought to establish the prevalence of vocal effort, both as the primary and the only symptom, among patients receiving treatment from clinicians specializing in voice disorders in various countries across South and North America. Second, this study aimed to distinguish key factors, including country of clinical practice, clinicians' experience, and the instruments employed to assess effort, associated with the identification of vocal effort. METHODS: This cross-sectional study surveyed speech-language pathologists (SLPs) from North and South America on vocal effort in patients. The survey covered SLP demographics, caseload composition, patient challenges, and measures of vocal effort that were used. Statistical analysis assessed relationships between SLP demographics, caseload, and vocal effort factors. RESULTS AND CONCLUSION: The results suggest significant geographical variations in SLPs' experiences with vocal effort. Colombian clinicians report significantly fewer voice cases and a lower proportion of vocal effort in their caseload, while Argentinian clinicians were more likely to report vocal effort in their voice cases. Years of experience were identified as a significant predictor of a higher likelihood of a voice-dominant caseload and higher rates of vocal effort among patients. Interestingly, using the Vocal Fatigue Index during the assessments increased the likelihood of reporting vocal effort in the clinicians' caseload. These findings suggest a potential association between experience, outcome measure selection, and vocal effort caseload. These lead to suggestions that opportunities for additional voice disorder training beyond that which SLPs find in school are valuable.