Antônio Luiz Amaral Pereira

Changes in immunoexpression of E-cadherin and β-catenin in oral squamous cell carcinoma with and without nodal metastasis

The aim of this study is to analyze the immunohistochemical expression of E-cadherin and beta-catenin in oral squamous cell carcinoma to better understand the biological behavior of this lesion. The sample consisted of 15 cases of the tongue and 15 of the lower lip. The pattern and intensity of the labeling and the analysis of the percentage of tumor cells immunopositive in membrane for E-cadherin and beta-catenin were related to the anatomic location of the lesion, the presence or absence of nodal metastasis, and the histological gradation of malignancy in the tumor invasion front. The presence or absence of cytoplasmic and nuclear labeling was also recorded. The membrane expression for E-cadherin and beta-catenin predominately displayed a heterogeneous pattern in the carcinomas studied. No significant difference was observed between the expression pattern and the quantity of cells immunopositive for E-cadherin and beta-catenin and the anatomic location of the lesion or the presence or absence of nodal metastasis. However, a statistically significant difference was found between the reduced expressio\n of these proteins and the high malignancy score. The reduced immunoexpression of these proteins in the membrane may be related to the high degree of cell indifferentiation in cases of oral squamous cell carcinoma with high scores.

Association between osteoporosis and periodontal disease

PURPOSE to verify the association of osteoporosis with periodontal disease. METHODS the study has included 39 postmenopausal women divided in three groups according to bone mass categories, through evaluation of mineral bone density (MBD), measured by X-ray double emission absorbimetry in the lumbar area (L1-L4): ): normal bone; osteopenia and osteoporosis. In all the participants the Clinical Insertion Level (CIL) index has been determined at the research onset and after one year, by the same examiner. The periodontal situation data have been submitted to statistical analysis with the paired t-Student test. RESULTS the periodontal exam has shown that postmenopausal women in the osteopenia presented lower CIL at the initial periodontal clinical exam (2.1+/-1.1 mm), while the ones in the normal bone showed less teeth support tissue loss after one year (3.1+/-1.6 mm). The statistical analysis has shown that there was no significant difference for the periodontal situation in the normal bone, but there was significant statistical difference for the osteopenia and osteoporosis patients, when CIL values from both evaluation periods were compared. CONCLUSIONS it is concluded that postmenopausal osteoporosis may be a possible risk factor for periodontal disease.

Immunohistochemical expression of E-cadherin and CD44v6 in squamous cell carcinomas of the lower lip and tongue

This study analyzed the immunohistochemical expression of E-cadherin and CD44v6 in 15 squamous cell carcinomas (SCCs) of lower lip and 15 SCCs of tongue in order to verify a possible association between these proteins and the anatomic location of the lesion, nodal metastasis and histological grading of malignancy. The pattern of expression and number of immunopositive cells were evaluated. The results were analyzed with the Fishers exact test, Mann-Whitney test and Spearmans Correlation Coefficient (r). using the SPSS software 10.0 for Windows. Statistical significance was set at 5% determined for a p-value<0.05 for all tests. There was no significant difference (p>0.05) in the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6, regarding the anatomical location and nodal metastasis. For the histological grading, low score SCCs showed higher immunopositivity for E-cadherin and CD44v6, both for the pattern of expression and number of immunopositive cells (p<0.05). There was a negative correlation between the total score of malignancy and the pattern of expression and number of immunopositive cells for E-cadherin and CD44v6 (p<0.05). In conclusion, SCCs of the lower lip and tongue did not reveal significant differences in the expression of E-cadherin and CD44v6. The expression of these adhesion molecules revealed association only with tumor histological grading of malignancy. Therefore, these results suggest that E-cadherin and CD44v6 may not help elucidating the differences between the biological behavior of SCCs of the lower lip and tongue.

Salivary IgA and periodontal treatment needs in diabetic patients

Salivary IgA can serve as a first line of defense against pathogens that colonize and invade mucosal surfaces and may be protective against periodontal disease. The aim of this study was to assess salivary immunoglobulin A levels in diabetic and non-diabetic patients with different periodontal treatment needs. The Periodontal Screening & Recording (PSR) system was used to evaluate the periodontal treatment needs of 41 diabetic and 42 non-diabetic patients. Unstimulated whole saliva was collected from each patient immediately before clinical examination and stored at -20 °C until analysis. Salivary immunoglobulin A (s-IgA) levels were determined using an enzyme-linked immunosorbent assay, and values were expressed as optical density. Diabetic and non-diabetic patients were compared using clinical and laboratory data. PSR data indicated that periodontal disease was more frequent and more severe in diabetic patients. A higher prevalence of codes 3 and 4 was observed in diabetics as compared with non-diabetics (odds ratio = 2, P < 0.05). Furthermore, non-diabetic patients had more healthy sextants (code 0) than did diabetic patients. Over half of diabetic patients (∼54%) presented with s-IgA levels that were lower than the normal range (optical density from 0.4 nm to 0.6 nm; P < 0.05). In addition, diabetic patients showed a higher variability in s-IgA levels as compared with non-diabetic patients. In conclusion, diabetic individuals had lower s-IgA levels, more-frequent and more-severe periodontal disease, and a greater need for periodontal treatment as compared with non-diabetic patients.

Salivary evaluation of pediatric patients with cancer, before and after antineoplasic treatment.

AIMS This study evaluated the salivary biochemical and immunological status of children with cancer undergoing to antineoplasic treatment in an attempt to identify alternatives for a less invasive and less painful monitoring of these patients. MATERIALS AND METHODS Unstimulated whole saliva samples were obtained from 115 children without cancer (control) and 32 children with cancer (CA). Children with cancer were also evaluated after antineoplasic treatment (CAT, n = 17). The salivary concentrations of glucose, triglycerides, total cholesterol, alkaline phosphatase, gamma-glutamyltransferase (GGT), urea, insulin, thyroid-stimulating hormone (TSH), triiodothyronine (T3), levothyroxine (T4), and immunoglobulin A (IgA) were determined. RESULTS Acute lymphocytic leukemia, acute myeloid leukemia, and Hodgkins lymphoma were the most frequent cancers, although cases of non-Hodgkins lymphoma, medulloblastoma, ependymoma, osteosarcoma, nephroblastoma, Ewings sarcoma, and endodermal sinus tumor were also observed. The salivary concentration of cholesterol, triglycerides, or GGT did not differ between groups. Instead, the concentrations of alkaline phosphatase and T4 were higher in patients with cancer, irrespective of treatment. TSH levels were higher in the CA group and urea concentration was lower in the CAT group. T3 was undetectable in all groups. Antineoplasic treatment increased the glucose level and decreased the insulin concentration. Salivary concentration of total IgA was lower in children with cancer, irrespective of treatment. CONCLUSIONS Cancer and antineoplasic treatment affected biochemical and immunological parameters in the saliva of children, shedding new light on the potential usefulness of saliva for monitoring children with cancer, especially to patients undergoing immunosuppressive therapy.

Salivary levels of calcium, phosphorus, potassium, albumin and correlation with serum biomarkers in hemodialysis patients

OBJECTIVES Evidences suggest that hemodialysis patients have reduced salivary flow and changes in the composition of salivary secretion. These changes may reflect local and systemic disorders. The objectives of this study were to compare the salivary levels of calcium (Ca), phosphorus (P), potassium (K) and albumin in hemodialysis patients and healthy subjects, and to investigate a possible correlation between their serum and salivary levels. DESIGN A case-control study was conducted with 60 hemodialysis patients (HD group) and 37 systemically healthy individuals (control group). Stimulated saliva samples were collected for biochemical analysis (Ca, P, K and albumin). Serum data were collected in the HD group. Statistical analysis included t-test, Pearson correlation and simple linear regression. RESULTS The HD group exhibited higher salivary levels of Ca, P, and albumin (p<0.05). There was a significant positive correlation between serum PTH and salivary phosphorus (r=0.342, p=0.009), and between serum PTH and salivary potassium (r=0.306, p=0.020). An increase of 100 pg/dL in serum PTH was associated with an elevation of salivary P levels (0.34 mg/dL, p=0.009), and salivary K levels (0.20 mmol/dL, p=0.02), in the HD group. CONCLUSIONS The findings suggest that HD patients present increased levels of salivary components (Ca, P, and albumin), and changes commonly observed in HD patients, such as hyperparathyroidism, appear to have an influence on salivary composition.

Conhecimentos e práticas de saúde bucal de gestantes usuárias dos serviços de saúde em São Luís, Maranhão, 2007-2008

Resumo OBJETIVO: descrever as caracteristicas dos cuidados de saude bucal durante o acompanhamento pre-natal e o conhecimento sobre saude bucal entre gestantes usuarias de servicos de saude publico e privado em Sao Luis, Maranhao, Brasil. METODOS: estudo descritivo com 300 gestantes entrevistadas em servico publico e 300 em servico privado, no periodo de agosto de 2007 a julho de 2008. RESULTADOS: a frequencia de escovacao dentaria foi similar entre as usuarias dos servicos publico e privado (p=0,156), enquanto o uso de fio dental (64,0% e 47,0%; p<0,001) e de colutorios (39,7% e 27,0%; p=0,001) foi mais frequente no servico privado, em relacao ao publico; a maioria das usuarias, tanto do servico publico (60,3%) como do privado (65,7%), desconheciam a associacao entre saude bucal e gravidez. CONCLUSAO: a frequencia de escovacao dentaria foi similar entre gestantes dos servicos publico e privado; os efeitos da gestacao sobre a saude bucal eram pouco conhecidos.OBJECTIVE to describe characteristics of oral health care during prenatal check-ups and knowledge about oral health among pregnant women using public and private health services in São Luís, Maranhão, Brazil. METHODS this is a descriptive study of 300 women interviewed in public health services and a further 300 interviewed in private health services between August 2007 and July 2008. RESULTS tooth brushing frequency was similar among users of public and private services (p=0.156), while flossing (64.0% and 47.0%; p<0.001) and mouthwashing (39.7% and 27.0%; p=0.001) was more frequent among private service users in relation to public service users; most users of public services (60.3%) and private services (65.7%) were unaware of the association between oral health and pregnancy. CONCLUSION frequency of tooth brushing was similar among pregnant women in public and private services; the effects of pregnancy on oral health were not well known.