Daliana Queiroga de Castro Gomes

Significance of galectins-1, -3, -4 and -7 in the progression of squamous cell carcinoma of the tongue

The aim of this study was to analyze the immunohistochemical expression of galectins-1, -3, -4, and -7 in 65 cases of squamous cell carcinoma of the tongue and to correlate this expression with clinical (disease outcome, metastasis, and clinical stage) and morphological parameters (histological grade of malignancy). Clinical data were obtained from the patient records. The histological grading system of malignancy proposed by Bryne (1998) [9] was used for the analysis of morphological parameters. The results were analyzed statistically by χ(2) test (p < 0.05). Galectin-1 expression was observed in 87.7% of cases and was significantly correlated with metastasis (p = 0.033) and clinical stage (p = 0.016). Immunoexpression of galectin-3 was observed in 87.7% of cases and was correlated with the presence of metastasis (p = 0.033) and histological grade of malignancy (p = 0.031). Galectin-4 showed no significant correlation with any of the parameters studied. Expression of galectin-7 was observed in 73.8% of cases and was significantly correlated with the histological grade of malignancy (p = 0.005). In conclusion, the intense immunoexpression of galectins-1, -3, and -7 suggests the participation of these proteins in oral carcinogenesis and their use as markers of biological behavior and tumor progression in squamous cell carcinoma of the tongue.

Prevalence of oral mucosal lesions among patients with diabetes mellitus types 1 and 2

BACKGROUND Patients with diabetes mellitus have been associated with a number of changes in the oral cavity, such as gingivitis, periodontitis, mucosal diseases, salivary dysfunction, altered taste, and burning mouth. OBJECTIVES To determine the prevalence of oral mucosal lesions in patients with diabetes mellitus. METHODS A cross-sectional observational study between August and October 2012 with a convenience sampling was performed for 51 patients with diabetes mellitus (type 1 and type 2). The study consisted of two phases: 1) a questionnaire application; 2) intraoral clinical examination. For the analysis of data, we used descriptive statistics, Fishers exact test in bivariate analysis (significance level of 0.05), and Poisson Regression. RESULTS The prevalence of oral lesions was 78.4%. Traumatic ulcers (16.4%) and actinic cheilitis (12.7%) were the most prevalent lesions. The lips (35.3%) and tongue (23.5%) were the most common location. The bivariate analysis showed an association with the type of diabetes, and two variables (age and comorbidity) were quite close to the significance level. In the Poisson Regression analysis, only diabetes type 2 remained significant after adjusting the model. CONCLUSIONS The results of this study show a high prevalence of oral mucosal lesions in diabetic patients. The oral mucosal lesions are mostly associated with diabetes type 2.

Desmoplastic melanoma of the lower lip: a case report.

Desmoplastic melanoma is a rare variant of malignant melanoma and one of the main causes of clinical and histological misdiagnosis in the realm of melanocytic neoplasms. Its relatively innocuous clinical appearance and the absence of pigmentation usually lead to a clinical misdiagnosis. The authors report a case of desmoplastic melanoma located in the lower lip of a 42-year-old man and review the literature regarding pathogenesis, clinicopathological features, differential diagnosis, and therapeutic management of desmoplastic melanomas.

Aspectos demográficos e manifestações clínicas bucais de pacientes soropositivos para o HIV/Aids

INTRODUCTION: The oral and perioral lesions are common in patients infected with HIV, and may represent the first signs of the disease, even before the systemic manifestations. OBJECTIVE : This study aimed to estimate the prevalence of oral manifestations in HIV seropositive individuals, considering the aspects socio-demographic, immunological and therapeutic. MATERIAL AND METHOD: Was performed nature study clinical-epidemiological transverse, between October 2007 to April 2008, with a sample of 40 patients. Was used the technique of intensive direct observation through appropriate clinical exam. Data were recorded on data sheets pre-prepared and analyzed by descriptive and inferential statistics. RESULT: There was a prevalence of females (52.5%), aged 40-49 years (45%). Treatment with antiretroviral drugs was found in 85.0% of cases, all being with high power therapy (HAART). It was observed that 52.5% of patients had a TCD4+ lymphocyte count above 500cel/mm ³ and 50.0% had an undetectable viral load. The prevalence of oral manifestations was 42.5%, the most significant for pseudomembranous candidiasis (19.23%), followed necrotizing ulcerative periodontitis (15.38%), hairy leukoplakia (11.54%) and angular cheilitis (11.54%). No association was observed between oral lesions and viral load (p=0.1268) nor the TCD4 cell count (p=0.3458). CONCLUSION: Prevalence of some oral manifestations associated with HIV infection is still high, with pseudomembranous candidiasis infection more prevalent, mainly among people with low education levels and longer HIV infection, independent of the therapy and immune status of the patient.

Analgesia durante o tratamento ortodôntico com o uso do laser de baixa intensidade: revisão sistemática

BACKGROUND AND OBJECTIVES: Pain is a typical symptom during early orthodontic treatment. This study aimed at reviewing the literature on the use of low intensity laser to relieve pain during orthodontic treatment. CONTENTS: Titles, summaries and articles were searched in the following databases: Pubmed/Medline, Cochrane Library, LILACS and Scielo. Three researchers have independently searched using defined inclusion and exclusion criteria. Eight clinical trials were included and six have observed significant pain relief after therapeutic laser. CONCLUSION: There are scientific evidences that low intensity laser decreases pain symptoms during dental movements after the placement of orthodontic elastics and after orthodontic adjustments. Its use by dentists is a feasible alternative for inducing less adverse effects as compared to anti-inflammatory analgesics, being indicated for allergic patients, children and patients with systemic impairment. However, there is the need for further scientific investigations using well-defined protocols.

Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report

Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.

Punica granatum Linn. prevention of oral candidiasis in patients undergoing anticancer treatment

Introduction Oral candidiasis is considered one of the complications of antineoplastic therapy of head and neck. Studies show that herbal medicine has proven to be a promising alternative for the treatment of candidiasis. Objective To evaluate the effectiveness of the gel Punica granatum Linn. in the prevention of oral candidiasis in patients undergoing radiotherapy with or without chemotherapy for squamous cell carcinoma of the head and neck, and adverse effects associated with its use. Material and method It was performed a clinical trial, double blind, in the period 2012-2013, with patients seen at a referral hospital for cancer treatment. The sample consisted of 17 patients who did not have signs nor symptoms of oral candidiasis. These patients were divided into two groups: experimental (n=11): composed of patients who used the gel Punica granatum Linn. 6.25% since the beginning of the anticancer treatment and completed a week after the end of the treatment regimen; control (n=6): for patients who used the gel Miconazol 2%, following the same guidelines of the previous group. Data were tabulated and analyzed using descriptive statistics, the chi-square test and calculation of continuing Yates correction (p<0.05). Result There was no oral candidiasis in 63.6% of patients in the experimental group and in none of the control group patients. Conclusion Most patients who used the experimental gel showed no clinical signs of fungal infection, and there was no association of adverse effects.

Evaluation of oral health status and quality of life of head and neck cancer patients after radiation therapy

Introduction. Neoplasm of the head and neck can be treated surgically, by radiation, chemotherapy, or using combination of these methods. In contrast to surgical and radiation treatment which mostly have a local effect, chemotherapy in addition to local have also a systemic effect. Both XRT in oral region and chemotherapy can affect oral health. The aim of this study was to assess the oral health status and quality of life in patients with head and neck cancer after receiving radiation therapy. Material and Methods. Quantitative, analytical and cross-sectional research methods along with the application of UW-QOL questionnaire version 4, were used. Seventy one patients of the outpatient facilities at two cancer hospitals in the state of Paraнba, Brazil, were included in the study. Oral health status was evaluated using the Lockhart and Clark criteria. Linear Poisson and Logistic Regression tests were applied to assess associations between the variables using a significance level of 5%. Results. Of the total number of patients, 71.83% were male, the average age was 62 years and 57.74% were non-Caucasian. The group that received dental monitoring and follow-up attained the highest (830.13) Quality of life scores, including: “pain” (93.13) and “taste” (83.07). The highest score for oral health in the group that did not receive dental monitoring and follow-up treatment was 4.08 for “oral hygiene”. Conclusion. Dental monitoring and follow-up should begin before radiation therapy, given that both the illness and methods used for the treatment negatively affect patients’ quality of life.

Head and neck cancer, quality of life, and determinant factors: a novel approach using decision tree analysis

OBJECTIVE The goal of the present study was to investigate health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) in patients under treatment for head and neck cancer and to identify the associated factors. STUDY DESIGN A cross-sectional study was conducted with 102 patients undergoing treatment for head and neck cancer at 2 medical centers. Participants answered a sociodemographic questionnaire and the Brazilian versions of the Medical Outcomes Study 36 (SF-36) and the Oral Health Impact Profile (OHIP-14) questionnaires to assess HRQoL and OHRQoL, respectively. Clinical aspects, cancer staging, and treatment approach were also investigated. Descriptive and multivariate analyses were performed by using decision tree analysis with the Chi-square Automatic Interaction Detector (CHAID) algorithm. RESULTS The decision tree revealed that reduced quality of life is associated with the clinical staging (adjusted P value = .035), patients gender (adjusted P value = .028), and treatment approach (adjusted P value = .032). Female patients who are diagnosed with advanced head and neck cancer and undergo radiotherapy or chemotherapy are more likely to exhibit lower rates of quality of life. CONCLUSIONS The results suggested that sociodemographic characteristics, clinical staging, and treatment approach can exert a significant influence on the quality of life of patients with head and neck cancer.

Analysis of survival rates and prognostic factors among patients with oral squamous cell carcinoma

Aim: The aim of the study was to estimate global and accumulated survival rates as well as prognostic factors among patients with oral squamous cell carcinoma (OSCC). Subject and methods: Data from the previous 5 years were extracted from patient charts at a cancer reference center. The occurrence of death resulting from the malignant tumor in patients with a diagnosis of OSCC was the dependent variable. The independent variables were tumor site, degree of cell differentiation, clinical staging, data of histopathological determination of OSCC, socio-demographic characteristics, smoking habit and treatment modality. Kaplan-Meier survival curves were created. Differences were analyzed using the log-rank and Wilcoxon tests. The Cox regression model was employed to evaluate factors associated with survival, with the calculation of hazard ratios (HR) (α = 5%). Results: The global survival rate was 57%. The stage of the tumor exercised a direct influence on accumulated survival. In the first year of evaluation, the survival rate of patients in stages I and II was 92.6%. The Cox regression analysis revealed the following variables to be significantly associated with survival: T classification of the clinical staging (HR = 2.283; 95% CI: 1.115–4.673) and degree of tumor invasion (HR = 1.834; 95% CI: 1.041–3.232). Conclusion: Clinical stage and degree of tumor invasion are important prognostic factors for OSCC.