Geraldo Oliveira Silva-Junior

Prevalence of oral manifestations in 203 patients with psoriasis

ous treatment. Female patients with failure of isotretinoin treatment had been included only in two studies. Furthermore, this was the first study to our knowledge which assessed the response to spironolactone of the acne located in the back. In literature, some of the studies specify that the patients included have a facial acne; only one of them describes that 32 patients out of 47 included in the study have acne located on the trunk; but the therapeutic response for this zone is not assessed. As reported in the literature, the rates of effectiveness of spironolactone in the treatment of acne vary a lot in different studies and probably depend on the main endpoint chosen. In our study, patients with isotretinoin treatment failure respond to the treatment noticeably with an improvement of facial acne in 50% of the cases and of the acne of the back in 37.5% of the cases. In conclusion, spironolactone is a therapeutic alternative in case of treatment failure with isotretinoin in adult women with acne. The efficacy in the case of back lesions is one of the novel aspects of our study.

Rosiglitazone (peroxisome proliferator-activated receptor-gamma) counters hypertension and adverse cardiac and vascular remodeling in 2K1C hypertensive rats.

Peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonists have been shown controlling blood pressure (BP) in spontaneously hypertensive rats and salt-sensitive hypertensive rats. The present study aims to test the hypothesis that PPAR-gamma agonist rosiglitazone has beneficial effects on cardiac and vascular adverse remodeling in a model of renovascular hypertension (two-kidneys-one-clip, 2K1C model). Wistar rats were divided into four groups (n=6): SHAM group, 2K1C, 2K1C+HYD (treated with hydralazine for 5 weeks) and 2K1C+ROSI (treated with rosiglitazone for 5 weeks). The left ventricle (LV), thoracic aorta (Ao) and common carotid artery (CCA) were analyzed. The BP did not show significant difference at the end of the experiment in groups 2K1C+ROSI, 2K1C+HYD and SHAM. The LV mass was smaller in 2K1C+ROSI compared with the other groups. The intima-media thickness was smaller in 2K1C+ROSI compared with untreated 2K1C ones, but not in 2K1C+HYD; 2K1C and 2K1C+HYD showed smaller Ao and CCA density of smooth muscle cell nuclei, and smaller surface density of the elastic lamellae than SHAM. The Ao and CCA circumferential wall tension and tensile stress were greater in 2K1C than in SHAM. Hypertrophied cardiomyocytes were seen in 2K1C, but not in 2K1C+ROSI and SHAM; 2K1C+ROSI had enhanced volume and length densities of intramyocardial arteries than 2K1C. The volume density of cardiac interstitium was greater in 2K1C and 2K1C+HYD than in SHAM. In conclusion, PPAR-gamma agonist rosiglitazone has beneficial effects controlling BP, reducing vascular adverse remodeling, and preserving intramyocardial vascularization in renovascular hypertensive rats (2K1C model).

Geographic stomatitis: an oral manifestation of psoriasis?

BACKGROUND Geographic stomatitis is an uncommon oral lesion that presents similar clinical, histopathological and genetic features as those of psoriasis. These findings suggest that this lesion may actually represent an oral manifestation of psoriasis. We report one case of geographic stomatitis and discuss a possible connection between this condition and psoriasis. MAIN OBSERVATIONS A 37-year-old woman presented with red patches, surrounded by a white border on the labial mucosa and a positive family history of psoriasis. Histopathological examination, immunohistochemical analysis with antibodies against CD4, CD8, CD20, CD68, CD31, and Ki-67 and HLA-A*, -B*, -C*, -DRB1*, -DQA1* and -DQB1* genotyping were performed. Histopathological examination revealed parakeratosis, marked elongation of rete ridges with acanthosis and clubbing, exocytosis, Munro microabscesses, pustule of Kogoj, dilated tortuous vessels at the tip of dermal papillae, and predominant superficial and perivascular lymphocytic chronic inflammatory cell infiltrate. Immunohistochemistry analysis revealed a predominant T-cell subepithelial infiltrate. Based on the referred clinicopathological findings and in the absence of cutaneous lesions, the diagnosis of geographic stomatitiswas confirmed. CONCLUSIONS This case and theoretical data indicate that geographic stomatitis may be an oral manifestation of psoriasis. Moreover, to improve our understanding, psoriatic patients should routinely undergo a detailed oral examination and patients with geographic stomatitis should routinely be submitted to a cutaneous routine examination.

Origin and Development of the Coronary Arteries

La formacion de la vascularizacion coronaria es un acontecimiento fundamental en el desarrollo del corazon e implica una serie de eventos temporales cuidadosamente regulados que incluyen vasculogenesis y angiogenesis. Esta revision se focaliza en el conocimiento sobre la formacion de las arterias coronarias y algunos mecanismos moleculares implicados en este proceso. Entender la embriogenesis coronaria es importante para las intervenciones relacionadas con las enfermedades cardiovasculares en los adultos, asi como tambien, para corregir defectos congenitos del corazon. La idea del desarrollo de la arteria coronaria, como resultado del crecimiento interno, cambio la comprension de diversas variaciones y anomalias congenitas de estas arterias descritas en la anatomia macroscopica.

Insights Into Coronary Artery Development in Model of Maternal Protein Restriction in Mice

Programming of fetal development is considered to be an important risk factor for noncommunicable diseases of adulthood, including coronary heart disease (CHD). Aiming to investigate the association between maternal nutrition and the development of the coronary arteries (CAs) in staged mice embryos, C57BL/6 mice embryos from Stages 16 to 23 were taken from mothers fed a normal protein (NP) or low protein (LP) diet, and the CA were studied. Although the LP embryos had lower masses, they had faster heart growth rates when compared with the NP embryos. The subepicardial plexuses were observed earlier in the NP embryos (Stage 20) than in the LP ones (Stage 22; P < 0.01). Apoptotic nuclei were seen around the aortic peritruncal ring beginning at Stage 18 in the NP and LP embryos. FLK1+ (fetal liver kinase 1 = VEGF‐r2 or vascular endothelial growth factor receptor 2) cells had a homogeneous distribution in the NP embryos as early as Stage 18, whereas a similar distribution in the LP embryos was only seen at Stages 22 and 23. Maternal protein restriction in mice leads to a delay in the growth of the heart in the embryonic period modifying the development of the subepicardial peritruncal plexus and the apoptosis in the future coronary orifice region. Anat Rec, 2011.

Regression of major recurrent aphthous ulcerations using a combination of intralesional corticosteroids and levamisole: a case report.

Recurrent aphthous ulcerations (RAU) are common oral lesions that affect approximately 10% to 20% of the population. The disease is characterized by recurrent and painful ulcerations of the oral non-keratinized mucosa, which measure from 3 to 10 mm in diameter and heal without scarring in 7 to 14 days.1 The etiology of RAU remains unknown, but there is increasing evidence that its development has an immunogenic basis. The search for its cause should concentrate on disorders associated with immunoderegulation, decreased mucosal barriers, or conditions that elevate the antigenic stimulus. Major RAU have irregular margins, frequently exceed 10 mm in size, and typically leave scars.2 There have been many attempts over the years to find an effective treatment for RAU. Because the etiology of RAU remains unknown, its treatment consists of therapeutic measures to suppress its symptoms rather than bringing about a definitive cure. The therapeutic choice depends on the severity of the disease, which is measured by the frequency of ulcer recurrence, the number of ulcers, their location and duration, and the level of associated orofacial pain.3,4 Cases of major RAU that are characterized by pain, fever, and dysphagia and that are recurrent usually require systemic therapy. Several systemic drugs have been used to treat major RAU, including systemic corticosteroids, dapsone, colchicine, thalidomide, pentoxifylline, low-dose interferon-α, and levamisole.2,5 The use of systemic corticosteroids and immuno-modulating agents has been the mainstay of treatment for major RAU. Intralesional steroid injections, which contain betamethasone dipropionate and betamethasone disodium phosphate, combined with levamisole therapy may successfully treat the large ulcers associated with major RAU.6 This paper presents a case report of major RAU where we tested the therapeutic efficacy of a treatment combining an intralesional corticosteroid and a drug used to modulate immune responses.

The Advantages of Oral Cytopathology in the Early Diagnosis of HIV/AIDS: Three Case Reports

Oral lesions are common in human immunodeficiency virus (HIV)-infected patients, which may indicate impairment of the patient’s general health status, and, in many cases, the oral lesions are the first sign of an HIV infection. Oral hairy leukoplakia (OHL) is a benign lesion of the oral mucosa related to Epstein-Barr virus (EBV) observed in HIV-positive individuals. The aim of this study was to report the contribution of oral cytopathology in the investigation of the HIV/AIDS status of patients as well as in the clinical and subclinical identification of OHL. Three patients were referred to the Oral Medicine Clinic in 2010. The patients were submitted to oral examination, and scrapes of the tongue were obtained. The Papanicolaou staining technique was used, and cytopathological analysis showed nuclear changes corresponding to cytopathic effects of EBV epithelial infection and candidiasis. The final diagnosis was OHL and candidiasis. Based on cytopathological diagnosis, an HIV serologic test was requested which revealed positive HIV serology. None of the patients was aware of their HIV serological status, and thus the cytopathology, by identifying OHL, contributed to the early diagnosis of HIV/AIDS. Cytopathology should be used as a routine procedure and it may be the method of choice for clinical and subclinical OHL diagnosis.

Perfil demográfico e odontológico de pacientes atendidos no Centro Odontológico para Pacientes com Necessidades Especiais da Associação Brasileira de Odontologia - Rio de Janeiro

Objective: to evaluate the demographic and dental profile of patients with special needs met in a Reference Center in the state of Rio de Janeiro, showing their main needs and the possibility of outpatient care. Material and Methods: the sample consisted of 410 patients, from whom demographic and clinical data were obtained. All the studied variables were entered in a database for descriptive statistical analysis. Results: two hundred and twenty-seven (55%) patients were male, 70% were white, and their average age was 34 years old. Inconclusive diagnosis, followed by autism spectrum disorder and intellectual disabilities, were the most found diagnoses. Most patients (78%) was from the metropolitan region. Regarding complaints and dental procedures, the main complaint was prevention (28%), and 2,902 procedures were performed. Concerning oral hygiene habits, 264 (64%) patients did not floss and 215 (52%) underwent toothbrushing three times a day. Only 57 (14%) cases required the use of sedative methods to carry out the dental treatment. Conclusion: there is a great demand for preventive and restorative treatments for patients with special needs, highlighting the need for daily strengthening practices of oral health promotion. In addition, we can see that most treatments performed were in the outpatient level, showing that the use of appropriate approach is essential for dental management, thus demystifying the care of these patients.

Variable expressivity and novel PTEN mutations in Cowden syndrome

Cowden syndrome (CS) is a phosphatase and tensin homolog gene (PTEN)-associated condition characterized by multiple mucocutaneous hamartomas and an increased risk of malignancies. We reported an isolated case and another of several individuals in one family affected by CS. The isolated case showed typical features, including fibrocystic breast disease, benign thyroid nodules, and multiple papillomatous lesions in the face and oral cavity, and the cause was a novel nonsense mutation-guanine (G) to thymine (T) transition at position 940 (c.940 G>T)-in PTEN. In the family, the proband showed erythema nodosum, duodenal ulcer, intestinal polyps, cervical lipoma, renal cysts, and glaucoma, whereas multiple members of her family were found to have intestinal polyps, and a sister had been diagnosed with breast cancer at early age. An intronic mutation-T>G transition at the +32 position of intron 8 (c.1026+32 T>G)-was found in this family, with in silico analysis revealing the creation of a new donor splice site. This study confirmed the involvement of PTEN in CS and the variable clinical expressivity of disease.

REVISTA BRASILEIRA DE ODONTOLOGIA: DO PASSADO AO FUTURO - OBSTÁCULOS E CONQUISTAS

A Revista Brasileira de Odontologia (RBO) e um periodico online , aberto, especializado e destina-se a publicacao de artigos originais de pesquisa, revisoes de literatura, comunicacoes breves, cartas ao editor, relacionados a odontologia ou disciplinas correlatas. Dirigida a classe odontologica ha 73 anos, e uma publicacao trimestral e editada pela Associacao Brasileira de Odontologia – Secao Rio de Janeiro. Nestes 73 anos de existencia, a RBO manteve continuamente sua publicacao, passando por diversas modificacoes, buscando se adequar a realidade da odontologia brasileira. A RBO por muitos anos foi considerada a principal fonte de literatura cientifica destinada a classe odontologica e, somente em 2008, passou a ser online , utilizando o Sistema Eletronico de Editoracao de Revistas (SEER). Deste periodo ate 2016, poucas mudancas foram realizadas, tornando-se uma revista com baixo indice de submissao e de rejeicao; alem do longo periodo entre a submissao e publicacao. Em 2016, apos a eleicao do novo conselho editorial, a RBO vem sofrendo grandes mudancas estruturais para competir com as diversas revistas da area odontologica, entretanto, muitos obstaculos ainda precisam ser superados, como a internacionalizacao e a indexacao em bases de renome. Diante deste contexto, o objetivo deste estudo e relatar a historia da Revista Brasileira de Odontologia, retratando as mudancas, conquistas e obstaculos dos seus 73 anos de existencia.