Leandro Napier Souza

Association Between IL1B (+3954) Polymorphisms and IL-1β Levels in Blood and Saliva, Together with Acute Graft-Versus-Host Disease

Graft-versus-host disease (GVHD) is associated with morbidity and mortality in the recipients of allogeneic hematopoietic stem cell transplants (allo-HSCTs). Interleukin-1β (IL-1β) is a potent inflammatory mediator involved in different inflammatory conditions. Therefore, we aimed to investigate the association of IL1B gene polymorphism in recipients and donors in cases in which acute GVHD (aGVHD) has been reported and the impact of this gene polymorphism on the level of cytokines in the blood and saliva. Fifty-eight consecutive allo-HSCT recipients and their donors were prospectively studied. Saliva and/or blood samples were obtained from the recipients and donors to identify the IL1B gene polymorphism, and cytokine levels were assessed by ELISA. Samples were collected weekly from 7 days before transplantation (day -7) to 100 days after allo-HSCT (day+100), for a total of 16 weeks or until death. aGVHD occurred in 27 individuals evaluated. A significant association was identified between the IL1B polymorphism in the donor and aGVHD development in the corresponding recipients. However, no significant association was detected between the IL1B polymorphism in recipients and the development of aGVHD. In the recipients who were diagnosed with aGVHD, the level of IL-1β in the saliva and blood were increased. In the saliva, IL-1β levels increased progressively from the time before the diagnosis of aGVHD until weeks after the diagnosis, whereas in the blood, IL-1β peak levels could be observed within the time allotted for diagnosis, followed by a decrease in the levels. In addition, we observed a significant association between the IL1B genotype of the recipient (CC) and high IL-1β levels in the saliva at week 13. In conclusion, IL-1β could be considered a useful predictor of aGVHD development.

Microchimerism in labial salivary glands of hematopoietic stem cell transplanted patients.

OBJECTIVE Microchimerism has been extensively investigated in autoimmune diseases, which display similarities with graft-vs-host disease. This study was conducted to investigate the presence of microchimerism in minor salivary glands of hematopoietic stem cell transplanted patients, one of the targets of graft-vs-host disease. METHODS Labial salivary glands biopsy specimens from 11 stem cell transplanted patients were analysed. The samples were grouped in control (five specimens from a female-to-female transplantation) and study group (five glands from male-to-female transplantation). One male transplanted patient was used as a positive control. Fluorescence in situ hybridization with Y-chromosome probe and immunofluorescence with anticytokeratin AE1/AE3 and CD45 were used to identify Y-chromosome positive glandular epithelial cells from allogeneic hematopoietic stem cell transplanted patients. RESULTS In the study group, all samples were positive to Y-chromosome and cytokeratin AE1/AE3, in agreement with the pattern exhibited by male labial salivary gland. None of the samples from control group were positive to Y-chromosome despite being positive to cytokeratin AE1/AE3. Positivity to CD45 was not relevant. CONCLUSION Microchimerism in the labial salivary glands of sex-mismatched stem cell transplanted patients is a real phenomenon. Further studies are necessary to elucidate the impact of this phenomenon on the clinical status of stem cell transplanted patients.

Cirurgia Oral em Pacientes sob Terapia com Anticoagulantes Orais: Revisão da Literatura e Apresentação de Dois Casos Clínicos

Abstract The treatment of patients under oral anticoagulation and undergoing oral surgery procedures remains controversial. The current professional practice recommends suspension or reduction of the dosage of anticoagulants, but recent studies emphasize that this behavior causes a greater risk to the patient. In such a way, this paper aims to review the literature concerning pre, per and post operatory care in patients receiving continuous oral anticoagulants and undergoing oral surgery as well as report of two cases.

Extending Coronectomy Indications to Third Molars with Taurodontism to Prevent Paresthesia and Mandible Fracture

Taurodontism is considered a dental anomaly responsible for a morphoanatomical change in the shape of the tooth in which the roots are reduced in size but the body of the tooth is enlarged and bulky. The aim of this paper is to present a case of a 25-year-old female patient with taurodontism of mandibular partially erupted third molars, presenting a high risk of angle fracture and paresthesia in case of their removal, treated by means of coronectomy. The postoperative period was uneventful and the patient remained in follow-up for 12 months. In conclusion, the identification of third molars with higher risk of complications related to their extractions is the key to consider conservative measures to avoid problems. Coronectomy is a relatively simple technique that should be taken into account when considering bulky, deeply located third molars with a high risk of paresthesia or mandibular fracture, even in presence of taurodontism.

Intraoral Excision of a Huge Cheek Lipoma

Lipomas are benign tumors of mature adipocytes unusual in the oral and maxillofacial region. The average size of cheek lipomas in the literature ranges from 1.5 to 2.5 cm, with the maximum size of 5 cm. Their etiology remains unclear. Lipomas present, clinically, as well circumscribed, slow growing, painless masses, usually treated by complete excision. The aim of this paper is to present a 78-year-old Caucasian male patient with a huge cheek lipoma compromising facial esthetics and treated through an intraoral excision. Postoperative period was uneventful with no signs of recurrence. Concluding, the intraoral approach is a relatively simple technique that should be taken into account when considering the surgical removal of cheek lipomas.

Ameloblastoma multiquístico mandibular tratado con terapia menos invasiva: Caso clínico y revisión de la literatura

Ameloblastoma is a benign odontogenic tumor, locally invasive and recurrent, representing approximately 10% of odontogenic tumors. The majority of cases occur in the mandible with slow and asymptomatic growth that can lead to facial deformities. The treatment of choice is based upon on the type, location and size of the tumor, as well as the age of the patient. A case of multicystic ameloblastoma of the mandible affecting a 57 years old female patient is presented discussing the diagnostic, histological, and less invasive treatment used in the case.

Osteonecrose dos Maxilares Associada ao Uso de Bisfosfonatos: Revisão da Literatura e Apresentação de um Caso Clínico.

Resumo Os bisfosfonatos sao medicamentos amplamente administrados a pacientes portadores de câncer de mama e prostata com metastases osseas, mieloma multiplo, osteoporose, doenca de Paget, hipercalcemia maligna e outras lesoes osseas metastaticas. A droga diminui a reabsorcao ossea, inibindo a actividade osteoclastica e o recrutamento de osteoclastos, promovendo a apoptose destes. A osteonecrose dos maxilares associada ao uso de bisfosfonatos tem sido relatada principalmente em pacientes submetidos a intervencoes odontologicas invasivas, como exodontias, cirurgias a retalho, endodontias, dentre outras. O presente estudo teve como objectivo realizar uma revisao de literatura sobre o assunto, levando em consideracao os factores etiologicos, os mecanismos de accao destes medicamentos, seus efeitos adversos e possiveis tratamentos, alem de descrever um caso clinico. Tendo em vista a dificuldade do tratamento e ao risco de intervencoes cirurgicas, pacientes que necessitam de medicamentos da classe dos bisfosfonatos devem, se possivel, ser submetidos a um exame odontologico criterioso, no qual todos os procedimentos necessarios sejam realizados previamente ao seu uso, diminuindo-se assim, os riscos da ocorrencia de osteonecrose.