Sonia Maria Soares Ferreira

Association between socioeconomic status and HIV-associated oral lesions in Rio de Janeiro from 1997 to 2004

The prevalence of HIV-related oral lesions may vary according to socioeconomic status and antiretroviral therapy, among other factors. This studys intent was to evaluate the association between socioeconomic indicators, CD4+ counts and HIV-related oral lesions in the city of Rio de Janeiro, RJ, Brazil. A retrospective epidemiological analysis was performed of the medical records of HIV-positive patients that attended the Federal University of Rio de Janeiro between 1997 and 2004. Gender, age, mode of HIV transmission, level of education, monthly familial income, CD4+ counts and HIV-related oral lesions were assessed. For statistical analysis, the Chi-square test was used with a level of significance of 5%. 254 medical records were reviewed: 83 women and 171 men. Monthly familial income below 2 minimum wages was associated with a higher prevalence of pseudomembranous candidiasis (p = 0.024), while income above 10 minimum wages was associated with a higher prevalence of salivary gland disease (p = 0.021). Lower socioeconomic status was associated with lower CD4+ counts (p = 0.017). In this study, an association was noted between socioeconomic status, immune suppression and prevalence of oral lesions. However, further studies are warranted using other socioeconomic variables in order to better assess this relationship.

Gender differences in oral manifestations among HIV-infected Brazilian adults

AIM The purpose of this study was to compare gender differences in the prevalence of oral lesions in HIV-infected Brazilian adults. METHODOLOGY A retrospective study was conducted of medical records from HIV/AIDS patients from 1993 to 2004. Oral lesions were only included in this study if definitively diagnosed through microscopic analysis, therapeutic test or according to EC-Clearing house criteria. RESULTS A total of 750 men and 237 women were included in the study. Statistically significant differences were observed only for oral hairy leukoplakia, Kaposi sarcoma and lymphadenopathy (P < 0.01). However, a model of logistic regression showed that only oral hairy leukoplakia presented a significant association with gender and males had a significantly likelihood (four times higher than females) of presenting with this oral manifestation [OR 4.3 (95% CI: 1.39-13.36)]. CONCLUSION These data shows that oral manifestations are less prevalent in females than in males, particularly oral hairy leukoplakia.

Influence of IL-1 gene polymorphism on the periodontal microbiota of HIV-infected Brazilian individuals

This study investigated the association of IL-1A (+4845) and IL-1B (+3954) gene polymorphism with the subgingival microbiota and periodontal status of HIV-infected Brazilian individuals on highly active antiretroviral therapy (HAART). One hundred and five subjects were included in the study, distributed into 2 HIV groups [29 chronic periodontitis (CP+) and 30 periodontally healthy (H+)]; and 2 non-HIV groups (29 CP- and 17 H- patients). IL-1A and B were genotyped by PCR and restriction enzyme digestion. Thirty-three bacterial species were detected by checkerboard. Overall, we observed a prevalence of the allele 2 in the IL1-A and IL-1B polymorphism at 30.5% and 25.7%, respectively. Only 11.4% of all patients were composite genotype-positive, and 75% of those were HIV-infected. No significant associations between polymorphism of the IL-1 gene and periodontitis or HIV infection were observed. Likewise, no significant differences in the frequency and counts of any bacterial species were found between individuals with and without allele 2 (IL-1A or IL-1B). The data indicated that the IL-1 gene polymorphism is neither associated with periodontal destruction nor with high levels of subgingival species, including putative periodontal pathogens in HIV Brazilian individuals on HAART.

IL-1 gene polymorphism and periodontal status of HIV Brazilians on highly active antiretroviral therapy

A genotype in the IL-1 gene cluster is associated with an increased risk of periodontitis. We investigated whether polymorphisms in the IL-1A +4845 and IL-1B +3954 loci affect the periodontal status of HIV-infected Brazilians on HAART. HIV-positive and HIV-negative subjects with periodontitis were genotyped for IL-1 by polymerase chain reaction and restriction enzyme digestion. Only 11.4% of patients were genotype positive. No associations between genotype positivity and HIV infection or periodontal status were found in this population.

Factors associated with specific clinical forms of oral candidiasis in HIV-infected Brazilian adults

OBJECTIVE This study assesses the association among factors related with specific clinical forms of oral candidiasis (OC) in HIV-infected Brazilian adults. DESIGN This study was conducted with 590 HIV-infected adults from 1997 to 2004. The OC diagnosis was based in accordance with the EC-Clearinghouse classification. Multivariate logistic regression analyses were performed to measure the association between HAART and OC, with pseudomembranous [PC], erythematous [EC], and angular cheilitis [AC]) adjusted for HIV-related diseases, smoking, alcohol consumption, injecting and non-injecting drug use. RESULTS Two hundred and eighteen (37.0%) individuals were undergoing HAART. The prevalence of PC, EC and AC was 21.2%, 15.7% and 8.8%, respectively. Approximately 64% of the individuals with PC and EC, and 76.5% with AC had absolute CD4 levels ≤200cells/mm(3). The results of the multivariate analysis showed that subjects not undergoing HAART had a significantly higher odds ratio for PC [OR 3.67 (95% CI: 1.97-6.80)] and EC [OR 1.88 (95% CI: 1.04-3.39)], and AC [OR 4.56 (95% CI: 1.58-13.19)]. In addition, smoking [OR 2.58 (95% CI: 1.43-4.68)] and pneumocystis pneumonia [OR 1.92 (95% CI: 1.07-3.42)] were associated with PC, while high alcohol consumption [OR 3.40 (95% CI: 1.13-10.18)] and cytomegalovirus infection [OR 2.34 (95% CI: 1.06-5.15)] were associated with EC. CONCLUSION The data indicates that the odds of having all clinical forms of OC are higher in HIV-infected adults not receiving HAART.

Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma

Aim To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). Methods One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. Results Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (p = 0.038), advanced cancer staging (p = 0.003), and procedures without surgery (p < 0.001). When these variables were included in the Cox regression model only surgery procedures (p = 0.005) demonstrated a significant effect on survival. Conclusion The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention.

Periradicular lesions in HIV-infected patients attending the faculty of dentistry: clinical findings, socio-demographics status, habits and laboratory data - seeking an association

OBJECTIVE: The purpose of this study was to estimate the prevalence of periradicular lesions in HIV-infected Brazilian patients and to assess the correlation of several factors with the periradicular status. METHOD: One hundred full-mouth periapical radiographs were evaluated. A total of 2,214 teeth were evaluated for the presence of periradicular lesions, caries lesions, coronal restorations, pulp cavity exposure and endodontic treatment. RESULTS: The prevalence of periradicular lesions was 46%. There were no significant differences between individuals with or without periradicular lesions with respect to their socio-demographic status, habits, laboratory data and route of HIV infection. However, the presence of a periradicular lesion was statistically correlated with the number of teeth with endodontic treatment (p = 0.018), inadequate endodontic treatment (p = 0.025), images suggesting pulp cavity exposure (p = 0.002) and caries lesions (p = 0.001). CONCLUSIONS: The prevalence of periradicular lesions in HIV-infected individuals was 46% and was not related to HIV infection.

Actinic cheilitis: case report

1 Acadêmica do Curso de Odontologia no Centro Universitário Cesmac. Maceió, ALBrasil. 2 Acadêmica do Curso de Odontologia no Centro Universitário Cesmac. Maceió, ALBrasil. 3 Cirurgiã-Dentista. Doutora em Ciências. Professora titular do Centro Universitário Cesmac. Maceió, ALBrasil. 4 Cirurgiã-Dentista. Mestra em Ensino na Saúde. Professora titular do Centro Universitário Cesmac. Maceió, ALBrasil. 5 Cirurgiã-Dentista. Doutora em Estomatopatologia. Professora titular do Centro Universitário Cesmac. Maceió, ALBrasil.

O perfil epidemiológico pode influenciar as características clínicas e malignas dos carcinomas orais e orofaríngeos

Objective: the aim of this study was to analyze possible associations between the epidemiological variables of the study and the clinical stage and malignancy grade of squamous cell carcinomas (SCCs) of the oral cavity and oropharynx, and to evaluate whether there is a correlation between clinical stage and histological grade in SCCs. Material and Methods: retrospective analytical study of SCCs cases diagnosed between June 2005 and December 2013. The data from medical records and histopathological findings of patients over 18 years old were entered into an Excel® spreadsheet and analyzed by SPSS® 20, using the chi-square and Fisher’s exact tests to analyse the variables. The level of significance of the tests was 0.05. Results: patients were predominantly black, male, illiterate, in their sixth decade of life, living in country towns and exposed to tobacco and alcohol. There was also predominance of advanced-stage tongue lesions with high-grade malignancy treated with combined radiotherapy and chemotherapy treatment. There was association between exposure to alcohol with advanced stage at diagnosis (p=<0.001). Conclusion: association of alcohol consumption with more advanced lesions at diagnosis underscores the need to address the risk factors more emphatically. Although classic factors implicated in the course of oral and oropharyngeal SCC have been observed, it is remarkable the high frequency of illiterate patients coming from country towns, which could have hampered the access to health care and contributed to a delayed diagnosis and thus, to a poorer prognosis.

Caracterização do atraso no diagnóstico do câncer de boca e orofaringe em dois centros de referência

Objectives To analyze the chronology of diagnosis and determine whether clinical and epidemiological variables have an influence on diagnostic delay at two referral centers. Methods The medical records of all patients older than 18 years diagnosed with oral/oropharyngeal cancer from June 2005 to June 2013 were analyzed using SPSS® 20. The association between epidemiological and clinical variables with patient and professional delay was performed using ANOVA, Student’s t-test, and Kruskal-Wallis test. Results In total, 121 medical records were included in the study. Patients were predominantly brown, male, illiterate, living in country towns, smokers, and heavy drinkers (mean age 64.3 years, SD=12.94). The majority (85.1%) of patients were diagnosed at advanced stages of their disease. The greatest delay was patient-related, mean 197.8 days (SD=323.9). Delay in establishing the medical diagnosis averaged 20 days (SD=25.9), and health care system-related delay was 71.1 days (SD=71.7). There was no association of clinical and epidemiological variables with delayed diagnosis (patient and professional). Conclusion Data from the present study suggest that clinical and epidemiological variables do not influence diagnostic delay.