Oral cancer staging established by magnetic resonance imaging

The aim of this study was to compare clinical staging and magnetic resonance imaging (MRI) staging for oral cancer, and to assess inter-observer agreement between oral and medical radiologists. A total of 10 patients diagnosed with oral cancer were assessed before treatment. A head and neck surgeon performed clinical TNM staging. Two medical radiologists and two oral radiologists performed a new staging assessment by interpreting MRI scans, without prior knowledge of the clinical staging. They evaluated the extent of the primary tumor (T), metastasis to regional lymph nodes (N) and grouping by stages. The data were analyzed using the Kappa Index. There was significant agreement (p < 0.05) between the clinical and MRI staging assessments made by one oral radiologist for N stage, and between those made by one medical radiologist for the T and N stages and for the grouping by stages. In the MRI assessment, there was significant agreement among all four observers for both T stage and grouping by stages. For the N stage, there was no significant agreement between one oral radiologist and one medical radiologist or between both medical radiologists. There was significant agreement among the remaining radiologists. There was no agreement between the clinical and MRI staging. These results indicate the importance of using MRI for the diagnosis of oral cancer. Training initiatives and calibration of medical and oral radiologists should be promoted to provide an improved multidisciplinary approach to oral cancer

Use of trolamine to prevent and treat acute radiation dermatitis: a systematic review and meta-analysis

Objetivo: avaliar os efeitos da trolamina na prevenção ou no tratamento da radiodermatite. Método: revisão sistemática e meta-análise. Em janeiro de 2016, foram desenvolvidas estratégias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Também foram realizadas buscas manuais para encontrar referências adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os títulos e resumos de cada referência cruzada de forma independente. O risco de viés dos estudos incluídos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidências e a classificação da força das recomendações foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clínicos controlados. Os controles utilizados foram calêndula, placebo, preferência institucional / atenção padrão, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequência de eventos e o índice de risco com intervalos de confiança de 95% em subgrupos, de acordo com a graduação da radiodermatite. Conclusão: com base nos estudos incluídos nesta revisão, a trolamina não pode ser considerada um produto padronizado para a prevenção ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeça e pescoço.Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.Objetivo: evaluar los efectos de la trolamina en la prevención o el tratamiento de la radiodermatitis. Método: revisión sistemática y meta-análisis. En enero de 2016 se desarrollaron estrategias detalladas de búsqueda individual para Cinahl, Cochrane Library Central, LILACS, PubMed y Web of Science. También se realizaron búsquedas manuales para encontrar referencias adicionales. Se utilizó Google Scholar para buscar literatura gris. Dos investigadores leyeron los títulos y los resúmenes de cada referencia cruzada independientemente. El riesgo de sesgo de los estudios incluidos fue analizado por la herramienta Cochrane Collaboration Risk of Bias Tool. La calidad de la evidencia y la clasificación de la fuerza de las recomendaciones se evaluó mediante los Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: se identificaron siete ensayos clínicos controlados. Los controles utilizados fueron caléndula, placebo, preferencia institucional / atención habitual, Aquaphor®, RadiaCare™ y Lipiderm™. Los estudios se agruparon utilizando la frecuencia de eventos y la razón de riesgo con intervalos de confianza del 95%, en subgrupos según la graduación de radiodermatitis. Conclusión: con base en los estudios incluidos en esta revisión, la trolamina no puede considerarse un producto estandarizado para prevenir o tratar la radiodermatitis en pacientes con cáncer de mama y cabeza y cuello

Uso de trolamina para prevenção e tratamento da radiodermatite aguda: revisão sistemática e meta-análise

Objetivo: evaluar los efectos de la trolamina en la prevención o el tratamiento de la radiodermatitis. Método: revisión sistemática y meta-análisis. En enero de 2016 se desarrollaron estrategias detalladas de búsqueda individual para Cinahl, Cochrane Library Central, LILACS, PubMed y Web of Science. También se realizaron búsquedas manuales para encontrar referencias adicionales. Se utilizó Google Scholar para buscar literatura gris. Dos investigadores leyeron los títulos y los resúmenes de cada referencia cruzada independientemente. El riesgo de sesgo de los estudios incluidos fue analizado por la herramienta Cochrane Collaboration Risk of Bias Tool. La calidad de la evidencia y la clasificación de la fuerza de las recomendaciones se evaluó mediante los Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: se identificaron siete ensayos clínicos controlados. Los controles utilizados fueron caléndula, placebo, preferencia institucional / atención habitual, Aquaphor®, RadiaCare™ y Lipiderm™. Los estudios se agruparon utilizando la frecuencia de eventos y la razón de riesgo con intervalos de confianza del 95%, en subgrupos según la graduación de radiodermatitis. Conclusión: con base en los estudios incluidos en esta revisión, la trolamina no puede considerarse un producto estandarizado para prevenir o tratar la radiodermatitis en pacientes con cáncer de mama y cabeza y cuello.Objetivo: avaliar os efeitos da trolamina na prevenção ou no tratamento da radiodermatite. Método: revisão sistemática e meta-análise. Em janeiro de 2016, foram desenvolvidas estratégias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Também foram realizadas buscas manuais para encontrar referências adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os títulos e resumos de cada referência cruzada de forma independente. O risco de viés dos estudos incluídos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidências e a classificação da força das recomendações foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clínicos controlados. Os controles utilizados foram calêndula, placebo, preferência institucional / atenção padrão, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequência de eventos e o índice de risco com intervalos de confiança de 95% em subgrupos, de acordo com a graduação da radiodermatite. Conclusão: com base nos estudos incluídos nesta revisão, a trolamina não pode ser considerada um produto padronizado para a prevenção ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeça e pescoço.Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer

Entinostat is a novel therapeutic agent to treat oral squamous cell carcinoma

IntroductionAlterations of the epigenome may influence cancer initiation and progression. At the cellular level, histones are key regulators of chromatin accessibility and gene transcription; thus, the inhibition of histone deacetylase enzymes (HDACs) constitutes an attractive target for therapy. In this study, we investigated the effects of the HDAC inhibitor entinostat on oral squamous cell carcinoma (OSCC).Materials and MethodsWe tested the effects of entinostat on OSCC cell lines. Cell viability and growth were analyzed using MTT assay. Cell cycle analysis, cell apoptosis, cancer stem cell (CSC) content, and the concentration of reactive oxygen species (ROS) in OSCC tumor cells were assessed using flow cytometry. The expression of histones and cell cycle regulatory proteins was examined by Western blot.ResultsThe administration of entinostat resulted in reduced proliferation of OSCC cells, followed by cell cycle arrest at the G0/G1 phase, as well as substantial tumor apoptosis. We found an increase in ROS production and significant reductions in CSCs. We also found that entinostat caused increased acetylation histone H3 and histone H4, and changes in the expression of cell cycle‐associated proteins such as p21.ConclusionThis study indicates that entinostat is a potential novel therapeutic agent for OSCC by halting tumor proliferation, inducing cytotoxicity and intracellular ROS, and attacking the CSCs.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162762/2/jop13039.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162762/1/jop13039_am.pd

Radiogenomics: A Personalized Strategy for Predicting Radiation-Induced Dermatitis

Although radiation therapy (RT) planning and execution techniques have evolved to minimize radiotoxicity to a considerable extent, adjacent tissues still receive a substantial dose of ionizing radiation, resulting in radiotoxicities that may limit patients’ quality of life. Depending on the location of tissue injury and the severity of the cellular response, there may also be a need to interrupt RT, thus interfering with the prognosis of the disease. There is a hypothesis that genetic factors may be associated with individual radiosensitivity. Recent studies have shown that genetic susceptibility accounts for approximately 80% of the differences in toxicity. The evolution of genomic sequencing techniques has enabled the study of radiogenomics, which is emerging as a fertile field to evaluate the role of genetic biomarkers. Radiogenomics focuses on the analysis of genetic variations and radiation responses, including tumor responses to RT and susceptibility to toxicity in adjacent tissues. Several studies involving polymorphisms have been conducted to assess the ability to predict RT-related acute and chronic skin toxicities, particularly in patients with breast and head and neck cancers. The purpose of this chapter is to discuss how radiogenomics can help in the management of radiotoxicities, particularly radiodermatitis

Effects of dual blockade in heart failure and renal dysfunction: Systematic review and meta-analysis

OBJECTIVE: The effect of dual renin-angiotensin system (RAS) inhibition in heart failure (HF) is still controversial. Systematic reviews have shown that dual RAS blockade may reduce mortality and hospitalizations, yet it has been associated with the increased risk of renal dysfunction (RD). Surprisingly, although RD in patients with HF is frequent, the effect of combining RAS inhibitors in HF patients with RD has never been studied in a meta-analysis. METHODS: A systematic review and meta-analysis of randomized clinical trials involving HF patients with RD who received dual blockade analyzing death, cardiovascular (CV) death or HF hospitalization, and adverse events. RESULTS: Out of 2258 screened articles, 12 studies were included (34,131 patients). Compared with monotherapy, dual RAS inhibition reduced hazard ratio of death to 0.94 (p=0.07) and significantly reduced CV death or HF hospitalization to 0.89 (p=0.0006) in all individuals, and to 0.86 (p=0.005) in patients with RD and to 0.91 (p=0.04) without RD. Nevertheless, dual RAS blockade significantly increased the risk of renal impairment (40%), hyperkalemia (44%), and hypotension (42%), although discontinuation of treatment occurs only in 3.68% versus 2.19% (p=0.00001). CONCLUSIONS: Dual RAS inhibition therapy reduces the risk of CV death or HF hospitalization. However, cautions monitoring for specific adverse events may be warranted

Expression of CD90 and P75NTR stem cell markers in ameloblastomas : a possible role in their biological behavior

Multicystic and unicystic ameloblastomas are benign odontogenic tumors that present distinct biological behavior. The investigation of stem cells has become an important branch of tumor biology, with several studies addressing the possible role of these cells in tumor growth, angiogenesis, progression, infiltration and invasiveness. This study evaluated the immunohistochemical expression of CD90(Thy-1) and P75NTR stem cell markers in multicystic and unicystic ameloblastomas. Seventeen (17) samples of ameloblastomas (multicystic, n = 10; unicystic, n = 7) were submitted to immunohistochemical reactions and graded semi-quantitatively. The Kolmogorov-Smirnov test was used to verify possible differences in CD90 and P75NTR expressions between multicystic and unicystic ameloblastomas (p < 0.05). CD90 immunostaining was observed in all multicystic ameloblastoma specimens (n = 10), in the cytoplasm of the fibroblasts and vascular endothelial cells of the tumor stroma, near the neoplastic odontogenic epithelia. The staining of stromal CD90 was significantly higher in multicystic than in unicystic ameloblastomas (p = 0.003). Nuclear P75NTR immunostaining was observed in all ameloblastoma specimens. A significant difference was seen in the epithelial staining of P75NTR between multicystic and unicystic types (p = 0.007). The increased expression of CD90 and P75NTR found in multicystic ameloblastomas suggests a behavioral biological difference between multicystic and unicystic ameloblastomas, as well as a difference in ameloblastoma development

Asparaginase induces selective dose- and time- dependent cytotoxicity, apoptosis, and reduction of NFκB expression in oral cancer cells

Asparaginase is fundamental to the treatment of haematological malignancies. However, little has been studied on the effects that asparaginase could exert on solid tumours. Thus, this study aimed to evaluate the effects of asparaginase on an oral carcinoma cell line. The cytotoxicity of asparaginase in SCC- 9 (tongue squamous cell carcinoma) and HaCaT (human keratinocyte) cell lines was evaluated with MTT cell viability assay. The cells were treated with asparaginase at 0.04, 0.16, 0.63, 1.0, 1.5, 2.5, and 5.0 IU/mL. Dose- response curves and IC50 values were obtained and the Tumour Selectivity Index (TSI) was calculated. The effect of asparaginase on procaspase- 3 and nuclear factor κB (NFκB) expression was evaluated with western blot because it was reported that the overexpression of NFκB has been shown to contribute to tumour cell survival, proliferation, and migration. Caspase 3/7 staining was performed to identify cell death using flow cytometry. Effective asparaginase concentrations were lower for SCC- 9 cells when compared to HaCaT cells. The cytotoxicity results at 48 and 72 hours were significantly different for SCC- 9 cells. The TSI indicated that asparaginase was selective for the tumour cells. A decrease in procaspase- 3 and NFκB protein levels was observed in SCC- 9 cells. Furthermore, asparaginase resulted in significant apoptosis after 48 and 72 hours. Based on these results, asparaginase was cytotoxic in a dose- and time- dependent manner, induces apoptosis, and reduces NFκB expression in oral cancer cells. These results encourage further studies on the effectiveness of this enzyme as a treatment for solid tumours, especially head and neck cancer.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154950/1/cep13256.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154950/2/cep13256_am.pd

Uso de trolamina para prevención y tratamiento de radiodermatitis aguda: revisión sistemática y meta-análisis

Objetivo: avaliar os efeitos da trolamina na prevenção ou no tratamento da radiodermatite. Método: revisão sistemática e meta-análise. Em janeiro de 2016, foram desenvolvidas estratégias detalhadas de busca individual para Cinahl, Cochrane Library Central, LILACS, PubMed e Web of Science. Também foram realizadas buscas manuais para encontrar referências adicionais. Se utilizou Google Scholar para buscar a literatura cinzenta. Dois investigadores leram os títulos e resumos de cada referência cruzada de forma independente. O risco de viés dos estudos incluídos foi analisado com a ferramenta Cochrane Collaboration Risk of Bias Tool. A qualidade das evidências e a classificação da força das recomendações foram avaliadas mediante os Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: foram identificados sete ensaios clínicos controlados. Os controles utilizados foram calêndula, placebo, preferência institucional / atenção padrão, Aquaphor®, RadiaCare™ e Lipiderm™. Os estudos foram agrupados utilizando a frequência de eventos e o índice de risco com intervalos de confiança de 95% em subgrupos, de acordo com a graduação da radiodermatite. Conclusão: com base nos estudos incluídos nesta revisão, a trolamina não pode ser considerada um produto padronizado para a prevenção ou o tratamento da radiodermatite em pacientes com câncer de mama e cabeça e pescoço.Objective: to evaluate the effects of trolamine in the prevention or treatment of radiation dermatitis. Method: systematic review and meta-analysis. Detailed individual search strategies for Cinahl, Cochrane Library Central, LILACS, PubMed, and Web of Science were developed in January 2016. A manual search was also performed to find additional references. A grey literature search was executed by using Google Scholar. Two researchers independently read the titles and abstracts from every cross-reference. The risk of bias of the included studies was analyzed by the Cochrane Collaboration Risk of Bias Tool. The quality of evidence and grading of strength of recommendations was assessed using Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Results: seven controlled clinical trials were identified. The controls used were calendula, placebo, institutional preference / usual care, Aquaphor®, RadiaCare™, and Lipiderm™. The studies were pooled using frequency of events and risk ratio with 95% confidence intervals, in subgroups according to radiation dermatitis graduation. Conclusion: based on the studies included in this review, trolamine cannot be considered as a standardized product to prevent or treat radiation dermatitis in patients with breast and head and neck cancer.Objetivo: evaluar los efectos de la trolamina en la prevención o el tratamiento de la radiodermatitis. Método: revisión sistemática y meta-análisis. En enero de 2016 se desarrollaron estrategias detalladas de búsqueda individual para Cinahl, Cochrane Library Central, LILACS, PubMed y Web of Science. También se realizaron búsquedas manuales para encontrar referencias adicionales. Se utilizó Google Scholar para buscar literatura gris. Dos investigadores leyeron los títulos y los resúmenes de cada referencia cruzada independientemente. El riesgo de sesgo de los estudios incluidos fue analizado por la herramienta Cochrane Collaboration Risk of Bias Tool. La calidad de la evidencia y la clasificación de la fuerza de las recomendaciones se evaluó mediante los Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Resultados: se identificaron siete ensayos clínicos controlados. Los controles utilizados fueron caléndula, placebo, preferencia institucional / atención habitual, Aquaphor®, RadiaCare™ y Lipiderm™. Los estudios se agruparon utilizando la frecuencia de eventos y la razón de riesgo con intervalos de confianza del 95%, en subgrupos según la graduación de radiodermatitis. Conclusión: con base en los estudios incluidos en esta revisión, la trolamina no puede considerarse un producto estandarizado para prevenir o tratar la radiodermatitis en pacientes con cáncer de mama y cabeza y cuello

Plants from Brazilian cerrado with potent tyrosinase inhibitory activity

The increased amount of melanin leads to skin disorders such as age spots, freckles, melasma and malignant melanoma. Tyrosinase is known to be the key enzyme in melanin production. Plants and their extracts are inexpensive and rich resources of active compounds that can be utilized to inhibit tyrosinase as well as can be used for the treatment of dermatological disorders associated with melanin hyperpigmentation. Using in vitro tyrosinase inhibitory activity assay, extracts from 13 plant species from Brazilian Cerrado were evaluated. The results showed that Pouteria torta and Eugenia dysenterica extracts presented potent in vitro tyrosinase inhibition compared to positive control kojic acid. Ethanol extract of Eugenia dysenterica leaves showed significant (p<0.05) tyrosinase inhibitory activity exhibiting the IC50 value of 11.88 µg/mL, compared to kojic acid (IC50 value of 13.14 µg/mL). Pouteria torta aqueous extract leaves also showed significant inhibitory activity with IC50 value of 30.01 µg/mL. These results indicate that Pouteria torta and Eugenia dysenterica extracts and their isolated constituents are promising agents for skin-whitening or antimelanogenesis formulations