Revisão sistemática dos efeitos tardios de distúrbios de desenvolvimento dentário em pacientes submetidos a transplante de células-tronco hematopoiéticas durante a infância

O objetivo desta pesquisa foi revisar sistematicamente as publicações referentes aos efeitos tardios decorrentes das alterações do desenvolvimento dentário em pacientes submetidos ao transplante de células-tronco hematopoiéticas durante a infância. A pesquisa sistemática da literatura avaliou os artigos publicados desde janeiro de 1980 até a presente data que se enquadraram nos critérios de inclusão/exclusão pré-determinados. A compilação dos dados foi dividida em distúrbios de desenvolvimento dentário qualitativos e quantitativos. Além disso, os registros demográficos foram contabilizados. Os primeiros e segundos pré-molares e os segundos molares foram os dentes significativamente mais afetados nas crianças submetidas ao transplante de células-tronco hematopoiéticas. Houve uma correlação positiva entre a idade em que as terapias antineoplásicas foram administradas e os distúrbios de desenvolvimento dentário qualitativos e quantitativos. A associação do tratamento mieloablativo por meio de radioterapia total ou em região de cabeça e pescoço apresentou correlação positiva com os distúrbios de desenvolvimento dentário. Essas alterações podem ser comumente vistas em pacientes que conseguem sobreviver ao transplante de células-tronco hematopoiéticas durante a infância. O conhecimento dessas alterações pode ajudar a melhorar o atendimento odontológico e elevar a qualidade de vida desses pacientes. Mais estudos são necessários para entender os efeitos de longo prazo dos distúrbios de desenvolvimento dentário para esse grupo de pacientes.The purpose of this systematic review was to evaluate published data and to update our current knowledge about the impact on dental development of childhood hematopoietic stem-cell transplantation (HSCT), as well as the late effects of preparative regimens, for the treatment of onco-hematological malignancies. A systematic literature research was conducted to assess articles published since January 1980 until the present day that fi tted the predetermined inclusion/exclusion criteria. Data compilation was divided into qualitative and quantitative dental development disturbances. Demographic records were also gathered. First and second premolars and second molars were signifi cantly more affected in HSCT children. There was a positive correlation between age at the time of anticancer therapy administration and qualitative and quantitative dental development disturbances. The association of total body or head and neck radiation mieloablative treatments was shown to enhance the magnitude of dental development disturbances. Dental development disturbances due to childhood HSCT are commonly seen in long-term survivors. The knowledge of these alterations may help improve dental care and elevate the quality of life of these patients. Further studies are needed to understand the long-term effects of dental development disturbances in this group of patients

A systematic review of the long-term effects of dental development disturbances after hematopoietic stem-cell transplantation in pediatric patients

The purpose of this systematic review was to evaluate published data and to update our current knowledge about the impact on dental development of childhood hematopoietic stem-cell transplantation (HSCT), as well as the late effects of preparative regimens, for the treatment of onco-hematological malignancies. A systematic literature research was conducted to assess articles published since January 1980 until the present day that fi tted the predetermined inclusion/exclusion criteria. Data compilation was divided into qualitative and quantitative dental development disturbances. Demographic records were also gathered. First and second premolars and second molars were signifi cantly more affected in HSCT children. There was a positive correlation between age at the time of anticancer therapy administration and qualitative and quantitative dental development disturbances. The association of total body or head and neck radiation mieloablative treatments was shown to enhance the magnitude of dental development disturbances. Dental development disturbances due to childhood HSCT are commonly seen in long-term survivors. The knowledge of these alterations may help improve dental care and elevate the quality of life of these patients. Further studies are needed to understand the long-term effects of dental development disturbances in this group of patients.O objetivo desta pesquisa foi revisar sistematicamente as publicações referentes aos efeitos tardios decorrentes das alterações do desenvolvimento dentário em pacientes submetidos ao transplante de células-tronco hematopoiéticas durante a infância. A pesquisa sistemática da literatura avaliou os artigos publicados desde janeiro de 1980 até a presente data que se enquadraram nos critérios de inclusão/exclusão pré-determinados. A compilação dos dados foi dividida em distúrbios de desenvolvimento dentário qualitativos e quantitativos. Além disso, os registros demográficos foram contabilizados. Os primeiros e segundos pré-molares e os segundos molares foram os dentes significativamente mais afetados nas crianças submetidas ao transplante de células-tronco hematopoiéticas. Houve uma correlação positiva entre a idade em que as terapias antineoplásicas foram administradas e os distúrbios de desenvolvimento dentário qualitativos e quantitativos. A associação do tratamento mieloablativo por meio de radioterapia total ou em região de cabeça e pescoço apresentou correlação positiva com os distúrbios de desenvolvimento dentário. Essas alterações podem ser comumente vistas em pacientes que conseguem sobreviver ao transplante de células-tronco hematopoiéticas durante a infância. O conhecimento dessas alterações pode ajudar a melhorar o atendimento odontológico e elevar a qualidade de vida desses pacientes. Mais estudos são necessários para entender os efeitos de longo prazo dos distúrbios de desenvolvimento dentário para esse grupo de pacientes

Oral soft-tissue sarcomas diagnosed in an oral pathology service: a 16year experience

Objective: This study analyzed the prevalence and clinic-pathological features of soft-tissue sarcomas diagnosed in a single-center of oral pathology from a School of Dentistry in Brazil. Materials and methods: All consecutive cases of intra-oral soft-tissue sarcomas diagnosed between January of 2002 and December of 2018 were retrieved from the files; patient data (sex, age and race) and characteristics of the lesions (site, size, clinical aspect and duration of injury) were collected. Results: Among a total of 62,255 biopsies diagnosed in the studied period, soft-tissue oral sarcomas comprised 76 cases (0.12%). Kaposi sarcoma, rhabdomyosarcoma, leiomyosarcoma encompassed 64.5% of the cases, and 53% of these were diagnosed as Kaposi Sarcoma. Male patients were more affected (59.2%) and white patients comprised 50%. In general, 39.4% of the patients were between 21-40yo. Conclusion: Soft-tissue sarcomas are rare in oral soft-tissue and in our pathology service, they comprised only 0.12% of all diseases diagnosed in the studied period. Kaposi sarcoma was the most frequent, followed by leiomyosarcoma and rhabdomyosarcoma. Thus, it is important for stomatologists and pathologists to be aware of their characteristics when examining oral mucosa, mainly their peculiarities regarding patient’s age, clinical appearance, and site of occurrence.Objetivo: Este estudo analisou a prevalência e as características clinico-patológicas de sarcomas de tecidos moles diagnosticados em um único centro de patologia oral de uma escola odontológica no Brasil. Materiais e métodos: Todos os casos consecutivos de sarcomas de tecido mole intraoral, diagnosticados entre janeiro de 2002 e dezembro de 2018, foram obtidos de arquivos; os dados dos pacientes (sexo, idade e raça) e as características da lesão (local, tamanho, aspecto clínico e duração da lesão) foram coletados. Resultado: De 62.255 biopsias diagnosticadas no período estudado, sarcoma oral de tecidos moles abrangia somente 76 dos casos (0,12%). Desses, sarcoma de Kaposi, rabdomiossarcoma e leiomiossarcoma correspondiam a  64,5%; dos quais, 53% foram diagnosticados como sarcoma de Kaposi. Pacientes masculinos foram os mais afetados (59,2%) e 50% dos pacientes eram brancos. Em geral, 39,4% dos pacientes tinham entre 21-40 anos de idade. Conclusão: Sarcomas de tecido mole são raros em tecido mole oral e, em nosso serviço de patolologia, totalizavam apenas 0,12% de todas as doenças diagnosticadas no período do estudo. Sarcoma de Kaposi foi o mais frequente, seguido por leiomiossarcoma e rabdomiossarcoma. Por isso é importante para estomatologistas e patologistas estarem atentos às características durante o exame da mucosa oral, principalmente às suas peculiaridades referentes à idade do paciente, a aparência clínica da lesão e o local da ocorrência

Early Diagnosis of Myocardial Dysfunction in Patients With Hematological Malignancies Submitted to Chemotherapy. Preliminary Results.

Early Diagnosis of Miocardial Dysfunction in Patients with Hematological Malignancies Submitted to Chemotherapy. Preliminary \ud Background: Considering the current diagnostic improvements and tl1erapeutic approaches, patients witl 1 cancer can now be healed or keep the disease under control, still, the chemotherapy may cause heart damage, evolving to Congestive Heart Failure. Recognition of those changes increases the chances of control the endpoints; hence, new parameters of cardiac and fluid mechanics analysis have been used to assess the myocardial function, pursuing an earlier diagnosis of the cardiac alterations. This study aimed to detect early cardiac dysfunction consequently to chemotherapy in patients with hematological malignancies (HM). Methods: Patients with leukemia and lymphoma, submitted to chemotherapy, without knowing heart diseases were studied. Healthy volunteers served as the control group. Conventional 2DE parameters of myocardial function were analyzed. The peak global longitudinal, circumferential and radial left ventricular (LV) strain were deternined by 2D and 3D speckle tracking (STE); peak area strain measured by 3D STE and LV torsionn, twisting rate, recoil / recoil rate assessed by 2D STE. The LV vortex formation time (VFT) during the rapid diastolic filling was estimated by the 2D mitral valve (MV) planimetry and Pulsed Doppler LV inflow by: VFT- 4(1-β) / π x α3 x LVEF Where 1- β is the E wave contribution to the LV stroke volume and α3 is a volumetric variable related to the MV area. The statistical level was settled on 5%. Results: See Table. Conclusion: Despite the differences between the two groups concerning the LVESV, LVEF and E´, those parameters still are in the normal range when considering the patients submitted to chemotherapy; thus, in the clinical setting, they are not so noticeable. The 3D GLS was smaller among the patients, oppositely to the 2D GLS, suggesting that the former variable is more accurate to assess tlhe LV systolic function. The VFT is a dimensionless measure of the optimal vortex development inside the LV chamber; reflecting the efficiency of the diastolic filling and, consequently, blood ejection. This index showed to be diminished in patients with HM submitted to chemotherapy, indicating an impairment of the in1pulse and thrust, hence appearing to be a very early marker of diastolic and systolic dysfunction in this group.CNP