Značaj FHIT i Bcl-2 u bolesnika s oralnim lihen planusom u usporedbi s zdravom oralnom sluznicom i oralnim karcinomom pločastih stanica

Background: Oral lichen planus (OLP) is a precancerous lesion which might progress into oral squamous cell cancer (OSCC) in 0-1.2 % of the affected patients. Albeit there are many published studies upon this topic, there are no universally accepted clinical and histopathological criteria which would suggest which patients will develop OSCC. Therefore, the aim of this study was to compare epithelial and sub epithelial FHIT and Bcl-2 expression between patients with OLP, OSCC and healthy oral mucosa.Materials and Methods: Fifty patients with OLP, 20 with OSCC who had histologically confi rmed diagnoses and 20 healthy controls were included in this study. Immuno-histochemical analysis was performed on primary monoclonal antibodies Bcl-2 (Dako, Finland) and FHIT (Zymed Laboratories Inc., USA) were used. Statistical analysis included Kolmogorov-Smirnoff test, χ2 test and Spearman’s correlation. All p values lower than p<0.05 were considered as significant. Results: Expression of FHIT in the OLP and OSCC epithelium is significantly decreased when compared to the healthy oral mucosa. However, no significant differences between FHIT expression between OLP and OSCC could be found. OLP and OSCC patients have signifi cantly increased expression values of Bcl-2 in the epithelium when compared to the epithelium of healthy participants. Furthermore, Bcl-2 expression is significantly increased in patients with OLP when compared to the patients with OSCC. Subepithelial infiltrate in OLP and OSCC reveals signifi cantly higher Bcl 2 expression when compared to the healthy controls. However, Bcl-2 expression in the infl ammatory infi ltrate is signifi cantly higher in OSCC patients when compared to the OLP patients. Conclusion: Loss of FHIT expression in the epithelium is not suffi cient for malignant transformation in OLP patients. It seems that other molecular changes are needed for OLP progression into OSCC. Bcl-2 expression in the infl ammatory infi ltrate is signifi cantly higher in OSCC patients when compared to the OLP patients and healthy controls, however bcl-2 expression in the epithelium does not correlate with precancerous (OLP) and OSCC lesions.Uvod: Oralni lihen planus (OLP) je prekancerozna lezija koji u 0-1,2 % oboljelih može progredirati u oralni karcinom pločastih stanica (OKPS). Premda su objavljeni brojni radovi na ovu temu, ne postoje opće prihvaćeni klinički i patohistološki kriteriji koji bi upućivali na to u kojih će se bolesnika razviti OKPS. Dakle, cilj je ovog istraživanja bio usporediti ekspresiju FHIT i Bcl-2 u epitelu i subepitelu pacijenata s OLP, OKPS te osoba sa zdravom oralnom sluznicom. Materijal i metode: U istraživanje je bilo uključeno pedeset pacijenata s histološki potvrđenom dijagnozom OLP, 20 pacijenata s histološki potvrđenom dijagnozom OKPS te 20 zdravih pacijenata kao kontrolna skupina. Korištene su imunohistokemijske analize na primarnim monoklonim protutijelima Bcl (Dako, Finska) i FHIT (Zymed Laboratories Inc., SAD). U statističkoj analizi korišteni su Kolmogorov-Smirnovljev test, hi kvadrat test i Spearmanov koefi cijent korelacije. P vrijednosti manje od 0.05 su smatrane značajnima. Rezultati: Ekspresija FHIT u epitelu zahvaćenom s OLP i OKPS je značajno smanjena u usporedbi sa zdravom oralnom sluznicom. Međutim, nije nađena značajna razlika u FHIT ekspresiji kod OLP i OKPS. Pacijenti oboljeli od OLP i OKPS imaju značajno pojačanu ekspresiju Bcl-2 u usporedbi s zdravim sudionicima. Nadalje, Bcl-2 ekspresija je značajno veća u pacijenata s OLP, nego u pacijenata s OKPS. Subepitelni infi ltrat u pacijenata s OLP i OKPS pokazuje značajno povećanje Bcl-2 ekspresije u odnosu na zdrave osobe iz kontrolne skupine. Međutim, Bcl-2 ekspresija u upalnom infiltratu je značajno viša u OKPS pacijenata nego li u OLP pacijenata. Zaključak: Gubitak FHIT ekspresije u epitelu sam po sebi nije dovoljan za zloćudnu transformaciju kod pacijenata koji boluju od OLP. Čini se da su za progresiju OLP u OKPS potrebne i druge molekularne promjene. Ekspresija Bcl-2 u upalnom infi ltrate je znakovito visa u bolesnika s OPKS u odnosu na bolesnicke s OLP i zdrave kontrole, ipak, ekspresija bcl-2 u epitelu ne korelira s prekanceroznim (OLP) odnosno lezijama OPKS

Uloga regionalne anestezije u postoperativnoj analgeziji pedijatrijskih bolesnika

Introduction/Objective Pain is a disturbing experience associated with existing or potential tissue damage, with a sensory, emotional, cognitive, and social component. The aim of this study was to show the efficiency of regional anesthetic techniques in postoperative pain in children. Methods The retrospective cohort study was conducted on a group of 564 pediatric patients during the period from 2013 to 2016. Types of regional anesthesia were classified into the following six groups: caudal, epidural, spinal block, upper limb blocks, lower limb blocks, and truncal nerve block. From statistical methods, we used descriptive statistical methods of absolute and relative numbers, measurements of variability, central tendencies for numerical features, and methods of inferential statistics. We used the ch2 test for the attributive features of observations. Results In relation to the postoperative time when an analgesic was required, a statistically significant difference was observed in the age of children (p = 0.000), disease diagnosis (p = 0.000), type of block (p = 0.000), type of local anesthetic (p = 0.000), and type of anesthesia or sedation preoperatively (p = 0.005). Conclusion Postoperative analgesia was most needed by older children and children who were awake during surgery. Children with injuries and tumors need postoperative analgesia the earliest. The longest postoperative analgesia was recorded in patients who received caudal block. The longest postoperative analgesia can be seen in patients who received levobupivacaine, bupivacaine or levobupivacaine combined with lidocaine to perform the block.Uvod/Cilj Bol predstavlja uznemirujuće iskustvo koje je povezano sa postojećim ili mogućim oštećenjem tkiva, sa senzornom, emocionalnom, kognitivnom i socijalnom komponentom. Cilj ove studije je prikaz efikasnosti tehnika regionalne anestezije na postoperativni bol kod dece. Metode Retrospektivna kohortna studija je sprovedena na grupi od 564 pedijatrijskih bolesnika u periodu od 2013. do 2016. godine. Vrste regionalne anestezije su klasifikovane u šest grupa: kaudalna, epiduralna, spinalna, blokovi gornjih ekstremiteta, donjih ekstremiteta i blok trupa. Od statističkih metoda koristili smo deskriptivne statističke metode apsolutnih i relativnih brojeva za atributivna obeležja posmatranja, mere varijabiliteta, centralne tendencije za numerička obeležja i metode inferencijalne statistike. Izbor testova za numerička obeležja posmatranja zavisiće od raspodele podataka. Za atributivna obeležja posmatranja koristili smo ch2 test. Rezultati U odnosu na postoperativno vreme kada je bio potreban analgetik, statistički značajna razlika uočena je u uzrastu dece (p = 0,000), dijagnozi bolesti (p = 0,000), vrsti bloka (p = 0,000), vrsti korišćenog lokalnog anestetika (p = 0,000), kao i vrsti perioperativne anestezije ili sedacije (p = 0,005). Zaključak Postoperativna analgezija je najpotrebnija starijoj deci i deci koja su bila budna tokom hirurške intervencije. Najranija postoperativna analgezija je potrebna deci sa povredama i tumorima. Najduža postoperativna analgezija je zabeležena kod bolesnika koji su dobili kaudalni blok, kao i bolesnika koji su primili levobupivakain, bupivakain ili levobupivakain u kombinaciji sa bupivakainom za izvođenje bloka

Oralne komplikacije zračenja glave i vrata

Almost all patients (90-100%) who have undergone radiation treatment (RT) of head and neck region develop at least one oral complication. Oral complications of head and neck RT can be acute and chronic. Acute complications occur during RT and include oral mucositis, dry mouth and taste sensation disorder. Chronic complications occur several weeks, months or years after RT cessation, and include radiation caries, osteoradionecrosis and trismus.Gotovo svi pacijenti (90-100%) koji su podvrgnuti terapijskom zračenju u području glave i vrata razviju neku od komplikacija u usnoj šupljini. Oralne komplikacije terapijskog zračenja glave i vrata mogu biti akutne i kronične. Akutne komplikacije nastaju tijekom zračenja i u njih ubrajamo oralni mukozitis, suhoću usta i poremećaj okusne osjetljivosti. Kronične komplikacije nastaju nekoliko tjedana, mjeseci ili godina po završetku zračenja, i podrazumijevaju radijacijski karijes, osteoradionekrozu i trizmus

Scarring alopecias

Ožiljne alopecije su heterogena skupina rijetkih poremećaja karakterizirana trajnom destrukcijom folikula dlake koja rezultira ožiljkom i trajnim, ireverzibilnim gubitkom dlaka. Smatra se da primarne ožiljne alopecije čine 3% ukupnog broja alopecija, a dijele se na primarne i sekundarne ožiljne alopecije. U ovom radu je naglasak na primarnim ožiljnim alopecijama, koje se klasificiraju tipu dominantnog upalnog infiltrata utvrđenog patohistološkom analizom bioptata zahvaćenog dijela vlasišta. Prema navedenoj klasifikaciji, primarne ožiljne alopecije dijele se na limfocitne, neutrofilne, mješovite i nespecifične. Limfocitne alopecije čine najveću skupinu primarnih ožiljnih alopecija obilježenih dominantno limfocitnim infiltratom i među njima razlikujemo nekoliko glavnih kliničkih entiteta: kronični kožni eritemski lupus, lichen planopilaris, frontalna fibrozirajuća alopecija, Graham-Little sindrom, pseudopelade Brocq, centralna centrifugalna ožiljna alopecija, alopecia mucinosa, keratosis follicularis spinulosa decalvans te, kao novi entitet, fibrozirajuća alopecija s posebnim uzorkom distribucije. Neutrofilne primarne ožiljne alopecije karakterizirane su većinski neutrofilnim infiltratom, a u ovu skupinu pripadaju folliculitis decalvans i disecirajući folikulitis vlasišta. Manje zastupljene primarne ožiljne alopecije su mješovite (acne keloidalis, acne necrotica i erozivna pustularna dermatoza vlasišta) i nespecifične (tinea capitis). Terapija ovih bolesti temelji se na smanjenju upale ako ista postoji (intralezionalni i lokalni kortikosteroidi, antibiotici) i modulaciji imunološkog odgovora (retinoidi, antimalarici, inhibitori kalcineurina). Naravno, svaki klinički entitet naveden u radu zahtijeva specifičnu terapiju koja je detaljno opisana.Scarring alopecia is a heterogeneous group of rare disorders characterized by permanent destruction of hair follicles resulting in scarring and permanent, irreversible hair loss. It has been estimated that primary scarring alopecias account for 3% of the total number of alopecia, and they are divided into primary and secondary scarring alopecia. This paper emphasizes primary scarring alopecias, which are classified according to the type of dominant inflammatory infiltrate determined by pathohistological analysis of biopsies of the affected part of the scalp. This classification divides primary scarring alopecias into lymphocytic, neutrophilic, mixed, and nonspecific. Lymphocytic alopecia is the largest group of primary scarring alopecia characterized by predominantly lymphocytic infiltrate, and among them, we distinguish several main clinical entities: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, Graham-Little syndrome, alopecia mucinosa, keratosis follicularis spinulosa decalvans and, as a new entity, fibrosing alopecia in a pattern of distribution. Neutrophilic primary scarring alopecia is characterized by a predominantly neutrophilic infiltrate, and folliculitis decalvans and dissecting scalp folliculitis belong to this group. Less common primary scarring alopecias include mixed (acne keloidalis, acne necrotica, and erosive pustular dermatosis of the scalp) and nonspecific (tinea capitis). Treatment of these diseases is based on reducing inflammation if present (intralesional and local corticosteroids, antibiotics) and modulating the immune response (retinoids, antimalarials, calcineurin inhibitors). Of course, each clinical entity listed in the paper requires a specific therapy that is described in detail

Scarring alopecias

Ožiljne alopecije su heterogena skupina rijetkih poremećaja karakterizirana trajnom destrukcijom folikula dlake koja rezultira ožiljkom i trajnim, ireverzibilnim gubitkom dlaka. Smatra se da primarne ožiljne alopecije čine 3% ukupnog broja alopecija, a dijele se na primarne i sekundarne ožiljne alopecije. U ovom radu je naglasak na primarnim ožiljnim alopecijama, koje se klasificiraju tipu dominantnog upalnog infiltrata utvrđenog patohistološkom analizom bioptata zahvaćenog dijela vlasišta. Prema navedenoj klasifikaciji, primarne ožiljne alopecije dijele se na limfocitne, neutrofilne, mješovite i nespecifične. Limfocitne alopecije čine najveću skupinu primarnih ožiljnih alopecija obilježenih dominantno limfocitnim infiltratom i među njima razlikujemo nekoliko glavnih kliničkih entiteta: kronični kožni eritemski lupus, lichen planopilaris, frontalna fibrozirajuća alopecija, Graham-Little sindrom, pseudopelade Brocq, centralna centrifugalna ožiljna alopecija, alopecia mucinosa, keratosis follicularis spinulosa decalvans te, kao novi entitet, fibrozirajuća alopecija s posebnim uzorkom distribucije. Neutrofilne primarne ožiljne alopecije karakterizirane su većinski neutrofilnim infiltratom, a u ovu skupinu pripadaju folliculitis decalvans i disecirajući folikulitis vlasišta. Manje zastupljene primarne ožiljne alopecije su mješovite (acne keloidalis, acne necrotica i erozivna pustularna dermatoza vlasišta) i nespecifične (tinea capitis). Terapija ovih bolesti temelji se na smanjenju upale ako ista postoji (intralezionalni i lokalni kortikosteroidi, antibiotici) i modulaciji imunološkog odgovora (retinoidi, antimalarici, inhibitori kalcineurina). Naravno, svaki klinički entitet naveden u radu zahtijeva specifičnu terapiju koja je detaljno opisana.Scarring alopecia is a heterogeneous group of rare disorders characterized by permanent destruction of hair follicles resulting in scarring and permanent, irreversible hair loss. It has been estimated that primary scarring alopecias account for 3% of the total number of alopecia, and they are divided into primary and secondary scarring alopecia. This paper emphasizes primary scarring alopecias, which are classified according to the type of dominant inflammatory infiltrate determined by pathohistological analysis of biopsies of the affected part of the scalp. This classification divides primary scarring alopecias into lymphocytic, neutrophilic, mixed, and nonspecific. Lymphocytic alopecia is the largest group of primary scarring alopecia characterized by predominantly lymphocytic infiltrate, and among them, we distinguish several main clinical entities: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, Graham-Little syndrome, alopecia mucinosa, keratosis follicularis spinulosa decalvans and, as a new entity, fibrosing alopecia in a pattern of distribution. Neutrophilic primary scarring alopecia is characterized by a predominantly neutrophilic infiltrate, and folliculitis decalvans and dissecting scalp folliculitis belong to this group. Less common primary scarring alopecias include mixed (acne keloidalis, acne necrotica, and erosive pustular dermatosis of the scalp) and nonspecific (tinea capitis). Treatment of these diseases is based on reducing inflammation if present (intralesional and local corticosteroids, antibiotics) and modulating the immune response (retinoids, antimalarials, calcineurin inhibitors). Of course, each clinical entity listed in the paper requires a specific therapy that is described in detail

Scarring alopecias

Ožiljne alopecije su heterogena skupina rijetkih poremećaja karakterizirana trajnom destrukcijom folikula dlake koja rezultira ožiljkom i trajnim, ireverzibilnim gubitkom dlaka. Smatra se da primarne ožiljne alopecije čine 3% ukupnog broja alopecija, a dijele se na primarne i sekundarne ožiljne alopecije. U ovom radu je naglasak na primarnim ožiljnim alopecijama, koje se klasificiraju tipu dominantnog upalnog infiltrata utvrđenog patohistološkom analizom bioptata zahvaćenog dijela vlasišta. Prema navedenoj klasifikaciji, primarne ožiljne alopecije dijele se na limfocitne, neutrofilne, mješovite i nespecifične. Limfocitne alopecije čine najveću skupinu primarnih ožiljnih alopecija obilježenih dominantno limfocitnim infiltratom i među njima razlikujemo nekoliko glavnih kliničkih entiteta: kronični kožni eritemski lupus, lichen planopilaris, frontalna fibrozirajuća alopecija, Graham-Little sindrom, pseudopelade Brocq, centralna centrifugalna ožiljna alopecija, alopecia mucinosa, keratosis follicularis spinulosa decalvans te, kao novi entitet, fibrozirajuća alopecija s posebnim uzorkom distribucije. Neutrofilne primarne ožiljne alopecije karakterizirane su većinski neutrofilnim infiltratom, a u ovu skupinu pripadaju folliculitis decalvans i disecirajući folikulitis vlasišta. Manje zastupljene primarne ožiljne alopecije su mješovite (acne keloidalis, acne necrotica i erozivna pustularna dermatoza vlasišta) i nespecifične (tinea capitis). Terapija ovih bolesti temelji se na smanjenju upale ako ista postoji (intralezionalni i lokalni kortikosteroidi, antibiotici) i modulaciji imunološkog odgovora (retinoidi, antimalarici, inhibitori kalcineurina). Naravno, svaki klinički entitet naveden u radu zahtijeva specifičnu terapiju koja je detaljno opisana.Scarring alopecia is a heterogeneous group of rare disorders characterized by permanent destruction of hair follicles resulting in scarring and permanent, irreversible hair loss. It has been estimated that primary scarring alopecias account for 3% of the total number of alopecia, and they are divided into primary and secondary scarring alopecia. This paper emphasizes primary scarring alopecias, which are classified according to the type of dominant inflammatory infiltrate determined by pathohistological analysis of biopsies of the affected part of the scalp. This classification divides primary scarring alopecias into lymphocytic, neutrophilic, mixed, and nonspecific. Lymphocytic alopecia is the largest group of primary scarring alopecia characterized by predominantly lymphocytic infiltrate, and among them, we distinguish several main clinical entities: chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, Graham-Little syndrome, alopecia mucinosa, keratosis follicularis spinulosa decalvans and, as a new entity, fibrosing alopecia in a pattern of distribution. Neutrophilic primary scarring alopecia is characterized by a predominantly neutrophilic infiltrate, and folliculitis decalvans and dissecting scalp folliculitis belong to this group. Less common primary scarring alopecias include mixed (acne keloidalis, acne necrotica, and erosive pustular dermatosis of the scalp) and nonspecific (tinea capitis). Treatment of these diseases is based on reducing inflammation if present (intralesional and local corticosteroids, antibiotics) and modulating the immune response (retinoids, antimalarials, calcineurin inhibitors). Of course, each clinical entity listed in the paper requires a specific therapy that is described in detail

Environmental and behavioural head and neck cancer risk factors

n/