Medidas de hemostasia local pós-exodontia unitárias em pacientes que fazem uso de varfarina: um estudo clínico controlado e randomizado

The present work is a clinical trial, controlled, blinded and randomized with patients on anticoagulation therapy with warfarin comparing local hemostatic measures for the control of post-tooth extraction bleeding. For that were employed two local hemostasis methods, with group I (control) using only irrigation, compression with gauze with saline and suture and group II (study) using irrigation, compress with gauze soaked with tranexamic acid and suture. The sample consisted of 37 patients with mean age of 45,5 years and 62,2% were female. After randomization 20 were allocated to the control group and 17 in the study group, and performed a surgical procedure per patient. The surgical procedure time lasted an average of 30,9 (± 7,5) minutes. All variables that could influence the outcome were similar between the groups, no significant difference was seen (p> 0,05). In assessing the immediate hemostasis to get the stagnation of bleeding was 9,1 (± 3.6) minutes. In the study group the time to get that hemostasis was much lower compared with the control, and this difference (6,018 / IC 95%: 4,677-7,359) was statistically significant (p 0,05). Na avaliação da hemostasia imediata a média para conseguir o estancamento do sangramento foi de 9,1 (±3,6) minutos. No grupo estudo o tempo para conseguir essa hemostasia foi bem menor se comparado com o controle, sendo essa diferença (6,018 / IC 95%: 4,677-7,359) estatisticamente significante (p<0,001). Avaliando o controle do sangramento de forma mediata o uso do ácido tranexâmico se mostrou mais associado significativamente com a não ocorrência de sangramento, principalmente nas primeiras 24h. Assim sendo essa medida de hemostasia local de forma tópica como compressa com gazes e irrigação local foi eficaz como um protocolo de hemostasia local na redução do tempo de hemostasia imediata e prevenção do sangramento mediato

Apoptosis and cell cycle aberrations in epithelial odontogenic lesions : an evidence by the expression of p53, Bcl-2 and Bax

Ameloblastoma (AMB), odontogenic keratocyst (OKC) and adenomatoid odontogenic tumor (AOT) are epithelial odontogenic lesions with diverse biologic profiles. Defects in regulation of apoptosis and cell cycle may be involved in the development and progression of those lesions, therefore we aimed to investigate the expression of Bcl-2, Bax and p53 to better understand the possible role of these proteins in AMBs, OKCs and AOTs. The studied sample consisted of 20 AMBs, 20 OKCs and 20 AOTs. Immunohistochemistry technique was performed for the antibodies p53, Bcl-2 and Bax. Immunoreactivity was observed in the epithelial component and positive cells were counted in five fields (100x magnification). Statistical analysis was performed with Kruskal-Wallis and Spearman tests (p<0.05). All lesions exhibited staining for the three studied proteins. There was no statistically significant associations between the expression of proteins and the lesions, however we identified a positive correlation between the expression of p53 and Bcl-2 (r = 0.200) and a negative correlation between p53 and Bax expressions (r = -0.100). In addition, p53 and Bax were similarly expressed between AMBs and OKCs. Bcl-2 was similarly expressed in AMBs and AOTs. Apoptosis regulatory proteins, as well as cell cycle proteins, are differently expressed in epithelial odontogenic lesions and their expression is possibly related to the biological behavior of AMB, OKC and AOT

Clinicopathological evaluation and survival of patients with squamous cell carcinoma of the tongue

Early detection of oral cancer is the most effective means of reducing morbidity, complexity, and extent of treatment. This study evaluated the clinicopathological profile of epidermoid carcinoma of the tongue, including treatment and survival. This observational, retrospective cross-sectional study evaluated patients with squamous cell carcinoma of the tongue treated at the Dr. Luiz Antônio Hospital, Natal, Brazil, from January 2001 to December 2011. Survival variables were calculated using the Kaplan-Meier method and compared by log rank tests. Of the 412 patients diagnosed in this period, 298 (72.3%) were men; their mean age was 60.5 years, and 69.2% were diagnosed with stage III/IV tumours. Improved survival was associated with early stage diagnosis, absence of affected lymph nodes at diagnosis, and treatment with surgery alone. Late stage diagnosis of oral cancer negatively affects patient survival. In addition, the general public should be made aware of the prognostic factors for oral SCC of the tongue and of the importance of periodic examinations of the oral cavity

Immunohistochemical expression of OCT4 and CD44 in major and minor salivary gland neoplasms

The aim of this study was to identify tumor parenchyma cells exhibiting immunohistochemical profile of stem cells by evaluating the immunoreactivity of OCT4 and CD44 in a number of cases of salivary gland neoplasms. The sample consisted of 20 pleomorphic adenomas, 20 mucoepidermoid carcinomas, and 20 adenoid cystic carcinomas located in major and minor salivary glands. The expression of OCT4 and CD44 was evaluated by the percentage of positive cells and the intensity of expression. All studied cases showed positive expression of OCT4 and CD44 and higher values than the control groups. For OCT4, luminal and non-luminal cells were immunostained in the case of pleomorphic adenomas and adenoid cystic carcinomas. Moreover, the immunoreactivity of CD44 was particularly evident in the nonluminal cells of these lesions. In mucoepidermoid carcinomas, there was immunoreactivity for both markers in squamous and intermediate cells and absence of staining in mucous cells. For both markers, a significantly higher immunostaining was verified in neoplasms located in the major salivary glands compared with lesions in minor salivary glands (p<0.001). In the total sample and in minor salivary glands, malignant neoplasms exhibited higher immunoreactivity for OCT4 than pleomorphic adenoma. A significant moderate positive correlation (r = 0.444 and p ≤ 0.001) was found between OCT4 and CD44 immunoexpression in the total sample. The high expression of OCT4 and CD44 may indicate that these proteins play an important role in identifying tumor stem cells

Avaliação clínica e histopatológica e hábitos associados ao surgimento de leucoplasias e eritroplasias orais

Objective: This research aims to establish the prevalence, factors associated with the onset, and clinical and histopathological features of oral leukoplakia and erythroplakia, so that these data can contribute to the prevention of these lesions and, consequently, of oral cancer. Material and method: A retrospective study was conducted at a reference service of Universidade Federal do Rio Grande do Norte (UFRN) from 2000 to 2012. To verify the association of variables, Pearson's chi-squared test and Fisher's exact test (p ≤ 0.05) were used. Results: Among 6,560 investigated records, 54 cases were selected, of which 44.4% were male and 55.6% female, with mean age of 56.93 years. Regarding habits, 72.2% were smokers and 25% were alcohol users; 17.9% showed association of both habits. Oral leukoplakia lesions were the most prevalent (0.65%) and oral erythroplakia showed greater association with malignancy in the histopathological presentation (p = 0.001). Most lesions showed no symptoms (p = 0.004). The most frequent was oral leukoplakia in smoking women, with mean age of 57 years. Conclusion: Knowledge of associated factors and clinical characteristics of oral leukoplakia and erythroplakia is essential for establishing the correct diagnosis and treatment.Objetivo: Esta pesquisa objetiva estabelecer a prevalência, os fatores associados ao surgimento e as características clínicas e histopatológicas das leucoplasias e eritroplasias orais, a fim de que estes dados possam contribuir na estratégia de prevenção ao desenvolvimento dessas lesões e, consequentemente, do câncer oral. Material e método: Foi realizado estudo retrospectivo em um serviço de referência da Universidade Federal do Rio Grande do Norte (UFRN) no período de 2000 a 2012. Para verificar a associação das variáveis foi utilizado o teste qui-quadrado e o exato de Fisher (p ≤ 0,05). Resultados: Foram investigados 6.560 prontuários, tendo sido selecionados 54 casos, dos quais 44,4% do sexo masculino e 55,6% do feminino, com idade média de 56,93 anos. Com relação aos hábitos, 72,2% eram fumantes e 25% usuários de álcool, sendo que 17,9% exibiam associação dos dois hábitos. As leucoplasias orais foram as lesões mais prevalentes (0,65%), e as eritroplasias orais apresentaram maior associação com apresentação maligna no diagnóstico histopatológico (p = 0,001). A maioria das lesões não apresentou sintomatologia (p = 0,004). A leucoplasia oral foi mais frequente em mulheres fumantes com média de idade de 57 anos. Conclusão: O conhecimento dos fatores associados e das características clínicas das eritroplasias e leucoplasias orais é essencial para o estabelecimento do correto diagnóstico e tratamento

Clinical and histopathological evaluation and habits associated with the onset of oral leukoplakia and erythroplakia

Objective:This research aims to establish the prevalence, factors associated with the onset, and clinical and histopathological features of oral leukoplakia and erythroplakia, so that these data can contribute to the prevention of these lesions and, consequently, of oral cancer.Material and method:A retrospective study was conducted at a reference service of Universidade Federal do Rio Grande do Norte (UFRN) from 2000 to 2012. To verify the association of variables, Pearson's chi-squared test and Fisher's exact test (p ≤ 0.05) were used.Results:Among 6,560 investigated records, 54 cases were selected, of which 44.4% were male and 55.6% female, with mean age of 56.93 years. Regarding habits, 72.2% were smokers and 25% were alcohol users; 17.9% showed association of both habits. Oral leukoplakia lesions were the most prevalent (0.65%) and oral erythroplakia showed greater association with malignancy in the histopathological presentation (p = 0.001). Most lesions showed no symptoms (p = 0.004). The most frequent was oral leukoplakia in smoking women, with mean age of 57 years.Conclusion:Knowledge of associated factors and clinical characteristics of oral leukoplakia and erythroplakia is essential for establishing the correct diagnosis and treatment

Treatment of oral hemangioma with sclerotherapy: case report

Hemangiomas are benign neoplasms that are common in the head and neck, but relatively rare in the oral cavity. They can cause esthetic and functional impairment, depending on location. The most common site is the upper lip, but they can occur in other areas, such as the tongue, buccal mucosa and palate. Treatment is primarily dependent on correct diagnosis of the lesion and on its anatomic location. The purpose of this article is to provide a description of a case of a hemangioma on the upper lip, treated by therapeutic sclerosis with monoethanolamine oleate (Ethamolin®), covering clinical characteristics and methods for diagnosing these lesions. Precise diagnosis and appropriate therapeutic management resulted in satisfactory esthetic and functional results, with total regression of the lesion and no signs of relapse at 1-year follow-up

Expression of urokinase-type plasminogen activator and its receptor in squamous cell carcinoma of the oral tongue

Abstract Urokinase-type plasminogen activator (uPA) and its receptor (uPAR) act in the proteolysis of basement membrane and extracellular matrix structures, facilitating tumor invasion. The purpose of this study was to evaluate the relationship between these proteins and clinicopathological parameters in squamous cell carcinoma of the oral tongue (SCCOT). Sixty cases of SCCOT were submitted to immunohistochemistry and analyzed semiquantitatively at the invasion front and in the tumor core. The results were associated with lymph node metastasis, clinical stage, locoregional recurrence, clinical outcome and histological grade of malignancy. A higher expression of uPA was observed in cases of tumors of high-grade versus low-grade malignancy (p = 0.010). Moreover, the cases with the worst pattern of invasion presented an overexpression of uPA (p = 0.011). The presence of locoregional recurrence was associated with uPAR (p = 0.039), and the expression of both biomarkers was much higher at the invasion front than in the tumor core (p < 0.001). The results suggest uPA and uPAR are involved in the progression and aggressiveness of SCCOT, mainly at the tumor-host interface