22 research outputs found
Unifocal orofacial granulomatosis in retromolar mucosa:surgical treatment with Er,Cr:YSGG laser
Orofacial granulomatosis is defined by permanent or recurrent swelling of orofacial tissues with different multiform
and multifocal clinical patterns. An 11-year old boy presented with a 2-month history of mucosa enlargement.
Intraoral examination revealed an erythematous, polylobulated, exophytic lesion with a smooth surface located in
retromolar mucosa, non-tender and non-infiltratated to palpation. The diagnosis was inflammatory lesion compatible
with pyogenic granuloma and laser excision was decided. Haematological parameters were within normal range,
as well as chest Xrays. These findings lead to a diagnosis of non-symptomatic orofacial granulomatosis, whose
early diagnosis can minimize the impact of systemic-related disorders, like Chron's disease
The role of p21Waf 1/CIP1 as a Cip/Kip type cell-cycle regulator in oral squamous cell carcinoma: review
Oral Squamous Cell Carcinoma (OSCC) is biologically characterized by the accumulation of multiple genetic and
molecular alterations that end up clinically characterized as a malignant neoplasm through a phenomenon known
as multistep. The members of the Cip/Kip family, specifically p21
Waf 1/CIP1
, are responsible for cell cycle control,
blocking the transition from phase G1 to phase S. We made a search of articles of peer-reviewed Journals in
PubMed/ Medline, crossing the keywords. The goal of this paper is to determine the relationship between p21
Waf 1/
CIP1
expression and several clinical and pathological aspects of OSCC, their relationship with p53 and HPV, as well
as genetic alterations in their expression pattern, their use as a prognosis market in the evolution of precancer
-
ous lesions and their roles in anticancer treatments. The results of p21
WA F1/C I P1
expression in OSCC showed mixed
results in terms of positivity/negativity throughout different studies. It seems that, although p21
Waf 1/CIP1
expression
is controlled in a p53-dependent manner, coexpression of both in OSCC is not intrinsically related. Although the
presence of HPV viral oncoproteins increases p21
Waf 1/CIP1
levels, the small number of studies, have forced us to
disregard the hypothesis that HPV infected lesions that present better prognosis are due to a p21
Waf 1/CIP1
-dependent
control. The role of p21
WA F1/C I P1
as cell-cycle regulator has been well described; however, its relationship to OSCC, the clinical and pathological variables of tumors, HPV and different treatments are not entirely clear. Thus, it would
be very interesting to pursue further study of this protein, which may have a significant value for the diagnosis, prog
nosis and therapy of this type of tumors
Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain.
Background: HIV-2 is a neglected virus despite estimates of 1–2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2.
Methods: In this retrospective observational study, we analysed all HIV-2-infected individuals treated with inte- grase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modal- ities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed.
Results: From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1).
Conclusions: Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individ- uals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options
HTLV-1 infection in solid organ transplant donors and recipients in Spain
HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy
Osteonecrosis of the jaws in 194 patients who have undergone intravenous bisphosphonate therapy in Spain
Background: Osteonecrosis of the jaw (ONJ) is a destructive bone process in patients undergoing bisphosphonate
therapy and it is modulated by local and systemic factors. The purpose of this article is to determine the prevalence
of ONJ in patients who have undergone intravenous bisphosphonate therapy, and relate the risk factors described
to establish a protocol to reduce the risk of developing ONJ.
Material and Methods: We performed a retrospective study on 194 patients treated with IV bisphosponates, analyzing clinical and pathological variables.
Results: The prevalence of ONJ was 12.9 %. The most remarkable complication was pain, which was reported
by 80% of patients. The average age of the patients undergoing bisphosphonate therapy was 68.91 years. Most of
non-diabetic patients did not develop ONJ (92.3%) (
p
=0.048). During bisphosphonate therapy, 3.1% of patients
underwent extractions in the same percentage in the maxilla and in the mandible; all of which, except for one
patient, developed ONJ (
p
<0.001). In regards to the periodontal state, 94.3% of patients without periodontal
problems did not develop ONJ (
p
=0.001). Almost 50% of the necrosis were located unifocally on the mandible
(
p
<0.001). The number of affected patients and the aggressiveness of the disease increased significantly three
years after starting treatment (
p
<0.001).
Conclusions: Etiology still is a controversial issue and we should focus on known risk factors, such as the development of surgical procedures in patients undergoing bisphosphonate therapy, especially in patients who have
already started their treatment, a group in which ONJ prevalence increases. Moreover, a bad periodontal state in these patients is also an important risk factor, and the control of diabetes reduces it. Due to the above, all patients
should be diagnosed and educated in oral hygiene prior to treatment, performing periodical maintenance, to detect
possible traumatisms and periodontal infection as soon as possible
Prognostic significance of monocarboxylate transporter expression in oral cavity tumors
Background:
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common type of cancer. The majority of patients present advanced stage disease and has poor survival. Therefore, it is imperative to search for new biomarkers and new alternative and effective treatment options. Most cancer cells rely on aerobic glycolysis to generate energy and metabolic intermediates. This phenotype is a hallmark of cancer, characterized by an increase in glucose consumption and production of high amounts of lactate. Consequently, cancer cells need to up-regulate many proteins and enzymes related with the glycolytic metabolism. Thus, the aim of this study was to characterize metabolic phenotype of oral cavity cancers (OCC) by assessing the expression pattern of monocarboxylate transporters (MCTs) 1, 2 and 4 and other proteins related with the glycolytic phenotype.
Material and Methods:
We evaluated the immunohistochemical expression of MCT1, MCT4, CD147, GLUT1 and CAIX in 135 human samples of OCC and investigated the correlation with clinicopathological parameters and the possible association with prognosis.
Results:
We observed that all proteins analyzed presented significantly higher plasma membrane expression in neoplastic compared to non-neoplastic samples. MCT4 was significantly associated with T-stage and advanced tumoral stage, while CD147 was significantly correlated with histologic differentiation. Interestingly, tumors expressing both MCT1 and MCT4 but negative for MCT2 were associated with shorter overall survival.
Conclusion:
Overexpression of MCT1/4, CD147, GLUT1 and CAIX, supports previous findings of metabolic reprograming in OCC, warranting future studies to explore the hyper-glycolytic phenotype of these tumors. Importantly, MCT expression revealed to have a prognostic value in OCC survival.
survival.This study was supported by the ON.2 SR&TD Integrated Program (NORTE-07-0124-FEDER-000017), co-funded by Programa Operacional Regional do Norte (ON.2- O Novo Norte), Quadro de Referencia Estrategico Nacional (QREN), through Fundo Europeu de Desenvolvimento Regional (FEDER)
Dermatopatología de la oclusión intraluminal vascular: parte I (trombos).
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi