Células de Hodgkin/Reed-Sternberg-like em linfoma difuso de grandes células B de boca : estudo histopatológico, imunoistoquímico e de hibridização in situ

Orientador: Oslei Paes de AlmeidaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O linfoma difuso de grandes células B (LDGCB) é o linfoma da cavidade bucal mais comum. Alguns dos LDGCB podem apresentar células grandes morfologicamente similares às células Hodgkin e Reed/Sternberg (HRS) dos linfomas de Hodgkin clássico (LHC). O objetivo deste estudo foi comparar os LDGCB bucal que apresentem células HRS-like (LDGCB-HRS) com o linfoma de Hodgkin primário nodal, considerando os aspectos histológicos e imunoistoquímicos (IQs), angiogênese, índice de mastócitos e células dendríticas (CD), por meio de um amplo painel IQ. Quize casos foram estudados, nos quais sete eram LDGCB-HRS like e oito eram LHC nodal. Para a análise dos aspectos histológicos e IQs foram utilizados os seguintes anticorpos: CD3, CD15, CD20, CD30, CD43, LCA, CD45RO, CD79a, CD83, EMA, MUM-1, PAX-5, perforina, granzyme B, FASN, Ki-67, LMP-1; e EBER1/2. Já para a análise da angiogênese foram utilizados os anticorpos CD34, CD31, D2-40, CD105, vWF e VEGF; e para o índice de mastócitos utilizou-se o mast cell triptase. Finalmente, para avaliar a expressão IQ das CD os anticorpos CD1a, CD83, CD123, CD207, S-100 e FXIIIa foram utilizados. Todas as lâminas foram escaneadas e as células HRS-like, mastócitos e CD imunopositivas foram analisados, assim como os parâmetros morfométricos da angiogênese. Os resultados mostraram que a imunoexpressão foi postiva em 100% de casos de LHC e em 57% dos casos de LDGCB de boca, enquanto que LCA, CD20 e CD79a foram exclusivos para todos os LDGCB, e apenas CD15 foi exclusivo para os LHC. Angiogênese e o índice de mastócitos estavam aumentados em ambas as lesões, e entre elas, o LHC obteve maiores valores que o LDGCB da cavidade bucal em todos os anticorpos analisados. Por fim, o índice de CDs foram estatisticamente significante entre os grupos, exceto para CD83, que não mostrou nenhuma diferença estatística. A distribuição de CD foi reconhecida principalmente na área tumoral e ao redor das células neoplásicas em ambas as entidades. Foi possível concluir que os LDGCB com células HRS-like da cavidade bucal devem ser incluídos no diagnóstico diferencial de LHC da cavidade bucal. Quando da avaliação destes casos, a analise morfológica detalhada assim como o uso de um amplo painel de IQ são recomendados para realizar o diagnóstico correto. A angiogênese é essencial para o desenvolvimento de LDGCB da cavidade bucal, e quaisquer dos anticorpos CD34, CD31 e vWF podem ser utilizados para avaliar os parâmetros morfométricos. A presença significativa de CD nestes linfomas provavelmente desempenha um papel patologicamente relevante nos linfomas. Nossos resultados sugerem que o aumento no número de CD parece ser um fator contribuinte para a resposta imune estimulada pelo crescimento tumoralAbstract: Diffuse large B-cell lymphoma (DLBCL) is the most common oral lymphoma. Some DLBCLs can present large cells morphologically similar to Hodgkin and Reed-Sternberg (HRS) cells of classical Hodgkin lymphoma (cHL). The objective of this study was to compare oral DLBCL presenting HRS-like cells (DLBCL-HRS like) with primary nodal cHL, considering the following aspects: histological and immunohistochemical (IHC), angiogenesis, index of mast cells and dendritic cells (DCs); through a broad immunohistochemical panel. Fifteen cases were studied, of which, seven were DLBCL-HRS like and eight were nodal cHL. For histological and IHC aspects, immunoexpression of CD3, CD15, CD20, CD30, CD43, LCA, CD45RO, CD79a, CD83, EMA, MUM-1, PAX-5, perforin, granzyme B, FASN, Ki-67, LMP-1; and EBER1/2, were assessed. As for angiogenesis analysis, the antibodies used were CD34, CD31, D2-40, CD105, vWF and VEGF; and for the index of mast cell were used the mast cell tryptase. Finally, for IHC expression of DCs, the antibodies used were CD1a, CD83, CD123, CD207, S-100, and FXIIIa. All slides were scanned and positive immunoreactive cells HRS-like, mast cell and DCs were analyzed, as well as morphometric parameters of angiogenesis. The results showed that the immunoexpression of CD30 was 100% positive in cHL and 57% in oral DLBCL HRS-like, while LCA, CD20 and CD79a were exclusive for all oral DLBCL, and only CD15 was exclusive for cHL. Angiogenesis and mast cell index values were increased in both lesions and between them, cHL was greater than oral DLBCL with all antibodies studied. Finally, DC subsets were statistically significant between groups, except CD83, which did not show statistical significance. The distribution of DCs was mainly in the tumor area, around neoplastic cells in both entities. It was possible to conclude that DLBCL-HRS should be included in the differential diagnosis of oral cHL. When evaluating these cases, a detailed morphologic and a broad IHC analyses for the correct diagnosis are recommended. Angiogenesis is essential to the development of DLBCL of the oral cavity and any of the antibodies CD34, CD31 and vWF could be used to evaluate morphometric parameters. The presence of significantly higher numbers of DCs in these lymphomas could suggest that these cells are likely to play a pathological relevant role in lymphomas. Our findings suggest that increased number of DCs in lymphomas appears to be a factor contributing to the immune response against tumor growthDoutoradoPatologiaDoutor em Estomatopatologi

Synthesis and Characterization of Silver Nanoparticles on Orthodontic Brackets: A New Alternative in the Prevention of White Spots

Abstract: Silver nanoparticles (AgNPs) are used for their powerful antibacterial e ect and their ability to adhere to surfaces due to their size; they are used in di erent areas of life, mainly in the area of health as medicine. More recently, in dentistry, the synthesis and characterization of AgNPs attracted significant attention due to their antibacterial properties. In this study, the AgNPs were synthesized using the most e ective method on di erent orthodontic brackets (metallic and esthetic) and characterized by scanning electron microscopy/energy-dispersive spectroscopy (SEM/EDS) and transmission electron microscopy (TEM). Their antimicrobial e ect was tested against the widely used standard human pathogens Staphylococcus aureus (Gram-negative) and Escherichia coli (Gram-positive). Our results showed that, via a simple chemical method, AgNPs can be synthesized on the surface of orthodontic brackets with good antimicrobial activity and the possibility of reducing dental decay, periodontal disease and white spots generated during orthodontic treatment

Fluoride releasing dental materials used in orthodontics: Literature review

BACKGROUND AND AIM: In this manuscript, fluoride releasing dental materials controlling demineralization in fixed orthodontic patients, and the current strategies to prevent white spots were evaluated. METHODS: General literature review was carried out in SciVerse ScienceDirect databases. The search strategy included the terms from Medical Subject Headings (MeSH) created by National Library of Medicine. RESULTS: 44 relevant studies were included and the respective data were extracted. Many studies showed new alternatives for the treatment of white spot lesions by the use of orthodontic appliances. CONCLUSION: Patients receiving fixed orthodontic treatment should be instructed in a proper brushing technique using a fluoride containing toothpaste, and high risk patients should be bonded with fluoride releasing agent. Additionally, it is recommended to apply fluoride varnish periodically during orthodontic treatment

Green Synthesis of Silver Nanoparticles Using Heterotheca inuloides and Its Antimicrobial Activity in Catgut Suture Threads

Abstract Silver nanoparticles were synthesized through a green method, using Heterotheca inuloides as a bioreducing agent. Moreover, catgut suture threads were decorated with those biogenic silver nanoparticles, and their antibacterial activity versus highly resistant pathogenic microorganisms was evaluated. The principles of green chemistry and nanotechnology allow us to obtain advanced materials, such as suture threads, which can reduce or avoid the prevalence of infectious processes in the medical field. Mexican medicinal plants, such as H. inuloides, represent an adequate alternative for biosynthesis; this plant species is known for its medicinal benefits and its antibacterial activity, and for that reason, it is being used in folk medicine

Green Synthesis of Silver Nanoparticles Using <em>Heterotheca inuloides</em> and Its Antimicrobial Activity in Catgut Suture Threads

Silver nanoparticles were synthesized through a green method, using Heterotheca inuloides as a bioreducing agent. Moreover, catgut suture threads were decorated with those biogenic silver nanoparticles, and their antibacterial activity versus highly resistant pathogenic microorganisms was evaluated. The principles of green chemistry and nanotechnology allow us to obtain advanced materials, such as suture threads, which can reduce or avoid the prevalence of infectious processes in the medical field. Mexican medicinal plants, such as H. inuloides, represent an adequate alternative for biosynthesis; this plant species is known for its medicinal benefits and its antibacterial activity, and for that reason, it is being used in folk medicine

Antimicrobial Activity of Biogenic Silver Nanoparticles from Syzygium aromaticum against the Five Most Common Microorganisms in the Oral Cavity

ARTICULO DE ACCESO LIBREAbstract: Syzygium aromaticum (clove) has been used as a dental analgesic, an anesthetic, and a bioreducing and capping agent in the formation of metallic nanoparticles. The main objective of this study was to evaluate the antimicrobial effect in oral microorganisms of biogenic silver nanoparticles (AgNPs) formed with aqueous extract of clove through an ecofriendly method “green synthesis”. The obtained AgNPs were characterized by UV-Vis (ultraviolet-visible spectroscopy), SEM-EDS (scanning electron microscopy–energy dispersive X-ray spectroscopy), TEM (transmission electron microscopy), and ζ potential, while its antimicrobial effect was corroborated against oral Grampositive and Gram-negative microorganisms, as well as yeast that is commonly present in the oral cavity. The AgNPs showed absorption at 400–500 nm in the UV-Vis spectrum, had an average size of 4–16 nm as observed by the high-resolution transmission electron microscopy (HR-TEM), and were of a crystalline nature and quasi-spherical form. The antimicrobial susceptibility test showed inhibition zones of 2–4 mm in diameter. Our results suggest that AgNPs synthesized with clove can be used as effective growth inhibitors in several oral microorganisms.S/

Estrategias y procedimientos operacionales en Radiología Oral para mitigar transmisión de SARS-CoV-2

Coronavirus disease (COVID-19) is highly transmissible through respiratory droplets, saliva, and aerosol particles. Infection can lead to severe acute respiratory syndrome and trigger multi-organ failure and death. Most clinical dental procedures involve contact with saliva or the generation of aerosols with saliva and blood. These airborne particles increase the risk of transmission by COVID-19 between dentists and patients. Thus, dentistry must adopt procedures to reduce transmission during dental procedures. Although these strategies may not be directly applicable to all institutions due to cultural, social, geographical, and economic differences, the underlying principles and implemented strategies remain relevant and can be adopted or modified by the institutions dealing with the current COVID-19 outbreak. The purpose of this article is to discuss one of the principal sources of COVID-19 transmission: saliva, the biofluid most frequently handled in a radiology environment. The authors also recommend strategies and operational procedures to decrease the spread of COVID-19 in a radiological routine.La enfermedad por coronavirus (COVID-19) se transmite fácilmente a través de gotitas respiratorias, saliva y partículas de aerosol. La infección puede desencadenar un síndrome respiratorio agudo severo, insuficiencia multiorgánica y, en algunos casos, la muerte. Los procedimientos clínicos dentales determinan el contacto con saliva o la generación de aerosoles con saliva y sangre, lo que implica un alto riesgo de transmisión por COVID-19 entre odontólogos y pacientes. Por ello, la práctica odontologica debe adoptar medidas para detener la propagación durante los procedimientos dentales. En este artículo se revisan las estrategias para mitigar el riesgo de transmisión de COVID-19. Si bien estas estrategias pueden no ser directamente aplicables a todas las instituciones debido a diferencias culturales, sociales, geográficas y económicas inherentes, los principios subyacentes y las estrategias implementadas siguen siendo relevantes y pueden ser adoptados o modificados por las instituciones que se ocupan del brote actual de COVID-19. El propósito de este artículo es discutir una de las principales fuentes de transmisión de COVID-19: la saliva, el biofluido que se maneja con mayor frecuencia en un entorno radiológico. Los autores también recomiendan estrategias y procedimientos operativos para disminuir la propagación de COVID-19 en una rutina radiológica

Clinicopathological and imunohistochemical study af actinic prurigo of lip

Orientador: Oslei Paes de AlmeidaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O prurigo actínico (PA) é uma fotodermatose familiar específica que afeta principalmente os mestiços, fruto da miscigenação entre índios e europeus, que habitam vários países da América do Norte, Central e do Sul. Pode manifestar-se em qualquer idade, no entanto a doença inicia-se freqüentemente na infância, entre os seis e oito anos de idade. É mais freqüente em mulheres, e atinge principalmente pessoas que vivem em regiões acima de mil metros de altitude. O PA afeta principalmente áreas da pele expostas ao sol. Clinicamente se apresenta de forma polimórfica. O objetivo deste estudo foi analisar as características clínicas, histopatológicas e a expressão de marcadores imunoistoquímicos de 43 casos de PA de lábio. Dezesseis casos envolviam pacientes do gênero masculino e 27 casos (62,80%) do gênero feminino, com idade média de 28,6 anos. Todos os casos envolviam o lábio inferior e outras áreas da face e do corpo, e 17 casos (39,54%) somente apresentavam manifestação em lábio inferior. As principais alterações clínicas eram: crosta, pápulas eritematosas, hiperpigmentação, descamação, placas, úlceras e edema. Microscopicamente observou-se no epitélio superficial principalmente hiperqueratose, ulceração, vacuolização das células da camada basal e exocitose. No conjuntivo subjacente observou-se quadro inflamatório crônico, em muitos casos predominando a presença de folículos linfóides em diversos graus de organização. Nenhum dos casos apresento elastose solar. Os marcadores imunoistoquímicos mostraram que os folículos linfóides apresentavam organização semelhante ao normal. Syndecan-1 marcou as células da camada espinhosa de forma homogênea, mas estava ausente nas células basais e suprabasais. D2-40 com marcação positiva e forte nas células dendríticas do centro folicular e camada basal do epitélio superficial. Mastócitos, eosinófilos e macrófagos estavam distribuídos entre as células linfoplasmocitárias.Abstract: Actinic prurigo (AP) is a specific familial photodermatosis that affects mainly mestizos, who live in many parts of North, Central and South America. AP can be clinically evident at any age, but it starts in infancy, between 6 and 8 years of age. It is more frequent in women. AP affects mainly persons living in regions above one thousand meters sea level. The disease affects mainly sun exposed skin, andclinically it is polymorphic. The objective of this study was to evaluate the clinical, histological and immunohistochemistry characteristics of 43 cases of AP of the lower lip. Sixteen cases were in males and 24 females (62.8%), with mean age of 28.6%. All cases involved the lower lip and other skin sites, but in 17 cases the lesions occurred only in the lower lip (39.54%). Hyperpigmentation, descamation, plaques, ulcers and edema were the main clinical alterations in our series. Microscopically on the superficial epithelial it was found mainly hyperqueratosis, ulceration, vacuolization of the basal and supra basal layer cells and exocytosis. In the subjacent connective tissue predominated a chronic inflammatory process, in many cases rich in lymphoid follicles in various degrees of organization. In none of the cases it was observed elastosis in the connective tissue. Immunohistochemistry markers confirmed that the follicles showed an organization similar to normal follicles. Syndecan-1 was expressed homogenously in the spinous layers of the superficial epithelium, but it was negative in the basal and suprabasal layers. D2-40 was positive in the dendritic cells of the follicular centers and basal cells of the superficial epithelium. Mast cell, eosinophils, and macrophages were found among the plasmatic cells.MestradoPatologiaMestre em Estomatopatologi

Effect of Human Development Index and other socioeconomic factors on mortality-to-incidence ratio of lips and oral cavity cancer in Mexican states: an ecological study

Objectives To assess the association between the Human Development Index (HDI) and covariates on the mortality-to-incidence ratio (MIR) of lips and oral cavity cancer (LOCC) in Mexico.Design Ecological study.Setting Data from 32 Mexican states for year 2019.Participants Data set of male and female populations from Mexico.Exposures Socioeconomic conditions based on HDI and covariates related to healthcare system capacity (total health spending per capita, school dropout and ratio of medical personnel in direct contact with patients).Primary and secondary outcome measures MIR of LOCC by state and sex was calculated from the Global Burden of Disease Study website for year 2019. Data for calculating HDI 2019 by state and covariates were obtained from the National Institute of Statistics and Geography. A multiple regression model was constructed to measure the effects of HDI and covariates on LOCC-MIR.Results Among the states with the highest HDI (&gt;0.780), Colima had the highest aged-standardised rates per 100.000 in men for incidence (5.026) and mortality (3.118). The greatest burden of the disease was found on men, with the highest Men:Women MIR in Colima (3.10) and Baja California Sur (2.73). The highest MIR (&gt;0.65) was found among the states with the lowest HDI (Oaxaca and Chiapas). For each unit of increase of the HDI there was a decrease in the LOCC- MIR of −0.778, controlling for the covariates. The most suitable regression model explained the 57% (F (p): 0.000) of the variance.Conclusions Men were most affected by LOCC in Mexican states. The highest MIRs of LOCC were found in the states with the highest HDI. But a worse prognosis of the disease, expressed as a higher MIR, is expected in contexts with lower HDI in the country, even with lower MIRs

Synthesis and Characterization of Silver Nanoparticles on Orthodontic Brackets: A New Alternative in the Prevention of White Spots

Silver nanoparticles (AgNPs) are used for their powerful antibacterial effect and their ability to adhere to surfaces due to their size; they are used in different areas of life, mainly in the area of health as medicine. More recently, in dentistry, the synthesis and characterization of AgNPs attracted significant attention due to their antibacterial properties. In this study, the AgNPs were synthesized using the most effective method on different orthodontic brackets (metallic and esthetic) and characterized by scanning electron microscopy/energy-dispersive spectroscopy (SEM/EDS) and transmission electron microscopy (TEM). Their antimicrobial effect was tested against the widely used standard human pathogens Staphylococcus aureus (Gram-negative) and Escherichia coli (Gram-positive). Our results showed that, via a simple chemical method, AgNPs can be synthesized on the surface of orthodontic brackets with good antimicrobial activity and the possibility of reducing dental decay, periodontal disease and white spots generated during orthodontic treatment