Risk factors of HIV-related oral lesions in adults

OBJETIVO: Analisar fatores de risco para a ocorrência de lesões bucais em adultos soropositivos para o HIV. MÉTODOS: Estudo transversal, descritivo analítico de prontuários médicos/odontológicos de 534 pacientes com lesões bucais associadas ao HIV em Porto Alegre, RS, no período de 1996 a 2011. Os dados foram coletados em cinco centros de referência em saúde para o atendimento de portadores do HIV e comorbidades associadas. Os dados sociodemográficos e clínico-laboratoriais foram coletados em formulários padronizados. Foram incluídos dados exclusivamente de lesões com diagnóstico definitivo e classificadas de acordo com os critérios da ECC on Oral Problems Related to HIV Infection. A análise dos dados foi realizada mediante a aplicação de tabulações cruzadas, teste do Qui-quadrado e modelos de regressão logística. RESULTADOS: Níveis de CD4+ ; 5.000 cópias/mm³ (p = 0,003) e tabagismo (p = 0,005). CONCLUSÕES: Graus de imunodeficiência moderados e severos e cargas virais detectáveis foram fatores de risco para o desenvolvimento de lesões bucais. O consumo de tabaco e álcool aumentou a suscetibilidade de desenvolver infecções oportunistas em adultos HIV positivos, independentemente do uso de terapia antirretroviral.OBJETIVO: Analizar factores de riesgo para la ocurrencia de lesiones bucales en adultos seropositivos para VIH. MÉTODOS: Estudio transversal, descriptivo analítico de prontuarios médicos/odontológicos de 534 pacientes con lesiones bucales asociadas al VIH en Porto Alegre, RS, Brasil, en el período de 1996 a 2011. Los datos se colectaron en cinco centros de referencia en salud para la atención de portadores del VIH y comorbilidades asociadas. Los datos sociodemográficos y clínico-laboratoriales se colectaron en formularios estandarizados. Se incluyeron datos exclusivamente de lesiones con diagnóstico y clasificadas de acuerdo con los criterios de la ECC on Oral Problems Related to HIV Infection. El análisis de los datos fue realizado mediante la aplicación de tabulaciones cruzadas, prueba de Chi-cuadrado y modelos de regresión logística. RESULTADOS: Niveles de CD4+ < 350 células/mm³ (p; 5.000 copias/mm³ (p = 0,003) y tabaquismo (p = 0,005). CONCLUSIONES: Grados de inmunodeficiencia moderados y severos y cargas virales detectables fueron factores de riesgo para el desarrollo de lesiones bucales. El consumo de tabaco y alcohol aumentó la susceptibilidad de desarrollar infecciones oportunistas en adultos VIH positivos, independientemente del uso de terapia anti=retroviral.OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005). CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors. Objective To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil. Material and Methods Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated. Results Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases. Conclusions The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG

Stomatological disorders in older people : an epidemiological study in the brazil southern

The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary

Erythromycin:an alternative for the management of oral mucositis?

Oral mucositis (OM) is an important acute adverse effect of anticancer therapy. This condition presents high morbidity and may lead to the suspension of anticancer therapy. We reviewed the literature on the pathobiology of OM and the properties of erythromycin (EM), to consider the possibility of its use for the prevention and treatment of OM. We searched the PubMed, Scopus and Web of Science databases and selected complete articles published in English or Spanish that met the inclusion criteria. The search terms ?erythromycin?, ?inflammation?, ?immunomodulation? and ?oral mucositis? were used. The control of free radicals, transcription factors and pro-inflammatory cytokines has been considered as the key to the management of OM. EM has the ability to modulate oxidative stress, acts on the transcriptional system and inhibits the production of several cytokines that have been directly implicated in OM pathobiology. The present review suggests that EM could be effective in the treatment of OM. Experimental studies investigating the use of EM in OM should be encouraged

Comparação de técnicas de avaliação do colágeno em secções histológicas de ratos submetidos a radioterapia

Introdução: o colágeno é uma proteína fibrosa que participa de diversos processos fisiológicos e patológicos. Dada sua importância, a avaliação desse componente tem sido de grande relevância em variadas pesquisas biológicas. Objetivo: verificar a concordância entre métodos quantitativos na análise do colágeno em secções teciduais histológicas. Metodologia: trata-se de estudo experimental, que utilizou secções teciduais coradas em Sirius Vermelho de 28 ratos Wistar, pertencentes a dois grupos experimentais, com animais submetidos à radioterapia, sem G1 ou com G2, e com úlcera produzida em dorso lingual para avaliação do reparo tecidual. Foram estabelecidos dois métodos para comparação das técnicas de avaliação do colágeno: morfometria por contagem manual de pontos com duas grades (320 e 588 pontos), e morfometria por segmentação de cor. Foram utilizados testes não paramétricos Mann Whitney, para as comparações entre os grupos, e Friedman e Nemenyi, para as comparações entre as técnicas. O teste de correlação de Pearson foi usado para avaliar a quantidade de colágeno entre os métodos. O nível de significância foi de 5%. Resultados: em ambos os grupos experimentais houve correlação significativa entre a quantidade de colágeno avaliada pela técnica de 320 e 588 pontos. Nos dois grupos, a porcentagem de colágeno foi significativamente maior quando avaliada pela técnica de 588 pontos do que pela técnica por segmentação por cor (p&lt;0,05). No grupo G2, houve correlação significativa entre a quantidade de colágeno avaliada pela técnica de 588 pontos e por segmentação por cor (p&lt;0,05). Pelas técnicas de 588 pontos e segmentação por cor, a quantidade de colágeno foi significativamente maior no grupo com lesão (p&lt;0,05). Conclusão: ainda que alguns resultados tenham se mostrado semelhantes entre as técnicas de contagem de pontos com grade de 588 pontos e segmentação por cor, os dados sugerem que a técnica de 588 pontos é mais eficaz na quantificação do colágeno

Carcinoma Verrucoso e Leucoplasia em um mesmo paciente: relato de caso clínico

The authors report a case of a 65 years-old female patient with two lesions that were present for 4 years. The patient did not smoke or drink alcohol. One of the lesions was proliferative, had verruciform and whiteness surface and was located in the buccal mucosa, at the right side; the other lesion was a plaque with irregular shape and white color and was located in tongue border, right side. The clinical vliagnosis was Oral Verrucous Carcinoma to the buccal mucosa and Leukoplakia to the border tongue lesion; both clinical diagnoses were confirmed by histopathologic exams. The patient was treated by surgery; after 6 months, she is well and recovering facial and tongue movement, with physiotherapy.Os autores descrevem o caso clínico de duas lesões presentes há mais de 4 anos, em uma paciente do sexo feminino, 65 anos de idade, que negou hábitos de tabagismo e etilismo. Uma das lesões encontrava-se em mucosa jugal, lado direito, exofítica, com superfície verrucóide e esbranquiçada; outra localizava-se na borda da língua, lado direito, em forma de placa branca. Os diagnósticos clínicos estabelecidos foram de Carcinoma Verrucoso para a lesão de mucosa jugal e de Leucoplasia para a lesão de língua, os quais foram confirmados no exame histopatológico. A paciente foi encaminhada para remoção cirúrgica de ambas as lesões. Decorridos 6 meses da cirurgia, a mesma encontra-se em bom estado de saúde geral, recuperando os movimentos faciais e linguais, através de fisioterapia

Cell carcinoma in a patient with Fanconi anemia

Fanconi anemia (FA) is an autosomal recessive disorder that might cause a variety of congenital and developmental abnormalities. The most important features of FA are progressive bone marrow failure and development of malignancies, particularly acute myeloid leukemia and solid tumors. This paper reports the case of a 12-year-old patient with FA assisted at the Stomatology and Bucomaxillofacial Cancer Prevention Service of São Lucas Hospital, Brazil, who had been submitted to bone marrow transplantation (BMT) at the age of 5 and exhibited oral lesions characteristic of chronic graft versus host disease (GVHD). The patient was treated and followed-up for the oral lesions. Eleven years after the BMT, he developed squamous cell carcinoma of the tongue with an aggressive behavior, which was considered an untreatable condition. The patient died few months later from asphyxia at the age of 16. The reasons for development of these malignant conditions are unknown. However, chromosomal instability typically observed in FA cases, BMT factors and GVHD have been considered. Systematic follow-up of these patients allows early and less invasive therapeutic approaches