A short account of metastatic bone disease

In adults, bone is the preferential target site for metastases from primary cancers of prostate, breast, lungs and thyroid. The tendency of these cancers to metastasize to bone is determined by the anatomical distribution of the blood vessels, by the genetic profile of the cancer cells and by the biological characteristics of the bone microenvironment that favour the growth of metastatic cells of certain cancers

Oral Mucosal Melanosis

In the mouth, melanin is produced by melanocytes residing in the basal cell layer of the oral epithelium. Melanin influences the colour of the oral mucosa and provides protection against reactive oxygen species and bacterial-derived enzymes and toxins and acts as a physical barrier to both microorganisms invading the oral epithelium and to other microenvironmental stressors. The functional activity of epithelial melanocytes is regulated by biological agents in the microenvironment, including proopiomelanocortin-derived peptides, and by reciprocal interactions between melanocytes on the one hand and neighbouring keratinocytes and signals from the underlying lamina propria on the other hand. Oral mucosal melanin hyperpigmentation is common and may be physiological or pathological, and in either case the pattern of distribution and the intensity of the melanosis are variable. Physiological melanin hyperpigmentation is the result of increased melanin biosynthesis by melanocytes in the basal cell layer of the oral epithelium, but pathological melanin pigmentation may be the result of increased number of normal melanocytes or atypical melanocytes, of increased melanogenic activity of normal or atypical melanocytes, or of both. Oral mucosal melanin hyperpigmentation may be secondary to disease, medications, or smoking, and physiological oral melanin hyperpigmentation may be clinically and histopathologically similar so that the differentiation between pathological and physiological oral melanosis can at times be difficult

Necrotizing Periodontal Diseases in a Semirural District of South Africa

Objectives. The aim of this study was to characterize the lesions of necrotizing gingivitis (NG) and necrotizing periodontitis (NP) with regard to extent and severity, and to correlate these parameters with the host HIV serostatus, CD4+ T-cell count, neutrophil count, age, and gender. Methods. Eighty-four consecutive patients, 39 black females and 45 black males aged 20–46 years, diagnosed with NG/NP were recruited to the study over a period of two years. Results. For both HIV-seropositive and -seronegative patients, the mandibular anterior gingiva was most frequently affected; 74% had NG/NP affecting ≥5 gingival tooth sites. Ninety percent of all patients had a mean severity of ≤4 mm. There was no statistically significant association between either extent or severity of NG/NP and HIV serostatus, CD4+ T-cell count, neutrophil count, age, or gender. The difference between the number of HIV-seropositive patients with NG/NP who had CD4+ T-cell counts ≤200 cells/mm3 and those who had CD4+ T cell counts of 201–499 cells/mm3 was not statistically significant. Conclusion. The clinical signs of NG/NP are similar in HIV-seropositive and -seronegative patients, and are not related to CD4+ T-cell count, to neutrophil count, to gender, or to age

Multiple congenital oral granular cell tumours in a newborn black female: a case report

© 2008 Feller et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Noma staging : a review

Noma is a bacterial, non-communicable, grossly destructive and disfiguring necrotising oro-facial disease. It is rare, but occurs most commonly in chronically malnourished children with other debilitating illnesses, in remote, povertystricken communities, mainly in sub-Saharan Africa, and much more rarely in central Latin America and in parts of Asia. In South Africa and in Zimbabwe, noma is observed, again rarely, in immunosuppressed HIV-seropositive subjects. The World Health Organization (WHO) has classified noma into five sequential stages: stage 1, acute necrotising ulcerative gingivitis; stage 2, oedema; stage 3, gangrene; stage 4, scarring; stage 5, sequela. In the opinion of the authors, this WHO classification requires fundamental re-appraisal. The purpose of this viewpoint article is to highlight the weaknesses of this classification, and to propose a simpler, more logical and practical evidence-based staging of noma, which if used should improve the quality and value of future epidemiological data about noma.https://tropmedhealth.biomedcentral.comam2023Periodontics and Oral Medicin

Epstein-Barr Virus and Its Association with Oral Hairy Leukoplakia: A Short Review

In immunocompromised subjects, Epstein-Barr virus (EBV) infection of terminally differentiated oral keratinocytes may result in subclinical productive infection of the virus in the stratum spinosum and in the stratum granulosum with shedding of infectious virions into the oral fluid in the desquamating cells. In a minority of cases this productive infection with dysregulation of the cell cycle of terminally differentiated epithelial cells may manifest as oral hairy leukoplakia. This is a white, hyperkeratotic, benign lesion of low morbidity, affecting primarily the lateral border of the tongue. Factors that determine whether productive EBV replication within the oral epithelium will cause oral hairy leukoplakia include the fitness of local immune responses, the profile of EBV gene expression, and local environmental factors

Epstein-Barr Virus and Its Association with Oral Hairy Leukoplakia: A Short Review

In immunocompromised subjects, Epstein-Barr virus (EBV) infection of terminally differentiated oral keratinocytes may result in subclinical productive infection of the virus in the stratum spinosum and in the stratum granulosum with shedding of infectious virions into the oral fluid in the desquamating cells. In a minority of cases this productive infection with dysregulation of the cell cycle of terminally differentiated epithelial cells may manifest as oral hairy leukoplakia. This is a white, hyperkeratotic, benign lesion of low morbidity, affecting primarily the lateral border of the tongue. Factors that determine whether productive EBV replication within the oral epithelium will cause oral hairy leukoplakia include the fitness of local immune responses, the profile of EBV gene expression, and local environmental factors

Chronic Psychosocial Stress in Relation to Cancer

Cross-sectional observational studies reveal that cancer is more prevalent in depressed persons. Psychosocial stressors such as depression, anxiety, stressful life events, poverty, and lack of social support may favor carcinogenesis. Cancer acquired under these circumstances has a poor prognosis. Conversely, when cancer has developed in the presence of these factors, effective management or treatment of these psychosocial stressors may bring about increased survival time of the affected persons. The purpose of this narrative literature review is to examine the role that maladaptive stress responses play in cancer initiation and progression. Relevant databases, hand searches and authorative texts were critically analysed and the findings were integrated. Stress is influenced by genetic, environmental, pharmacological, and infectious factors in addition to the chronicity of depression, social isolation, and poor stress-coping capacity. Chronic psychosocial stress-induced maladaptive activation of the neuroendocrine system may dysregulate immunoinflammatory responses, alter oncogene expression, promote tumor-related angiogenesis, and accelerate growth of cancer with stimulation of neuroendocrine activity, which may favor cancer progression. The evidence that associates psychosocial stressors to cancer progression is stronger than the evidence which links the same psychosocial stressors to cancer incidence

The interrelation between aerobic exercise, mental well-being, stress response and epigenetics

Mental well-being is a subjective, adaptive state of mind arising from complex dynamic interactions between cognitive, emotional and psychosocial factors. Positive mental well-being may promote good physical health, occupational functioning and academic achievement. In the moderate-to-vigorous intensity of aerobic range, regular cardiorespiratory exercise of sufficient duration and frequency has the capacity to boost resources of mental energy, to improve sleep, mental alertness and social interactions, to buffer maladaptive upregulated emotional responses to psychosocial stressors, to decrease anxiety, to moderate depressive symptoms and to support or even improve cognitive functioning. Epigenetic modification is a biological mechanism by which environmental factors influence cellular phenotype and function. Psychosocial stressors, and regular performance of aerobic exercise have opposite effects on the central nervous system, mediated at least in part through epigenetic modifications that reprogram the expression of relevant genes. Generally, physically active persons are more resilient to stress and experience fewer depressive symptoms than do physically inactive persons; and, indeed, regular moderate to strenuous aerobic activity has a mood-enhancing effect and has been proven to mitigate negative affectivity stress responses. The purpose of this narrative review is to discuss the mechanisms that appear to play a role in aerobic exercise-induced improvement in mental well-being.https://www.oatext.com/Biomedical-Research-and-Reviews-BRR.phphj2022Periodontics and Oral Medicin

Interrelations between pain, stress and executive functioning

AIM: The purpose of this narrative review is to discuss the interrelations between pain, stress and executive functions. IMPLICATIONS FOR PRACTICE : Self-regulation, through executive functioning, exerts control over cognition, emotion and behaviour. The reciprocal neural functional connectivity between the prefrontal cortex and the limbic system allows for the integration of cognitive and emotional neural pathways and then for higher-order psychological processes (reasoning, judgement etc.) to generate goal-directed adaptive behaviours and to regulate responses to psychosocial stressors and pain signals. Impairment in cognitive executive functioning may result in poor regulation of stress-, pain- and emotion-related processing of information. Conversely, adverse emotion, pain and stress impair executive functioning. The characteristic of the feedback and feedforward neural connections (quantity and quality) between the prefrontal cortex and the limbic system determine adaptive behaviour, stress response and pain experience.https://journals.sagepub.com/home/bjphj2021Periodontics and Oral MedicinePsychiatr