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Traditional guidelines for determining the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) are used to make therapeutic decisions. However, only 50% of the patients had lived for more than five years. The present study aimed to analyze the correlation of traditional prognostic factors such as tumor size, histological grading, regional metastases, and treatment with the survival of patients with HNSCC. A total of 78 patients diagnosed with HNSCC were followed up for 10 years after diagnosis and treatment. The health status of the patients was tracked at four time points, and according to the evolution of the patients and their final clinical status, we performed a prognostic analysis based on the clinical outcomes observed during the follow-up period. The final study cohort comprised 50 patients. Most patients had tumors < 4 cm in size (64%) and no regional metastases (64%); no patients had distant metastases at the time of diagnosis. Most individuals had tumors with good (48%) and moderate (46%) degrees of malignancy. At the end of the follow-up period, only 14% of the patients were discharged, 42% died of the tumor, and 44% remained under observation owing to the presence of a potentially malignant disorder, relapse, or metastases. This analysis showed that traditional prognostic factors were not accurate in detecting subclinical changes or predicting the clinical evolution of patients. [ABSTRACT FROM AUTHOR]

This ca se study presents a 36-year-old female patient who experienced itching and painful lesions that seemed to "move around the mouth." The condition displayed a cyclical pattern, with lesions coming and going over seven months. Clinical examination revealed swelling and erythema on the lip and buccal mucosa, along with serpiginous tracks. After a thorough evaluation, the patient received a diagnosis of oral larva migrans, and the lesions resolved following the administration of ivermectin. At an 18-month follow-up, there were no signs of recurrence. Larva migrans is a parasitic infection that rarely affects the oral mucosa, posing a diagnostic challenge in oral healthcare and causing distress for the patient. Oral health professionals should remain vigilant and consider this condition as a potential differential diagnosis for erythematous oral lesions. [ABSTRACT FROM AUTHOR]

The aim of the present study was to analyze the relationship of OM with possible risk factors such as oral health condition, immunological status and IL-1β profile in patients submitted to hematopoietic stem cell transplantation (HSCT). Fifty-four individuals submitted to HSCT were included. All patients received previous dental treatment and photobiomodulation (PBM) as the institutional OM preventive protocol. OM scores, immune status, and IL-1β levels were determined during the conditioning period and at D+3 and D+8 after HSC infusion. IL-1β gene polymorphism was also analyzed during conditioning. Possible associations of OM with risk factors were analyzed using conditional Fisher's exact test. OM was observed in 34 patients (62.9%) classified as Grade 1 (13 patients/24.1%), Grade 2 (14 patients/25.9%), Grade 3 (3 patients/5.5%), and Grade 4 (4 patients/7.4%). Allogeneic HSCT individuals exhibited a higher OM grade than autologous subjects. Moreover, an association was observed between severe OM and severe gingivitis (p = 0.01), neutropenia (p = 0.03), and leukopenia (p = 0.04). A significant association between OM and lower IL-1β levels was detected at three time points, i.e., conditioning (p = 0.048), D+3 (p = 0.01), and D+8 (p = 0.005). The results showed that IL-1β gene polymorphism was not associated with OM. Our study provided important insights into the scope of OM risk factors in the setting of HSCT. Patients submitted to HSCT with severe gingivitis prior to chemotherapy and with severe neutropenia and leukopenia exhibited a higher OM grade. Further investigation will be necessary to better understand the exact role of IL-1β in the context of OM pathobiology and to validate cytokine analysis in larger cohorts. [ABSTRACT FROM AUTHOR]

In many cases, the microscopic analysis of soft tissue tumors is complex. The final accurate diagnosis usually involves morphology and immunohistochemical characteristics that should be coupled with clinical findings. A 77-year-old female patient presented with an asymptomatic purplish sessile nodule in the hard palate. Serologic examination results showed normal limits. Tomographic image disclosed a well-circumscribed exophytic mass associated with discrete bone reabsorption of floor of the nasal fossa. Histopathologic examination revealed histiocytoid and spindle cell proliferation with multiple pericytomalike vessels in a fibrous connective tissue. An immunohistochemical panel showed a positive stain for CD10, vimentin, CD163, CD68; a negative result for creatine kinase, M type (CKM), CD31, CD 34, p63, S100, smooth muscle actin (SMA), human herpesvirus 8 (HHV-8), desmin, and proliferative index (Ki-67) of 10%. A final diagnosis of benign fibrous histiocytoma was concluded. The healing process was uneventful and no recurrence was observed during 14 months of follow-up. [ABSTRACT FROM AUTHOR]

Background: Parietaria judaica pollen is a common cause of pollinosis in the Mediterranean area. Objective: This study sought to purify and characterize the peptidase responsible for the majority of proteolytic activity present in the pollen extract of P judaica, and to investigate its contribution to the allergic response. Methods: A serial of chromatographic steps was applied to isolate the peptidase from P judaica''s pollen, and its biochemical properties were determined. Bioactive peptides present in the airways were incubated with the peptidase, and their degradation was visualized by direct protein sequencing. In addition, we measured the cellular detachment, by methylene blue binding assay, of an airway-derived epithelial cell line (A549) in the presence of the peptidase, and visualized, by Western blot, the degradation of proteins from intercellular junctions. Results: We purified a 98-kDa peptidase from the pollen of P judaica that was classified as an aminopeptidase on the basis of its biochemical properties and internal amino acid sequence. The aminopeptidase was able to degrade bioactive peptides. Moreover, the aminopeptidase caused cellular detachment of A549 cell line and degradation of occludin and E-cadherin. Conclusion: Our results suggest that the P judaica aminopeptidase can alter the integrity of the epithelium barrier by degrading occludin as well as E-cadherin. In addition, P judaica aminopeptidase can degrade bioactive peptides, which can exacerbate the overall bronchoconstrictive effect detected in asthmatic lungs. Clinical implications: The novel aminopeptidase described here could constitute a relevant therapeutic target in the treatment of allergic disorders induced by the pollen of P judaica. [Copyright &y& Elsevier]

Acquired immunodeficiency syndrome (AIDS) is a chronic systemic disease. This condition can be manifested if the patient is infected by the human immunodeficiency virus (HIV). This virus attacks the immune system and interferes in the host resistance. Consequently, infected organisms become immunosuppressed and susceptible to acquiring other opportunistic infections and injuries. The HIV-related diseases most frequent in the oral cavity are candidiasis, gingivitis, oral hairy leukoplakia, herpes simplex, and Kaposi sarcoma. The objective of this study is to report 4 clinical cases of patients with the oral disorders listed above. AIDS oral manifestations may represent the first clinical signs of HIV infection. Therefore, knowledge of oral lesions associated with HIV infection is extremely important for the oral surgeon. Based on this, the health professional can make the HIV diagnosis of this complex systemic disease, in some cases not previously diagnosed. [ABSTRACT FROM AUTHOR]

Paracoccidioidomycosis is a disease caused by the dimorphic fungus Paracoccidioides brasiliensis. A 46-year-old male patient, chronic smoker, crack and cocaine user reported a history of completed syphilis treatment 5 years ago. The patient described a recent history of a mouth burn secondary to chlorine. Clinical examination revealed moriform ulcers with hemorrhagic dots on the surface on the lower labial mucosa, buccal mucosa, and hard palate. The histopathologic diagnosis of this incisional biopsy was paracoccidioidomycosis. Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) were considered reactant in both serologic investigations. The patient was referred for treatment of both infections. After 7 months of drug therapy, the oral lesions regressed, and the patient did not report more symptoms. The present case emphasizes the importance of the detailed clinical examination and complementary tests. The presence of coinfections is highlighted, because the patient's habits could favor these contaminations. The oral surgeon knowledge about these diseases allows for prompt diagnosis and minimizes morbidity. [ABSTRACT FROM AUTHOR]