Epidemiological features of esophageal cancer. Squamous cell carcinoma versus adenocarcinoma

PURPOSE: To analyze the epidemiological features of patients with esophageal cancer according to the histopathological types: squamous cell carcinoma or adenocarcinoma. METHODS: A total of 100 patients with esophageal cancer, being 50 squamous cell carcinomas and 50 adenocarcinomas were analyzed for demographics, nutritional factors, lifestyle habits, benign pathological conditions associated, like Barrett's esophagus and megaesophagus, tumor stage and survival rates. The nutritional factors evaluated included body mass index, percent weight loss, hemoglobin and albumin serum levels. RESULTS: Esophageal cancer occurred more often in men over 50 years-old in both histological groups. No significant differences on age and gender were found between the histological groups. Squamous cell carcinoma was significantly more frequent in blacks than adenocarcinoma. Alcohol consumption and smoking were significantly associated with squamous cell carcinoma. Higher values of body mass index were seen in patients with adenocarcinoma. Barrett's esophagus was found in nine patients (18%) with adenocarcinoma, and megaesophagus in two patients (4%) with squamous cell carcinoma. The majority of patients were on stages III and IV in both histological groups. The mean survival rates were 7.7 ± 9.5 months for patients with squamous cell carcinoma and 8.0 ± 10.9 months for patients with adenocarcinoma. No significant differences on tumor stage and survival rates were detected between the histological groups. CONCLUSION: Epidemiological features are distinct for the histopathological types of esophageal cancer. Squamous cell carcinoma is associated with black race, alcohol and smoking, while adenocarcinoma is related to higher body mass index, white race and Barrett's esophagus.

uPAR expression in canine normal prostate and with proliferative disorders

Prostatic lesions such as prostatic intraepithelial neoplasia (PIN) and proliferative inflammatory atrophy (PIA) are studied in human and canine species due to their malignance potential. The plasminogen activator (PA) system has been suggested to play a central role in cell adhesion, angiogenesis, inflammation, and tumor invasion. The urokinase-type plasminogen activator receptor (uPAR) is a component of the PA, with a range of expression in tumor and stromal cells. In this study, uPAR expression in both canine normal prostates and with proliferative disorders (benign prostatic hyperplasia-BPH, proliferative inflammatory atrophy-PIA, prostatic intraepithelial neoplasia-PIN, and carcinoma-PC) was evaluated by immunohistochemistry in a tissue microarray (TMA) slide to establish the role of this enzyme in extracellular matrix (ECM) remodeling and in the processes of tissue invasion. A total of 298 cores and 355 diagnoses were obtained, with 36 (10.1%) normal prostates, 46 (13.0%) with BPH, 128 (36.1%) with PIA, 74 (20.8%) with PIN and 71 (20.0%) with PC. There is variation in the expression of uPAR in canine prostate according to the lesion, with lower expression in normal tissue and with BPH, and higher expression in tissue with PIA, PIN and PC. The high expression of uPAR in inflammatory and neoplastic microenvironment indicates increased proteolytic activity in canine prostates with PIA, PIN, and PC.

Silk fibroin biopolymer films as efficient hosts for DFB laser operation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Anticoagulant treatment for subsegmental pulmonary embolism

BackgroundAcute pulmonary embolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke.The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate of diagnosis. More cases of peripheral PEs, such as isolated subsegmental PE (SSPE) and incidental PE, have thereby been identified. These two conditions are usually found in patients with few or none of the classic PE symptoms such as haemoptysis or pleuritic pain, acute dyspnoea or circulatory collapse. However, in patients with reduced cardio-pulmonary (C/P) reserve the classic PE symptoms can be found with isolated SSPEs. Incidental SSPE is found casually in asymptomatic patients, usually by diagnostic imaging performed for other reasons (for example routine CT for cancer staging in oncologic patients).Traditionally, all PEs are anticoagulated in a similar manner independent of the location, number and size of the thrombi. It has been suggested that many patients with SSPE may be treated without benefit, increasing adverse events by possible unnecessary use of anticoagulants.Patients with isolated SSPE or incidental PE may have a more benign clinical presentation compared with those with proximal PEs. However, the clinical significance in patients and their prognosis have to be studied to evaluate whether anticoagulation therapy is required.ObjectivesTo assess the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE.Search methodsThe Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched October 2013) and CENTRAL (2013, Issue 9). MEDLINE, EMBASE, LILACS and clinical trials databases were also searched (October 2013).Selection criteriaRandomised controlled trials of anticoagulation therapy versus no intervention in patients with SSPE or incidental SSPE.Data collection and analysisTwo review authors inspected all citations to ensure reliable selection. We planned for two review authors to independently extract data and to assess the methodological quality of identified trials using the criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions.Main resultsNo studies were identified that met the inclusion criteria.Authors' conclusionsThere is no randomised controlled trial evidence for the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE, and therefore we can not draw any conclusions. Well-conducted research is required before informed practice decisions can be made.

Proposal to utilize simplified Swensen protocol in diagnosis of isolated pulmonary nodule

Background: The problem of diagnosing whether a solitary pulmonary nodule is benign or malignant is even greater in developing countries due to a higher prevalence of infectious diseases. These infections generate a large number of patients who are generally asymptomatic and with a pulmonary nodule that cannot be accurately defined as having benign or malignant etiology.Purpose: To verify the percentages of benign versus malignant non-calcified nodules, the length of time after contrast agent injection is spiral computed tomography (CT) most sensitive and specific, and whether three postcontrast phases are necessary.Material and Methods: We studied 23 patients with solitary pulmonary nodules identified on chest radiographs or CT. Spiral scans were obtained with Swensen protocol, but at 3, 4, and 5 min after contrast injection onset. Nodules were classified as benign or malignant by histopathological examination or by an absence or presence of growth after 2 years of follow-up CT.Results: Of the 23 patients studied, 18 (78.2%) showed a final diagnosis of benign and five (21.7%) malignant nodules. Despite the small sample size, we obtained results similar to those of Swensen et al., with 80.0% sensitivity, 55.5% specificity, and 60.8% accuracy. Four minutes gave the greatest mean enhancement in both malignant and benign lesions.Conclusion: Small non-calcified benign nodules were much more frequent than malignant nodules. The best time for dynamic contrast-enhanced CT density analysis was 4 min postcontrast. As well as saving time and money, this simplified Swensen protocol with only precontrast and 4 min postcontrast phases also reduces patient exposure to ionizing radiation.

Association among XRCC1, XRCC3, and BLHX gene polymorphisms and chromosome instability in lymphocytes from patients with endometriosis and ovarian cancer

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Conservative Approach: Using Decompression Procedure for Management of a Large Unicystic Ameloblastoma of the Mandible

Ameloblastoma is a relatively uncommon benign odontogenic tumor, which is locally aggressive and has a high tendency to recur, despite its benign histopathologic features. This pathology can be classified into 4 groups: unicystic, solid or multicystic, peripheral, and malignant. There are 3 variants of unicystic ameloblastoma, as luminal, intraluminal, and mural. Therefore, in mural ameloblastoma, the fibrous wall of the cyst is infiltrated with tumor nodules, and for this reason it is considered the most aggressive variant of unicystic ameloblastomas. Various treatment techniques for ameloblastomas have been proposed, which include decompression, enucleation/curettage, sclerotizing solution, cryosurgery, marginal resection, and aggressive resection. Literature shows treatment of this lesion continues to be a subject of intense interest and some controversy. Thus, the authors aimed to describe a case of a mural unicystic ameloblastoma of follicular subtype in a 19-year-old subject who was successfully treated using conservative approaches, as decompression. The patient has been followed up for 3 years, and has remained clinically and radiographically disease-free.

Using Conservative Condylectomy for Management of a Large Osteochondroma of the Mandibular Condyle With 6-Year Follow- up

Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure.

Synchronous Ossifying Fibromas of Maxilla and Mandible

Ossifying fibroma is a benign neoplasm composed of fibrocellular tissue and mineralized material of varying appearance, which is most commonly seen in the posterior region of the mandible as a solitary lesion. We report an unusual case of synchronous ossifying fibroma of maxilla and mandible. To the best of our knowledge, only 13 similar cases have been previously reported.

Total Spontaneous Regression of a Central Giant Cell Granuloma After Incisional Biopsy: A Four-Year Follow-Up Case Report

Central giant cell granuloma (CGCG) of the jaws represents a localized and benign neoplastic lesion sometimes characterized by aggressive osteolytic proliferation. The World Health Organization defines it as an intraosseous lesion composed of cellular and dense connective tissues that contain multiple hemorrhagic foci, an aggregation of multinucleated giant cells, and occasional bone tissue trabeculae. The origin of this lesion is uncertain; however, factors such as local trauma, inflammation, intraosseous hemorrhage, and genetic abnormalities have been identified as possible causes. CGCG generally affects those younger than 30 years and occurs more frequently in women (2: 1). This lesion corresponds to approximately 7% of all benign tumors of the jaws, with prevalence in the anterior region of the jaw. Aggressive lesions are characterized by symptoms, such as pain, numbness, rapid growth, cortical perforation, root resorption, and a high recurrence rate after curettage. In contrast, nonaggressive CGCGs have a slow rate of growth, may contain sparse trabeculation, and are less likely to move teeth or cause root resorption or cortical perforation. Nonaggressive CGCGs are generally asymptomatic lesions and thus are frequently found on routine dental radiographs. Radiographically, the 2 forms of CGCG present as radiolucent, expansive, unilocular or multilocular masses with well-defined margins. The histopathology of CGCG is characterized by multinucleated giant cells, surrounded by round, oval, and spindle-shaped mononuclear cells, scattered in dense connective tissue with hemorrhagic and abundant vascularization foci. The final diagnosis is determined by histopathologic analysis of the biopsy specimen. The preferred treatment for CGCG consists of excisional biopsy, curettage with a safety margin, and partial or total resection of the affected bone. Conservative treatments include local injections of steroids, calcitonin, and antiangiogenic therapy. Drug treatment using antibiotics, painkillers, and corticosteroids and clinical and radiographic monitoring are necessary for approximately 10 days after surgery. There are only a few cases of spontaneous CGCG regression described in the literature; therefore, a detailed case report of CGCG regression in a 12-yearold boy with a 4-year follow-up is presented and compared with previous studies. (c) 2014 American Association of Oral and Maxillofacial Surgeons

Da prescrição radiográfica: uma análise em medicina bucal

A redução da dose de radiação ao paciente é aceita em Radiologia Odontológica, com a finalidade de diminuir os riscos associados ao exame radiográfico. Para atingir este objetivo, além do avanço tecnológico ocorrido nas últimas décadas, devemos considerar a importância do Critério de Seleção para o paciente e da prescrição radiográfica na indicação correta do tipo de radiografia necessária para cada um deles. O objetivo deste trabalho foi avaliar a prescrição radiográfica de pacientes atendidos pelo Serviço de Medicina Bucal da Faculdade de Odontologia de Araraquara - UNESP durante o período de 1989 a 1993. Selecionamos 396 prontuários que constituiu a totalidade dos que continham exames radiográficos. Para a análise da prescrição radiográfica, consideramos as informações obtidas da ficha clínica e da interpretação das radiografias, utilizando os Critérios de Seleção e a análise de decisão clínica. Os resultados demonstraram um alto índice de pacientes com prescrição incorreta (44,0%); tendo em 24,7% dos pacientes ocorrido mais de uma radiografia prescrita incorretamente. Com relação ao tipo de técnica com prescrição incorreta, em 31,6% dos pacientes foi realizada a radiografia panorâmica, vindo a seguir a oclusal (28,7%), outro (17,2%) e a associação da panorâmica e oclusal (12,6%). Pacientes portadores de doenças e alterações de tecido mole tiveram a mais alta freqüência de prescrições incorretas, seguidos pelos portadores de doenças das glândulas salivares (13,5%) (incluindo os tumores); outros (10,1%); distúrbios da A.T.M. (9,0%); inflamação e infecção dos maxilares (6,8%); tumores benignos (5,6%) e tumores malignos (5,6%). Em 62,9% dos pacientes, o exame radiográfico contribuiu para o diagnóstico e tratamento. A alta porcentagem de prescrição incorreta encontrada evidencia a necessidade de... (Resumo completo, clicar acesso eletrônico abaixo).

Towards a Brazilian radon map: consortium radon Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

ARFI elastography as a complementary diagnostic method for mammary neoplasia in female dogs - preliminary results

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ultrasonografia Doppler na reprodução de pequenos animais

The Doppler ultrasound allows the assessment of blood flow and the differentiate vessels according to each spectral pattern, location and organ that irrigate, helping the examinations and disease diagnosis. The main methods used are Pulsed Doppler, Color Doppler and Power Doppler. In Brazil veterinary medicine, it shows progress since 1990, but its use is limited by the equipment high cost, the need for operator experience and patient cooperation. There are studies in obstetrics and reproduction of dogs and cats, such as evaluation of the testicular vasculature, including the use of contrast material, and attempts to evaluate prostate in healthy dogs or pathological conditions (cancer and testicular torsion , orchitis and benign prostatic hyperplasia; estrous cycle monitoring, evaluation of irrigation in follicles and corpus luteum, uterus and breasts (mammary tumors) in bitches; monitoring pregnancy from the assessment of maternal, fetal and placental hemodynamics, both in dogs as in cats, and aspirations for early detection of pregnancy in dogs. However, new studies are still required, given the lack of these species, especially cats

Identificação de genes candidatos ao desenvolvimento de Leiomiomas Uterinos

Uterine leiomyomas (UL) are benign smooth muscle tumors from myometrium, representing the major indication for hysterectomies and a significant public health problem. Several genetics alterations have been associated with its development and pathogenesis. Although the initial factors that lead to the development of uterine leiomyomas are unclear, there are several evidences showing that ovarian steroids, estrogen and progesterone, are associated with these tumors.Recent reports, however, show others genes related with distinct signalization pathways besides sex hormones, which may be or not activated by these hormones, are associated with uterine leiomyomas development. In this study, the AHR, ESR1, ESR2, PGR and WNT7A gene transcripts expression was evaluated using quantitative real time RT-PCR in 58 UL samples compared to five normal myometrium tissues to explore the hormonal molecular basis of these tumors and associate these expression pattern with clinical and pathological features. The present study showed AHR, ESR1, ESR2, PGR and WNT7A down expression in 60%, 43%, 52%, 60% e 40% of the tumors, respectively, and a significant AHR loss of expression compared with the controls samples (P=0.0130). The comparison between the genes expression values revealed a positive correlation between the AHR and ESR1 transcripts (P<0.0001; r=0.6911) and between the genes ESR1 and WNT7A (P<0.0001; r=0.5655). The expression pattern was compared with clinical and pathological features. The WNT7A gene presented a differential expression pattern between the proliferative and secretory phase of menstrual cycle (P=0.0373) and the AHR and ESR1 genes were differentially expressed between women in reproductive and menopause years (P=0.0267; P=0.0415, respectively). The ESR1 and WNT7A down regulation was statistically ...(Complete abstract click electronic access below)