Diabetes mellitus in a patient with glycogen storage disease type Ia: a case report

Glycogen storage disease type Ia is a genetic disorder that is associated with persistent fasting hypoglycemia and the inability to produce endogenous glucose. The development of diabetes with glycogen storage...

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Cancer stem cell and its niche in malignant progression of oral potentially malignant disorders

Publication date: December 2017
Source:Oral Oncology, Volume 75
Author(s): Subin Surendran, Gangotri Siddappa, Amrutha Mohan, Wesley Hicks, Vijayvel Jayaprakash, Christina Mimikos, Mohammed Mahri, Fatima Almarzouki, Kayla Morrell, Ravindra Ravi, Sindhu Govindan, C.N. Sushma, Nisheena Raghavan, Praveen Birur, Jeyaram Ilayaraja, Mihai Merzianu, Mary Reid, Amritha Suresh, Moni Abraham Kuriakose
ObjectiveThe purpose of this study was to determine association between cancer stem cells (CSCs) and their niche with progression of oral potentially malignant disorders.Materials and methodsPatients with histologically confirmed oral potentially malignant disorders, stratified into high/low risk lesions based on the degree of dysplasia and oral cancer were included in this study. Immunohistochemical profiling of markers of CSCs (CD44), endothelial cells (CD31) and CSC-vascular niche cross-talk (CXCR4 and SDF1) were carried out. Statistical analysis was performed to correlate the relationship of markers with histopathology grade (ANOVA, and χ² test, unpaired t test) using GraphPad InStat v3.06.ResultsThe study included 550 samples (349 patients) and analysis showed progressive increase in expression levels of CSC and its niche markers with increase in grade of dysplasia as compared to the normal cohort (p < 0.05). Co-expression analysis revealed that, in comparison to the normal cohort, a larger percentage of patients showed increased expression of CD31 and CD44 (CD31^high/CD44^high; p < 0.05) and of CXCR4 and SDF1 (CXCR4^high/SDF1^high; p = 0.04), suggesting an association of the CSCs and the vascular niche. Further, distribution of patients with CD44^high/CXCR4^high (p < 0.05) and CD31^high/SDF1^high (p = 0.01) was significantly increased in the high-risk group (18%), suggesting a correlation between CD44⁺/CXCR4⁺ cells, the vascular niche and progression of oral dysplastic lesions.ConclusionThe increased expression of CSCs, the vascular niche and their cross talk markers are associated with increase in severity of dysplasia suggesting their role in the progression of oral potentially malignant disorders and may hence be used in identifying high-risk OPMD.



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Evaluating the association between household air pollution and oral cancer

Publication date: Available online 12 November 2017
Source:Oral Oncology
Author(s): A. Thirumal Raj, Shankargouda Patil, Sachin C. Sarode, Gargi S. Sarode, Chandini Rajkumar




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The utility of oral brush cytology in the early detection of oral cancer and oral potentially malignant disorders: A systematic review

Abstract

Objectives

This systematic review aimed to analyze the published evidence for the use of oral brush cytology for the early detection of oral cancer and oral potentially malignant disorders (OPMDs).

Methods

Literature was systematically searched through several databases: MEDLINE, EMBASE, PubMed, SCOPUS, Cochrane Library and Web of Science. Additional review was performed through cross checks on the bibliographies of selected articles. The inclusion criteria involved studies assessing the utility of oral brush cytology on human tissues and its applications in the diagnosis, screening or surveillance of oral cancer or OPMDs.

Results

The search strategy resulted in 343 abstracts or full-text articles, of which 36 met the inclusion criteria. The year of publication ranged from 1994 to 2017, and a total of 4302 samples from OPMDs, oral squamous cell carcinoma, and healthy controls have been investigated. Baby toothbrush, Cytobrush, OralCDx^®, and Orcellex^® are the brushes that were used to obtain transepithelial mucosal samples for conventional and liquid-based cytology evaluation.

Conclusions

Findings from this paper indicate that meaningful evidence-based recommendations for the implementation of a minimally-invasive technique to be utilized as an adjunctive tool for screening and early detection of oral cancer and OPMDs are complicated from the reported studies in the literature. There is need for well-designed clinical studies to assess the accuracy of oral brush cytology utilizing validated cytological assessment criteria for the diagnosis and prediction of OPMDs.

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CRP is linked to disease activity, impact and response to treatment in patients with chronic spontaneous urticaria

Abstract

Background

Elevated levels of C-reactive protein (CRP), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria. Here, we retrospectively analyzed data from 1,253 CSU patients from two centers to answer the following questions: 1) What is the prevalence of elevated levels of CRP in CSU? 2) Why do CSU patients show elevated levels of CRP? 3) Are elevated CRP levels relevant?

Methods

Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR, CBC with differential, D-dimer, fibrinogen, C3, C4, IL-6 etc. For most patients, we also collected data on age, gender, duration of CSU, presence of angioedema, activity (UAS at the time of blood sampling and for 7 days), quality of life (CU-Q2oL and/or DLQI), comorbidities and possible causes of CSU, and autologous serum skin test (ASST) response. The efficacy of second generation antihistamines was evaluated at the day of blood collecting.

Results

One third of CSU patients had elevated levels of CRP. Higher levels of CRP were associated with ASST positivity (p=0.009) and arterial hypertension (p=0.005), but not with other possible causes or comorbidities of CSU. CRP correlated with urticaria activity (p<0.001), quality of life impairment (p=0.026), inflammatory and coagulation markers (p<0.001). CRP levels were significantly higher in non-responders to antihistamines as compared to responders (p<0.001).

Conclusion

Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU.

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Ethical and legal aspects in the care of singers and actors

Gustavo Polacow Korn, Carlos Michaelis Jr., Vania Rosa Moraes
Braz J Otorhinolaryngol.2017;83:609-10

Texto Completo - PDF

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Health‐related quality of life and disability in patients with acute unilateral peripheral vestibular disorders

Maria Petri, Magdalena Chirilă, Sorana D. Bolboacă, Marcel Cosgarea
Braz J Otorhinolaryngol.2017;83:611-8

Resumo - Texto Completo - PDF

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