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A 57-year-old woman sought dental care for an asymptomatic lesion in the lower molar region, with one year of evolution. She had no underlying disease. Clinical examination revealed a smooth, normochromic, pedunculated nodule measuring 0.5 cm in diameter in the gingiva region of tooth 46. The diagnostic hypothesis was pyogenic granuloma. An excisional biopsy was performed, and the histopathological report was peripheral ossifying fibroma (POF) combined with peripheral giant cell lesion (PGCL). The literature reports that POF and PGCL have similar etiologies and may be associated with local irritative factors. This case report shows that it is possible to find more than one type of diagnosis in the same lesion, highlighting the need for professionals to keep up to date in dealing with cases that deviate from the classic pattern. This case illustrates the importance of histopathological examination for the correct diagnosis of lesions and prognosis for the patient. [ABSTRACT FROM AUTHOR]

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Water is essential for the socio-economic development of a region and also for the survival of human beings. Water scarcity has direct and indirect impacts on the environment, the economy and human health. It can change the profile of morbidity and mortality of diseases, as well as having an impact on the supply of services that are essential public to the quality of life. This study aims to contextualize the occurrence of drought in Brazil, its effects on human health, as well as actions to be developed by the health sector to reduce the risk to those living in affected areas, with an emphasis on the monitoring of the quality of drinking water. This is a descriptive, qualitative study with a documental basis. The documents that were researched were related to initiatives by the Health Surveillance Secretariat of the Ministry of Health up until 2014. It is necessary to strengthen the performance capacity of the Unified Health System (SUS) in order to develop timely responses to reduce the risk to public health. [ABSTRACT FROM AUTHOR]

Mineralocorticoids have been implicated in the pathogenesis of diastolic heart failure. On the contrary, angiotensin (Ang)-(1-7) has emerged as a potential strategy for treatment of cardiac dysfunction induced by excessive mineralocorticoid receptor activation. A critical question about the cardioprotective effect of Ang-(1-7) in hypertensive models is its dependence on blood pressure (BP) reduction. Here, we addressed this question by investigating the mechanisms involved in Ang-(1-7) cardioprotection against mineralocorticoid receptor activation. Sprague-Dawley (SD) and transgenic (TG) rats that overexpress an Ang-(1-7) producing fusion protein (TG(A1-7)3292) were treated with deoxycorticosterone acetate (DOCA) for 6 weeks. After treatment, SD rats became hypertensive and developed ventricular hypertrophy. These parameters were attenuated in TG-DOCA. SD-DOCA rats developed diastolic dysfunction which was associated at the cellular level with reduced Ca(2+) transient. Oppositely, TG-DOCA myocytes presented enhanced Ca(2+) transient. Moreover, higher extracellular signal-regulated kinase phosphorylation, type 1 phosphatase, and protein kinase Cα levels were found in SD-DOCA cells. In vivo, pressor effects of DOCA can contribute to the diastolic dysfunction, raising the question of whether protection in TG was a consequence of reduced BP. To address this issue, BP in SD-DOCA was kept at TG-DOCA level by giving hydralazine or by reducing the DOCA amount given to rats (Low-DOCA). Under similar BP, diastolic dysfunction and molecular changes were still evident in DOCA-hydralazine and SD-low-DOCA, but not in TG-DOCA. In conclusion, Ang-(1-7) protective signaling against DOCA-induced diastolic dysfunction occurs independently of BP attenuation and is mediated by the activation of pathways involved in Ca(2+) handling, hypertrophy, and survival. [ABSTRACT FROM AUTHOR]

The correct histopathologic diagnosis is crucial to choose the correct therapy to prevent irreversible damage to the patient. The objective of this work is to present a clinical case of a maxillary lesion first histopathologically diagnosed as unicystic ameloblastoma, but the second opinion of an oral pathologist resulted in a new histopathologic diagnosis of calcifying odontogenic cyst associated with a compound odontoma. Both odontogenic lesions are benign, well-defined, slow growing, with little morbidity, differing from the previous report; therefore, treatment was conservative. This work highlights the importance of a capable professional for the histopathologic diagnosis of lesions occurring in oral and perioral regions for adequate treatment and management. [ABSTRACT FROM AUTHOR]

A 66-year-old male patient who was an ex-smoker and ex-drinker presented with a main complaint of "tongue pain" for 6 months. Physical examination revealed an extensive heterogeneous plaque with mixed white and red patches, irregular borders, and with the largest diameter of 5 cm, located at the left lateral border of the tongue and floor of mouth. Based on the characteristics of the lesion, the clinical diagnosis was leukoplakia. The lesion was mapped using the toluidine blue stain; 4 areas were stained positive, and 2 areas were subjected to incisional biopsy. Histopathologic analysis revealed epithelial dysplasia and squamous cell carcinoma. The definite diagnosis was squamous cell carcinoma. The patient was referred to the head and neck surgery service, where he underwent partial glossectomy and is being followed up with no evidence of recurrence. Toluidine blue stain is important for selection of the incisional biopsy area in extensive heterogeneous lesions suspected of potentially malignant oral disorders and oral cancer. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to evaluate the biocompatibility of a self-adhesive gutta-percha material and compare it with that of conventional gutta-percha. Methods Standard quantities of bioactive gutta-percha and conventional gutta-percha were directly inserted subcutaneously into the dorsal connective tissue of 30 BALB/c mice according to ISO 10993-6. After 7, 21, and 63 days each, 10 animals were euthanized, and the materials and surrounding tissue were removed. Tissue samples were subjected to histological processing resulting in 5-μm-thick slices stained with hematoxylin-eosin and Gomori trichrome stain. A grade ranging from I–IV was used to classify the inflammatory reaction. The Mann-Whitney U test with Bonferroni correction was used to compare the grade of inflammation induced by the materials at each time point. Qualitative evaluation of biocompatibility over time was also performed. Results Bioactive gutta-percha was more biocompatible than conventional gutta-percha at each time interval ( P < .05). Tissue exposed to bioactive gutta-percha reached “no inflammation” (grade I) at the 21-day interval, whereas it took 63 days for the conventional gutta-percha to reach the “slight inflammation” level (grade II). Conclusions Bioactive gutta-percha presented good tissue reaction at all time points. It may serve as an alternative to gutta-percha in terms of biocompatibility. [ABSTRACT FROM AUTHOR]

The article focuses on the role of aldosterone and angiotensin-(1-7) in ventricular myoctes, as they impact on development of heart disease. A study was performed on images of the cardiomyocytes, where the effects of aldosterone and angiotensin-(1-7) were examined in signaling of ventricular myocytes. Results revealed that both molecules can cross-talk to boost calcium signaling in ventricular myocytes.

The renin-angiotensin (Ang) system plays a pivotal role in the pathogenesis of cardiovascular disease, with Ang II being the major effector of this system. Multiple lines of evidence have shown that Ang-(1-7) exerts cardioprotective effects in the heart by counterregulating Ang II actions. The questions that remain are how and where Ang-(1-7) exerts its effects. By using a combination of molecular biology, confocal microscopy, and a transgenic rat model with increased levels of circulating Ang-(1-7) (TGR[A1-7]3292), we evaluated the signaling pathways involved in Ang-(1-7) cardioprotection against Ang II-induced pathological remodeling in ventricular cardiomyocytes. Rats were infused with Ang II for 2 weeks. We found that ventricular myocytes from TGR(A1-7)3292 rats are protected from Ang II pathological remodeling characterized by Ca(2+) signaling dysfunction, hypertrophic fetal gene expression, glycogen synthase kinase 3beta inactivation, and nuclear factor of activated T-cells nuclear accumulation. Moreover, cardiomyocytes from TGR(A1-7)3292 rats infused with Ang II presented increased expression levels of neuronal NO synthase. To provide a signaling pathway involved in the beneficial effects of Ang-(1-7), we treated neonatal cardiomyocytes with Ang-(1-7) and Ang II for 36 hours. Treatment of cardiomyocytes with Ang-(1-7) prevented Ang II-induced hypertrophy by modulating calcineurin/nuclear factor of activated T-cell signaling cascade. Importantly, antihypertrophic effects of Ang-(1-7) on Ang II-treated cardiomyocytes were prevented by N(G)-nitro-l-arginine methyl ester and 1H-1,2,4oxadiazolo4,2-aquinoxalin-1-one, suggesting that these effects are mediated by NO/cGMP. Taken together, these data reveal a key role for NO/cGMP as a mediator of Ang-(1-7) beneficial effects in cardiac cells. [ABSTRACT FROM AUTHOR]

Abstract: GPR91 is an orphan G-protein-coupled receptor (GPCR) that has been characterized as a receptor for succinate, a citric acid cycle intermediate, in several tissues. In the heart, the role of succinate is unknown. We now report that rat ventricular cardiomyocytes express GPR91. We found that succinate, through GPR91, increases the amplitude and the rate of decline of global Ca2+ transient, by increasing the phosphorylation levels of ryanodine receptor and phospholamban, two well known Ca2+ handling proteins. The effects of succinate on Ca2+ transient were abolished by pre-treatment with adenylyl cyclase and cAMP-dependent protein kinase (PKA) inhibitors. Direct PKA activation by succinate was further confirmed using a FRET-based A-kinase activity reporter. Additionally, succinate decreases cardiomyocyte viability through a caspase-3 activation pathway, effect also prevented by PKA inhibition. Taken together, these observations show that succinate acts as a signaling molecule in cardiomyocytes, modulating global Ca2+ transient and cell viability through a PKA-dependent pathway. [Copyright &y& Elsevier]

Abstract: Muscarinic (mAChRs) and nicotinic acetylcholine receptors (nAChRs) are involved in various physiological processes, including neuronal development. We provide evidence for expression of functional nicotinic and muscarinic receptors during differentiation of P19 carcinoma embryonic cells, as an in vitro model of early neurogenesis. We have detected expression and activity of α2–α7, β2, β4 nAChR and M1–M5 mAChR subtypes during neuronal differentiation. Nicotinic α3 and β2 mRNA transcription was induced by addition of retinoic acid to P19 cells. Gene expression of α2, α4–α7, β4 nAChR subunits decreased during initial differentiation and increased again when P19 cells underwent final maturation. Receptor response in terms of nicotinic agonist-evoked Ca2+ flux was observed in embryonic and neuronal-differentiated cells. Muscarinic receptor response, merely present in undifferentiated P19 cells, increased during neuronal differentiation. The nAChR-induced elevation of intracellular calcium ([Ca2+]i) response in undifferentiated cells was due to Ca2+ influx. In differentiated P19 neurons the nAChR-induced [Ca2+]i response was reduced following pretreatment with ryanodine, while the mAChR-induced response was unaffected indicating the contribution of Ca2+ release from ryanodine-sensitive stores to nAChR- but not mAChR-mediated Ca2+ responses. The presence of functional nAChRs in embryonic cells suggests that these receptors are involved in triggering Ca2+ waves during initial neuronal differentiation. [Copyright &y& Elsevier]

A 53-year-old black woman was referred complaining of "lip infection" 4 months ago. After medical consultation she was diagnosed as having a stress injury. Anamnesis revealed systemic arterial hypertension. Extraoral examination showed swollen resected lower lip, painful ulcers covered by crusts and pseudomembrane throughout lower lip, and periodic pulsatile pain. Intraoral examination was normal. Diagnostic hypotheses were exfoliative cheilitis and actinic prurigo. Treatment consisted of local hydration with dexpanthenol cream and ketoconazole, betamethasone, and neomycin topical cream. After 15 days, there was significant clinical improvement, but erythematous regions remained. The medication was maintained for another 15 days without complete resolution. Final clinical diagnosis was actinic prurigo of the lip. Actinic prurigo is an idiopathic photodermatosis that affects skin exposed to sunlight and labial and conjunctival mucosa. It more often affects young women and presents clinically as pruritic lower lip cheilitis that normally does not respond to conventional therapy. [ABSTRACT FROM AUTHOR]

The report describes a case of mandibular osteosarcoma in a 25-year-old black male patient complaining of increase of volume in mandible with evolution of 4 months. The anamnesis stated a previous history of mucoepidermoid carcinoma in the left retroauricular region treated by parotidectomy 18 years ago. Physical examination revealed the swelling of the left body of the mandible with face asymmetry and an expansive increase of volume in the buccal region of the mandible, extending to vestibule depth, associated with pain on palpation and paresthesia. Panoramic radiograph revealed a poorly defined radiolucent image without sclerotic border, with destruction of the periodontal ligament corresponding to tooth 36. Incisional biopsy was performed, and the histopathologic report was compatible with osteosarcoma. The patient was referred for oncology treatment. Osteosarcomas in the mandible are extremely rare, and this case justifies investigation as the patient had already presented another type of tumor in the proximal region. [ABSTRACT FROM AUTHOR]

Osteomas are benign bone tumors commonly restricted to craniofacial skeleton. They occur in 2 distinct forms: periosteal, arising from bone surfaces and endostea, arising from medullary bone. This clinical case presents a white 61-year-old female patient with chewing pain complaint, prosthetic maladjustment, and vestibular bone expansion of the mandible anterior region 5 years earlier. The patient sought a dental implant clinic for oral rehabilitation, and a radiographic examination revealed a single lesion. The patient was referred to a stomatology clinic, and a cone beam computed tomography was requested, which revealed a well-circumscribed hypodense image with a well-defined hypodense halo, suggesting complex odontoma. The patient was submitted for excisional biopsy, and the histopathologic diagnosis was endosteal osteoma. Endosteal osteomas are characterized by slow growth and make differential diagnosis radiographically with sclerotic lesions, such as condensing osteitis, cementoblastoma, and complex odontoma. Histopathologic analysis is important for diagnostic confirmation and adequate management. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) is a malignant neoplasm of salivary glands that, with slow growth and infiltrative tumor, clinically is characterized by a firm mass. A 49-year-old brown female patient sought dental care with complaints of "headaches and nasal congestion over 10 months." On the anamnesis she reported systemic arterial hypertension. Extraoral examination revealed facial asymmetry in the left maxillary region and absence of palpable lymph nodes. The intraoral examination revealed an increase in volume and ulcerated lesions in the left hard palate region. Radiopaque examination of the maxillary sinus and reabsorption of the 28 were performed on the radiographic examination. An incisional biopsy was performed with a diagnostic hypothesis of lymphoma. Histopathology reported an ACC. The patient was referred for oncologic treatment and will undergo subtotal maxillectomy with reconstruction by head and neck microsurgery. The biological aggressiveness of ACC is usually underestimated because of slow growth. [ABSTRACT FROM AUTHOR]

A 10-year-old white male patient was referred to the clinic because of absence of tooth 37. Extraoral examination was irrelevant. Intraoral examination showed absence of tooth 37 and the left inferior retromolar region covered by normal mucosa with normal bone contour. Cone beam computed tomography revealed unilocular hypodense image with hyperdense margin and hyperdense foci inside, between the unerupted teeth 36 and 37, which was displaced. Diagnostic hypothesis was odontoma. Treatment consisted of lesion excision under local anesthesia, and tooth 37 has been maintained. The histopathologic report confirmed the final diagnosis of ameloblastic fibrodentinoma. The patient is under follow-up without relapse. [ABSTRACT FROM AUTHOR]

Mineralocorticoids have been implicated in the pathogenesis of cardiac diseases. In contraposition, Angiotensin (Ang)-(1-7) has been shown to attenuate cardiac dysfunction induced by excessive mineralocorticoid receptor (MR) activation in vivo, suggesting a possible interaction between these two signaling pathways in the heart. Here, we investigated whether there is a cross-talk between MR signaling and Ang-(1-7) and its consequences for cardiomyocyte function. For this, we used a transgenic rat that overexpress an Ang-(1-7)-producing fusion protein, TGR(A1-7)3292 (TG), which induces an increase in circulating levels of this peptide, treated or not with deoxycorticosterone acetate (DOCA). After six weeks of DOCA-salt, rats presented increased blood pressure and cardiac ejection fraction when compared to SD control rats. Marked cardiac hypertrophy was also observed at six weeks of DOCA-salt treatment. In contrast, TG DOCA rats did not develop cardiac hypertrophy or changes in ventricular function. qPCR analysis of ventricular myocytes from SD DOCA-salt rats revealed a six fold increase in MR and a three fold increase in ß-myosin heavy chain mRNA transcripts. These changes were significantly attenuated in cardiomyocytes from TG DOCA rats. We also examined intracellular Ca2+ levels in freshly isolated Fluo-4-loaded cells. The amplitude of the [Ca2+]i transient was reduced in SD DOCA cardiomyocytes (F/F0=5.12+ 0.1 n=56 in SD versus F/F0=3.75+0.1 n=65 in SD DOCA myocytes, p<0.05). These changes were at least partly explained by reduced SERCA2 protein and altered PLN phosphorylation in these cells. In contrast, TG DOCA cardiomyocytes presented enhanced Ca2+ transient (F/F0=8.02+ 0.2 n=68 myocytes) and increased SERCA2 expression. Cardiomyocytes from TG rats presented Ca2+ transient comparable to SD cells. SD DOCA rats also showed increased PP1 and PKC alpha expression in comparison to SD and TG DOCA cells. These results suggest that Ang-(1-7) and MR signaling pathways cross-talk to enhance Ca2+ transient in cardiomyocytes preventing the Ca2+ signaling dysfunction characteristic of excessive MR activation. These data provide a better understanding of the cardioprotective effects of this putative therapeutic peptide. [ABSTRACT FROM AUTHOR]