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Objective: To evaluate the influence of MMR proteins on clinicopathological characteristics and prognosis of salivary gland adenoid cystic carcinoma (ACC). Method: The solid pattern of ACC showed lower expression for MSH2 (p = 0.039). Significant imbalance in MSH2/MSH6 immunostaining was observed in all histological patterns (p < 0.001), and imbalance in PMS2/MLH1 immunostaining was observed in the cribriform pattern (p = 0.011). The presence of capsule was associated with high expression of MSH6 (p = 0.019), MLH1 (p = 0.045) and PMS2 (p = 0.009). The absence of cribriform pattern (p = 0.002) and capsule pattern (p = 0.025), as well as low expression for MSH6 (p = 0.006) and PMS2 (p = 0.037) were associated with lower overall survival. In multivariate analysis, loss of MSH2 (p = 0.039) and MLH1 (p = 0.017) were significantly associated with worse overall survival. Results: Twenty‐four ACC were clinical‐pathologically evaluated and we perform immunohistochemistry for MSH2, MSH6, PMS2 and MLH1. Percentage counting of positive cells was performed in 10 fields of each histological pattern (cribriform, tubular and solid) and the averages of the 30 fields were considered for evaluation with other clinical‐pathological variables (Kruskal‐Wallis/Dunn, Friedman/Dunn, chi‐square, Log‐Rank Mantel‐Cox tests and Cox regression; SPSS v20.0, p < 0.05). Discussion: Salivary glands' ACC shows imbalance of the MMR complex and loss of expression of its components is associated with the overall survival of these patients. [ABSTRACT FROM AUTHOR]

Ulcerated lesions have been observed in SARS-CoV-2 patients and their treatment is a challenge. We aim to report the treatment of oral lesions with low-level laser therapy (LLLT) in a patient with SARS-CoV-2. The patient diagnosed with COVID-19 was admitted to the intensive care unit, on mechanical ventilation, and on a nasogastric tube diet that persisted due to oral lesions. Painful ulcerated lesions, clinically diagnosed as viral ulcer, were found on the tongue, palate, labial commissure, and oropharynx during the oral evaluation. An antimicrobial photodynamic therapy with methylene blue and red laser (high energy) was performed, followed by treatment with LLLT with red laser. Significant clinical improvement of the lesions was observed after seven sessions of LLLT, with the oral diet being reestablished. Oral mucosal lesions in patients with COVID-19 are usually symptomatic and with onset after systemic symptoms. LLLT has been used in the management of these lesions, with promising results. [ABSTRACT FROM AUTHOR]

Immobilization protocols for head and neck radiotherapy (HNR) are needed to reduce radiation dispersion in non-tumoral tissues and to reduce damage to noble structures; however, involuntary mandibular movements require additional adaptations of thermoplastic masks. Our objective was to describe an easy and low-cost disposition to help thermoplastic masks immobilize the mandible during HNR. We created Styrofoam models to stabilize the mandible which was used to make adaptation to the thermoplastic masks. The Styrofoam model was inserted into alginate to construct a mold and a self-curing acrylic resin was added into the mold. After the acrylic resin hardened, the dispositive mandibular immobilizer was removed from the alginate mold and adjusted with Maxicut and Minicut or other drills and sandpaper. The alginate mold can be used on the same day to create backup devices. Our device was made in a simple way, has a low cost, and helps the thermoplastic masks to immobilize the mandible, leading to a more precise individualization of head and neck immobilization that can reduce unanticipated radiation scatter and improve radiation distribution. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced dentistry schools (DSs) to adapt their teaching techniques to digital platforms. Therefore, we aimed to evaluate distance classes in the Brazilian DS curriculum. After an online search of higher education institutions (HEIs) with DS on the e-Ministry of Education (MEC) platform, we included institutions with at least one graduated class to extract the age/localization of the DS, funding, number of authorized seats, MEC-grade, ENADEscore, and workload. HEIs' webpages were consulted to identify the curriculum, subjects offered in the distance education (DE) format, extracurricular programs, scientific events, postgraduate programs, and institutional YouTube channels. Chi-square/Fisher's tests plus binary logistic regression were performed (SPSS 20.0, p < 0.05). Of the 241 DSs evaluated, 82 (34.0%) offered distance classes, and a high prevalence was observed in the southeast region (p <0.001) and private HEIs (p = 0.001). HEIs with distance classes had lower ENADE scores (p = 0.004), lower workload (p = 0.007), and higher workload for optional subjects (p = 0.016), doctoral programs (p = 0.041), specialization courses (p = 0.017), and institutional YouTube channels (p < 0.001). Southern dental schools (p < 0.001), lower workload (p = 0.022), optional subjects (p = 0.033), and institutional YouTube channels (p = 0.005) were independently associated with distance classes. In one-third of the Brazilian DSs, distance classes and institutional YouTube channels were strongly associated variables. The association of distance learning with lower workload and low academic performance draws attention to the need for regulatory bodies for controlling the quality of DE. [ABSTRACT FROM AUTHOR]

Background: Squamous cell carcinoma (SCC) is the most common histological type in the oropharynx with high incidence and mortality. The Pi3K-AKT signaling pathway is important for understanding prognostic factors such as metastasis, which is involved in the aetiopathogenesis of cancer and is associated with angiogenesis, progression, and cell survival. The aim of this study was to evaluate the correlation of the Pi3K/AKT pathway with prognostic factors associated with oropharyngeal SCC, including overall survival., Materials and Methods: Patients diagnosed and treated for oropharyngeal SCC at the Haroldo Juaçaba Hospital were included in the study. Clinicopathological and socio-demographic data were collected by reviewing patient records and reports. Excisional biopsies were analyzed by immunohistochemical techniques using TMA for the detection of antibodies against ANTI-AKT, ANTI-Pi3K, ANTI-p16, ANTI-Ki67, and ANTI-p53. Immunoexpression was evaluated qualitatively and quantitatively using ImageJ software, and data were correlated with patient survival., Results: There was a significant reduction in nuclear Pi3K immunoexpression in perilesional tissue compared to primary tumors and nodal metastases (p<0.001). Cytoplasmic Pi3K was increased in primary tumors and decreased in nodal metastases (p=0.001). pAKT expression in p16-negative tumors was associated with poorer overall survival. Further studies are needed to understand how this pathway may influence tumor progression and multimodal therapies., Conclusion: The PI3K/AKT pathway regulates cell survival and apoptosis and is associated with the malignant transformation of oropharyngeal tumors. AKT expression in p16-negative tumors is a strong predictor of poor prognosis.

Ulcerated lesions have been observed in SARS-CoV-2 patients and their treatment is a challenge. We aim to report the treatment of oral lesions with low-level laser therapy (LLLT) in a patient with SARS-CoV-2. The patient diagnosed with COVID-19 was admitted to the intensive care unit, on mechanical ventilation, and on a nasogastric tube diet that persisted due to oral lesions. Painful ulcerated lesions, clinically diagnosed as viral ulcer, were found on the tongue, palate, labial commissure, and oropharynx during the oral evaluation. An antimicrobial photodynamic therapy with methylene blue and red laser (high energy) was performed, followed by treatment with LLLT with red laser. Significant clinical improvement of the lesions was observed after seven sessions of LLLT, with the oral diet being reestablished. Oral mucosal lesions in patients with COVID-19 are usually symptomatic and with onset after systemic symptoms. LLLT has been used in the management of these lesions, with promising results., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Contemporary Clinical Dentistry.)

Background: Opioids are the most effective drugs currently available for cancer pain management. The administration of morphine, in addition to its analgesic effect, can alter tumor development., Objective: To characterize the immunoexpression of opioid receptors µ and κ in oropharyngeal squamous cell carcinoma, and correlate it with prognostic factors, proliferation markers, and cell death., Materials and Methods: A retrospective, cross-sectional observational study was carried out with 50 patients diagnosed at Haroldo Juaçaba Hospital. Sociodemographic, clinicopathological, and overall survival data were collected, and excisional biopsies were taken for immunohistochemistry using tissue microarrays for opioid receptors µ and κ, Ki-67, and caspase-3. Immunolabeling was evaluated and correlated with other variables using Mann-Whitney, Kruskal-Wallis, Spearman correlation, log-rank (Mantel-Cox), and Cox regression tests., Results: Immunoexpression of opioid receptors µ and κ, Ki-67, and caspase-3 was significantly higher in p16+ and p16- primary tumors and lymph node metastases than in surgical resection margins. The overall survival of patients with p16- tumors was 57.53 ± 8.43 months and that of patients with p16+ tumors was slightly higher at 75.92 ± 11.14 months. Multivariate analysis showed that the expression of opioid receptors µ and κ in the nucleus was directly associated with a lower and higher risk of death, respectively., Conclusion: We found increased expression of opioid receptors µ and κ in tumor tissues. The nuclear expression of opioid receptors µ and κ influences overall survival and may be a prognostic factor of oropharyngeal squamous cell carcinoma., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Retrospectively to evaluate the influence of radiochemotherapy (RCT) in the treatment of surgically and non-surgically treated Oral Squamous Cell Carcinoma (OSCC)., Material and Methods: We analysed 934 patients treated in Hospital Haroldo Juaçaba (2000-2014; 15 years of study) by extraction of data type of cancer, localization of tumour, sex, age, race, education level, risk factors (smoking and alcohol use), year of diagnosis, TNM stage, therapeutic approach, health system used (public or private) and overall survival (OS). Surgically and non-surgically treated OSCC were compared by chi-square and Fisher's exact tests, and their prognostic factors were analysed by log-rank Mantel-Cox plus Cox regression tests (SPSS 20.0, p <0.05)., Results: Non-surgically treated OSCC patients had a lower OS than surgically treated OSCC patients ( p <0.001), but an increase in OS was shown in both groups. Although the 2010-2014 period ( p =0.003), education level ( p =0.032), tongue/mouth floor/palate localization ( p =0.023) and TNM stage ( p <0.05) were important in non-surgically treated OSCC OS, the major prognostic factors were node metastasis ( p =0.003) and non-use of RCT ( p =0.039) (multivariate analysis). In surgically treated OSCC patients, higher OS was shown in the 2010-2014 period ( p <0.001), females ( p =0.012), non-drinkers ( p =0.011), non-smokers ( p =0.009) and those with lower TNM stage ( p <0.05), but the major prognostic factor was the 2010-2014 period ( p =0.004) (multivariate analysis), which was directly associated with an increase in RCT indication ( p <0.001)., Conclusions: The increase in RCT improved the OS in this large cohort of surgically and non-surgically treated OSCC patients. Key words: Mouth neoplasms, neck, radiotherapy, drug therapy, combination., Competing Interests: Conflicts of interest All authors must disclose any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work., (Copyright: © 2021 Medicina Oral S.L.)

Objective: Breast cancer is a disease of great concern. The prognosis of this tumor is related to its staging. Opioids are widely used to minimize pain in oncology clinics; however, the relationship between the administration of opioids and their effects on tumor cells has yet to be elucidated. Therefore, this study aimed to evaluate the immunoexpression of mu- (μ) and kappa- (κ) opioid receptors and their correlation with markers of angiogenesis, cell proliferation, and apoptosis in biopsies of breast tumors., Methods: Demographic data, tumor characteristics, opioid use, and prognostic factors were collected from medical records. After the selection of the excisional biopsies, immunohistochemistry was performed for μ- and κ-opioid receptors, vascular endothelial growth factor (VEGF), Ki-67, and TUNEL., Results: A significant predominance of Ki-67 and μ-opioid receptor immunoexpression in the lymph nodes was observed in patients administered opioid medications. The luminal A subtype showed higher apoptosis levels (TUNEL) compared to the luminal B subtype. Patients with T4 tumor who had recurrence demonstrated a reduced expression of κ-opioid receptors at the lymph node location. Correlation analyses between the μ and κ opioid markers, VEGF, Ki-67, and TUNEL showed that these findings are likely involved in the same mechanisms the cancer of T4 stage breast cancer., Conclusion: The κ-opioid receptor has a lower immunoexpression in nodal tumor metastasis with recurrence, whereas the μ-opioid receptor is directly related to expression of TUNEL-positive cells  in tumors and indirectly to Ki-67 in nodal metastasis. Neither of the two receptors was expressed in the primary tumor or nodal metastasis in relation to VEGF.