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Objectives To examine the prognostic significance of pretreatment C‐reactive protein (CRP), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), and cardiac troponin T (cTnT) levels on all‐cause mortality 3 years after head and neck squamous cell carcinoma (HNSCC) diagnosis. Subjects and Methods Data from 118 consecutive HNSCC patients, treated between 2012 and 2015, were evaluated prospectively. The impact of CRP, high‐sensitive (hs)‐cTnT, and NT‐proBNP levels on the 3‐year overall survival was estimated using the Kaplan–Meier method and Cox proportional hazard models. Results During the 36‐month follow‐up, 37 patients (31.35%) died. Multivariate analysis revealed that elevated CRP (Hazard ratio: 3.71, 95% CI: 1.44–9.53, p = .007) and NT‐proBNP levels (Hazard ratio: 5.04, 95% CI: 2.02–12.55, p = .001) were associated with negative prognosis, independent on age, sex, smoking and alcohol status, TNM classification, tumor site, body mass index (BMI), systolic blood pressure (SBP), and treatment modality (except for radiotherapy). hs‐cTnT had no influence over the prognosis, but it was correlated with TNM classification and SBP. CRP was significantly correlated with BMI and TNM classification, and NT‐proBNP with SBP and hs‐cTnT. Conclusions Pretreatment CRP and NT‐proBNP levels were identified as independent prognostic markers for poor clinical outcome 3 years after HNSCC diagnosis.

Purpose: Oral mucositis is a painful condition that occurs in patients who undergo chemotherapy. Due to the worsening of oral mucositis, the patient may progress to a worse clinical condition and interrupt antineoplastic treatment. There is little literature on low-power laser therapy in chemotherapy for other solid tumors. The purpose of this study was to investigate whether low-level laser therapy (LLLT) applied before chemotherapy could prevent oral mucositis in patients with solid tumors. Methods: Laser therapy was applied at a frequency of 630nm, with a dose of 2J / cm 2 , for the prevention of oral mucositis induced by chemotherapy specifically for non-hematological tumors. Epidemiological data, total neutrophils, general side effects, development of oral mucositis and degree, and the performance of low-power laser therapy to prevent oral mucositis were collected. The involvement of oxidative stress was evaluated by the enzyme superoxide dismutase (SOD) through blood samples, before and after chemotherapy treatments. Results: LLLT in the proposed protocol is efficient in reducing the development of oral mucositis (only at grade I/II) in patients under chemotherapy and able to reduce the severity of oral mucosal lesions, in patients who developed mucositis after the use of the laser for prevention. All individuals who underwent LLLT protocol did not show a significant reduction of SOD activity after the last chemotherapy cycle. Conclusions: The prophylactic laser therapy protocol proposed by the study, defined at a frequency of 630nm, a dose of 2J / cm2, demonstrated the ability to decrease the occurrence of oral mucositis in patients undergoing chemotherapy protocols to solid tumors. This effect could be related to preserved SOD activity, as it was observed that oral mucositis is related to leukopenia and reduced SOD activity and LLLT protocol prevented the decrease of SOD activity.

The present study aims to evaluate the longitudinal effects of induced experimental infections in gnotoxenic animals on the expression of inflammatory chemokines and their receptors in periradicular tissues. The null hypothesis tested was that Enterococcus faecalis and Fusobacterium nucleatum had no effect on CCR5, CCL5, CXCL10, CCL2/MCP-1, CXCR2 and CCR1 expression. Two groups of five animals (n = 5) aged between 8 and 12 weeks were used in this study. The animals were anaesthetized, and coronary access was performed in the first molar on the right and left sides. Microorganisms were inoculated into the left molar, and the right molar was sealed without contamination to function as a control. Animals were sacrificed 7 and 14 days after infection, and periapical tissues were collected. The cytokine mRNA expression levels were assessed using realtime PCR. The chemokine mRNA expression levels demonstrated that the experimental infection was capable of inducing increased chemokine expression on day 7 compared to that on day 14, except for CCR5 and CCL5, which showed no changes. The gnotoxenic animal model proved to be effective and allowed evaluation of the immune response against a known infection. Additionally, this study demonstrates that gene expression of chemokines and their receptors against the experimental infection preferentially prevailed during the initial phase of induction of the periradicular alteration (i.e., on day 7 post-infection).

Background:Alive vaccines should be used with caution in autoimmune diseases (AID).1 Objectives:To evaluate prospectively adverse events and efficacy of the Yellow Fever vaccine in patients with AID.Methods:Prospective study, including 190 individuals, 47 with Rheumatoid Arthritis (RA), 36 primary Sjögren’s Syndrome (SS), 48 Ankylosing Spondylitis (AS), 8 Systemic Sclerosis (SSc), 24 Systemic Lupus Erythematosous (SLE), and 29 Healthy Controls (HC). All individuals received 17DD (Biomanguinhos-FIOCRUZ) YF vaccine, for the first time during the 2017 Brazilian Campaign, aged > 18 years, had no or low disease activity, low immunossupression. Exclusion Criteria: previous vaccination for yellow fever or PRNT > 1:50 at baseline, primary or secondary immunodeficiency, under treatment with cyclophosphamide, chlorambucil, mycophenolate mofetil, calcineurin inhibitors, azathioprine> 2mg/kg/day, prednisone ≥20mg/day, methotrexate >20mg/week or any immunobiological drug. Viremia (CRP) and plaque reduction neutralization test (PRNT; GeoMean title) were measured before (D0) and D3, D4, D5, D6, D7, D14, D28 after vaccine. Adverse events (AE) were registered through patient report diary and medical interview at D7, D14 and D28.Results:Mean age was 52 years old for AID and 56 for HC. No serious adverse event was reported. However, mild local AE was more reported in AID as compared to HC (34.2% vs 3.4%, p=0.000). The frequency of AE was higher in AID compared to HC (34.1 vs. 3.4%). The Risk (Odds Ratio; 95%CI) for AE was 14.53 (1.9-109.7, p=0.000) and AID subgroups: RA=14.5 (1.8-116.2, p=0.0016), AS= 9.3 (1.1-76.2, p=0.0248), SS 25.1 (3.1-204.5, p<0.0001), SLE 9.3 (1.0-84.1, p=0.0377), SSc 56.0 (4.1-769.0, p=0.0014). The PRNT levels expressed in reverse of serum dilution was lower in AID 181 (144-228, p=0.04) as well in AS 112 (73-170, p<0.001), and in SLE 143 (61-332, p=0.01) as compared to HC 440 (291-665). The seropositivity rates were lower in AID after 28 days (78% vs. 96%, p=0.04) as well as in AS (73%, p=0.02) and SLE (73%, p=0.03) as compared to HC (Figure 1). Viremia peak was slightly late and low in AID (D6=5.8 x 103) compared to HC (D5= 8.3 x 103. Seropositivity was statistically lower at D14 in AID as compared HC (21% vs. 75%, p=0.04) and remained lower at D28 in AS and SLE subgroups.Conclusion:Efficacy was lower in AID, especially in SLE and AS, in spite of viremia peak at D5-D6 similar to HC. Taking together, results suggest that YF vaccine is safe in AID with low disease activity and under low immunossupression, but probably a booster dose should be necessary.References[1] Lopez A, Mariette X, Bachelez H, et al. Vaccination recommendations for the adult immunosuppressed patient: A systematic review and comprehensive field synopsis. Journal of Autoimmunity 2017;80:10-27Acknowledgement:SORES and FAPESDisclosure of Interests:None declared