Purpose: Clinical, radiological and histological evaluation of root perforations treated with mineral trioxide aggregate (MTA) or Portland cements, and calcium sulfate barrier. Methods: One molar and 11 premolar teeth of a male mongrel dog received endodontic treatment and furcations were perforated with a high-speed round bur and treated with a calcium sulfate barrier. MTA, Portland cement type II (PCII) and type V (PCV), and white Portland cement (WPC) were used as obturation materials. The teeth were restored with composite resin and periapical radiographs were taken. The animal was euthanized 120 days post-surgery for treatment evaluation. RESUMOObjetivo: Avaliar clínica, radiológica e histologicamente perfurações radiculares tratadas com MTA e cimentos Portland, com barreira de sulfato de cálcio. Métodos: A amostra foi constituída por 11 dentes pré-molares e um molar de cão macho, sem raça definida. Após tratamento endodôntico realizaram-se perfurações nas furcas com broca esférica de alta rotação e barreira de sulfato de cálcio. Foram utiliados os cimentos MTA, Portland tipo II (CPII), Portland tipo V (CPV) e Portland branco estrutural (CPB). Os dentes foram restaurados com resina composta e submetidos a radiografias periapicais. O animal foi confinado por 120 dias e submetido à eutanásia para avaliações. Resultados: Primeiro pré-molar inferior direito (MTA), terceiro pré-molar inferior direito (CPV), segundo pré-molar inferior esquerdo (MTA) e segundo pré-molar inferior direito (CPB): clinicamente normal; leve área radiotransparente na furca; pequeno infiltrado inflamatório e neoformação óssea. Terceiro pré-molar inferior esquerdo (CPII), primeiro pré-molar superior direito (CPB), terceiro pré-molar superior direito (CPII) e primeiro molar superior esquerdo (CPV): clinicamente normal; área radiopaca na furca; neoformação óssea. Segundo pré-molar superior direito (MTA), segundo pré-molar superior esquerdo (CPB) e terceiro pré-molar superior esquerdo (CPII): clinicamente com lesão na furca; intensa área radiolucida; infiltrado inflamatório intenso. Conclusão: Todos os cimentos induziram a neoformação óssea.
BackgroundThe diagnosis of pancreatic cystic neoplasms has become more accurate recently. In some cases, however, doubt remains regarding the lesion’s malignant potential. CA 19–9 has long been identified as a reliable biomarker in differentiating pancreatic benign and malignant lesions, especially in non-jaundiced patients.Case report and discussionWe report a case of a young female who presented with a mucinous lesion in the tail of the pancreas and a serum CA 19–9 over 1,000,000 U/mL. She was taken to surgery and had a distal pancreatectomy and splenectomy. Pathology reports showed only a mucinous cystadenoma. After 1 year of follow-up, her serum CA 19–9 was normal. Following that, the work-up in these lesions, the role of the biomarker in pancreatic adenocarcinoma and in the differentiation between benign and malignant lesions is discussed.
Objective: Several inflammatory markers such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), have been linked to prognosis of several malignancies including hepatocellular carcinoma (HCC). We aim to assess NLR and PLR as potential predictors of extrahepatic spread of HCC. Methods: Retrospective analysis of prospectively collected data on newly diagnosed patients with HCC between 2011 and 2015 was done. Results: A total of 180 patients were included. The mean age at the time of diagnosis was 58.8 (range: 31e82) years. HCV was found to be the most common cause of liver cirrhosis 108 (60%). 22 (12.2%) patients were classified as class C according to Child-Pugh criteria. The follow up of patients ranged from 0.1 to 4.4 years (mean = 1.0 AE 1.1 years).During follow-up 80 patients died (overall survival of 51.1%). Forty seven patients (26%) had at least one extrahepatic metastasis at the time of diagnosis (Single site-10 vs Multiple sites-37).Comparativeanalysisbetweenthosewhodevelopedmetastasis and those who didn't included several variable including inflammatory markers. Potential risk factors, at significance level of P < 0.05, included higher serum platelets, lower PLR, bigger tumor diameter, bigger total tumor volume, multiple/ bilobar HCC and macroscopic vascular invasion. However, multi-variate regression analysis revealed that tumor diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85e20.12) (P = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10e27.30) (P = 0.037) were the only predictors of met-astaticbehaviorofHCC. Conclusion: Tumors size (>5 cm) and bilobar involvement are determinants of the extra-hepatic metastasis in HCC patients while NLR and PLR ratios are not.
BackgroundOrofacial pain (OFP) is an undesirable sensation frequently associated with head and neck cancer (HNC) and its treatment. OFP negatively impacts the quality of life of oncological patients. The approach to OFP diagnosis and management can differ if the patient visits a dentist or physician. The aim of this study was to present a case series of HNC with OFP managed by a dentist team and to discuss its role in the management of OFP.Material and MethodsWe recruited twenty-two adult patients with OFP and previous diagnosis of HNC referred to an academic dental clinic from 2015 to 2017.ResultsNociceptive was more frequent than mixed and neuropathic pain, however 54,4% of the cases showed a neurological component. All types of pain were managed by dentist through removal of pain’s cause and appropriated local and systemic treatment. The intensity of pain was reduced in 86,3% of patients, and 45,4% of them reported absence of pain at the end of treatment.ConclusionsDentist’s assessment plays a distinct and crucial role in the diagnosis and management of OFP in HNC patients throughout the oncological treatment. Key words:Pain, orofacial, neoplasm, head and neck, dentist.
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