Maria Elvira Pizzigatti Corrêa

Universidade Estadual de Campinas (UNICAMP)

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Cármino Antônio De Souza

Universidade Estadual de Campinas (UNICAMP)

Afonso Celso Vigorito

Universidade Estadual de Campinas (UNICAMP)

Eliana Cristina Martins Miranda

Universidade do Tocantins

Cláudio Maranhão Pereira

Instituto do Câncer do Estado de São Paulo

Oslei Paes de Almeida

Universidade Estadual de Campinas (UNICAMP)

Vinícius Rabelo Torregrossa

Universidade Estadual de Campinas (UNICAMP)

Maria Cláudia Rodrigues Moreira

Instituto Nacional do Câncer

Elad Sharon

National Cancer Institute

Patrı́cia Freire Gasparetto

Universidade Paulista

Maria Letícia Cintra

Universidade Estadual de Campinas (UNICAMP)

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Universidade Estadual de Campinas (UNICAMP)

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Universidade de São Paulo

Hospital de Clínicas da Unicamp

Instituto Nacional do Câncer

Harvard University

Faculdade São Leopoldo Mandic

Fundação Faculdade de Odontologia

Universidade Federal do Rio de Janeiro

Universidade Estadual Paulista (Unesp)

Massachusetts General Hospital

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Adesivos de fibrina : avaliação clinica e experimental

Maria Elvira Pizzigatti Corrêa Maria Lourdes Barjas‐Castro

Os adesivos teciduais sao produtos originarios de proteinas do plasma humano, utilizados como agentes hemostaticos em diferentes procedimentos cirurgicos. Objetivos: avaliar a influencia da cola de fibrina como agente hemostatico local apos extracoes dentarias em pacientes hemofilicos. Analisar a influencia dos adesivos nos processos de reparacao tecidual em pele e em alveolo dentario em modelo animal. Capitulo I Pacientes e Metodos: Foram realizadas extracoes dentarias em 31 pacientes hemofilicos, sem previa terapia de reposicao de fatores de coagulacao. Os pacientes receberam antifibrinolitico oral (Ipsilon® - 200mg/kg, VO, 8/8 horas, por 7 dias). Foi realizada a avaliacao da saude bucal atraves dos indices: Gengival (IG); Indice de Placa (IP) e atraves do Indice CPOD (dentes cariados, perdidos e obturados). Apos as extracoes os alveolos foram preenchidos com cola de fibrina autologa. Os pacientes foram avaliados 24 horas apos o procedimento. Resultados: em seis procedimentos (19,4%) foram observados sangramentos que foram controlados com reaplicacao da cola de fibrina e dose unica de fator de coagulacao (um hemofilico grave, 3 hemofilicos moderados e em 2 hemofilicos leves). As medias dos indices IG, IP e CPOD foram, no grupo que sangrou, 1,7; 1,8; e 18 e, no que nao apresentou sangramento, 1,8; 1,8; e 19, respectivamente. Conclusao: A cola de fibrina foi efetiva como agente hemostatico local apos extracoes dentarias em pacientes hemofilicos, reduzindo significantemente a terapia de reposicao de fatores de coagulacao. As condicoes de saude bucal, refletidas pelos resultados obtidos atraves da avaliacao dos indices IG, IP e CPOD, demonstraram nao haver influencia desses fatores na eficacia da cola de fibrina autologa como agente hemostatico local. Capitulo II - Material e Metodos: Vinte e cinco ratos Wistar foram submetidos a duas incisoes em dorso de pele apos anestesia intramuscular. Na incisao do lado direito, foram inseridas esponjas embebidas em Selante de Fibrina associado ao fator XIII e aprotinina (Beriplast P® - Aventis Beringher) e, na incisao do lado esquerdo, foram inseridas esponjas sem adesivos, como controle. Os animais foram divididos em cinco grupos e sacrificados nos dias 1, 7, 14, 21, e 28 apos a cirurgia. O tecido do dorso do animal foi dissecado e preparado blocos para analise microscopica (HE). O estudo histomorfometrico foi realizado em microscopio KS400 (40x - Zeiss, Jena). A composicao celular do tecido de granulacao foi analisada randomicamente, em 20 campos de cada amostra. Os dados foram estatisticamente analisados usando o Wilcoxon signed rank test. Os resultados mostraram um elevado numero de celulas inflamatorias na periferia do grupo com Selante de Fibrina comparado com o controle. Esses dados sugerem que o Selante de Fibrina induziu uma intensa e prolongada resposta inflamatoria no processo cicatricial e que o Selante de Fibrina persistiu ate 28 dias apos a cirurgia.Capitulo III: Material e Metodos: Setenta e cinco ratos Wistar foram submetidos a extracao do incisivo superior apos anestesia intramuscular. Os ratos foram divididos em 3 diferentes grupos e os adesivos foram aplicados nos alveolos. O primeiro grupo (25 ratos) recebeu cola de fibrina, o segundo grupo (25) Selante de Fibrina (Beriplast P® - Aventis Beringher) e o terceiro (25) foi considerado como grupo controle. Os animais foram sacrificados por inalacao de eter nos dias 1, 7, 14, e 28 apos a cirurgia. Os crânios foram dissecados, submetidos a descalcificacao e preparados para analise microscopica (HE). O estudo histomorfometrico foi realizado pelo sistema KS400 (Zeiss,Jena). Neoformacao ossea foi cuidadosamente delimitada em quatro regioes alveolares. Os dados foram analisados estatisticamente usando regressao multipla, ANOVA e Turkey test. Os resultados mostraram que a neoformacao ossea (µm2) no grupo controle e com Selante de Fibrina foram estatisticamente similar, entretanto o alveolo que recebeu a cola de fibrina apresentou menor area de formacao ossea comparada com o grupo que recebeu o Selante (p=0,0034). Concluindo, os adesivos defibrina nao influenciaram no processo de cicatrizacao ossea Abstract

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Oral Graft-Versus-Host Disease

Dental Clinics of North America (2008)

Mark M. Schubert Maria Elvira Pizzigatti Corrêa

10.1016/j.cden.2007.10.004

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Systematic review of basic oral care for the management of oral mucositis in cancer patients

Supportive Care in Cancer (2013)

Deborah B. McGuire Janet S. Fulton Jumin Park Carlton G. Brown Maria Elvira Pizzigatti Corrêa

Mucositis

Pain medicine

Oral Cancers

10.1007/s00520-013-1942-0

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Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines

Supportive Care in Cancer (2019)

Maria Elvira Pizzigatti Corrêa Karis Kin Fong Cheng Karen Chiang Abhishek Kandwal Charles L. Loprinzi

Mucositis

Cryotherapy

Guideline

Amifostine

10.1007/s00520-019-05217-x

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Citations (73)

Author response for "Oral shedding of CMV and HSV‐1 in hematopoietic stem cell transplantation patients"

André Luiz Ferreira Costa Bruna A. Santos Vinícius Rabelo Torregrossa Eliana Cristina Martins Miranda Afonso Celso Vigorito

Viral Shedding

10.1111/odi.13690/v2/response1

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Oral involvement of chronic graft-versus-host disease in hematopoietic stem cell transplant recipients.

PubMed (2012)

Cesar Werneck Noce Alessandra Oliveira Ferrari Gomes A Copello Raquel D Barbosa Simone Sant'anna

Oral manifestations are common in patients who are diagnosed with chronic graft-versus-host-disease (cGVHD). These manifestations can present as oral mucosal lesions, salivary gland dysfunction, or reduction of the mouth opening due to cutaneous sclerosis. Although several studies have reported the prevalence of oral involvement in cGVHD, few have reported details of different types and severity of oral lesions of cGVHD, according to the NIH. Furthermore, the authors are aware of only one published study concerning oral manifestations of cGVHD in Brazil. The purpose of this study was to evaluate the prevalence and severity of oral involvement of cGVHD. Oral evaluation of hematopoietic stem cell transplant (HSCT) recipients was conducted on 22 patients (12 men and 10 women) from December 2007 to May 2009. The following categories were assessed: Age, gender, underlying disease, time postHSCT, history of GVHD, therapy for GVHD, oral lesions, xerostomia, resting salivary flow rate, and mouth opening. Oral lesions were classified according to NIH criteria, and the results were submitted to a descriptive analysis. According to the NIH, patients presented diagnostic (40.9%), distinctive (31.9%), and common (9.1%) features of oral cGVHD. Oral involvement of cGVHD was identified in 81.8% of patients, 68.2% as mucosal lesions and 59.1% as salivary gland dysfunction. Reduced mouth opening was observed in 12 patients (80%), with one case associated with cutaneous sclerosis. Oral involvement was frequent in these patients; for many, it was the first clinical manifestation of cGVHD.

Oral medicine

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Hepatoblastoma: The Indiana Experience with Preoperative Chemotherapy for Inoperable Tumors; Clinicopathological Considerations

Pediatric Pathology & Laboratory Medicine (1997)

Stephen A. Heifetz Matt French Maria Elvira Pizzigatti Corrêa Jay L. Grosfeld

Analysis of the prognostic importance of various clinicopathological parameters in 17 hepatoblastomas (HBs) confirmed the utility of preoperative chemotherapy to convert inoperable to resectable tumors. There was no significant survival advantage for patients who underwent initial tumor resection compared with those resected following chemotherapy, although complete resection, with or without prior chemotherapy, was critical for cure. Young age was associated with better survival but did not correlate with histologic subtype or clinical stage. A relationship between low initial alpha-fetoprotein (AFP) level and tumor resectability was noted, perhaps related to tumor size, but tumor location was of greater importance than size in determining resectability. Neither the mean proportions of fetal and embryonal epithelium, nor their mitotic activity, nor the presence of vascular invasion in the prechemotherapy biopsy specimens was predictive of outcome, but the low mitotic activity of the fetal component correlated with ultimate resectability. On the other hand, although complete resection was necessary for survival, histologic examination of postchemotherapy specimens had additional predictive value; the presence of vascular invasion, the amount of viable mesenchyme, the extent of tumor necrosis, the proportion of embryonal epithelium, and the mitotic activity of the epithelial component in postchemotherapy resection specimens were each predictive of outcome. Although the presence of osteoid was not predictive, both the proportion of HBs that contained osteoid and the extent of mature mesenchymal tissues within individual HBs were increased by chemotherapy, suggesting that maturation of previously immature clones had been induced. We conclude that although complete resectability remains the fundamental goal of therapy, evaluation of the clinicopathologic characteristics that we have found to be predictive of outcome may permit tailoring of therapeutic regimens to individual patients; those whose tumors are deemed likely to respond well may require less toxic preoperative chemotherapy, and those deemed likely to progress in spite of complete resection may be considered for more aggressive postoperative regimens.

Hepatoblastoma

10.1080/15513819709168750

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Chronic GVHD in minor salivary glands and oral mucosa: histopathological and immunohistochemical evaluation of 25 patients

Journal of Oral Pathology and Medicine (2005)

Andresa Borges Soares Paulo Rogério de Faria Luís Alberto Magna Maria Elvira Pizzigatti Corrêa Claudevan A. Sousa

Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells.Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining.The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands.Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.

Minor Salivary Glands

Oral mucosa

Histopathology

10.1111/j.1600-0714.2005.00322.x

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Citations (60)

Linear Epidermal Nevus of the Oral Cavity: A Rare Diagnosis

Case Reports in Medicine (2012)

Mariana Dutra de Cássia Ferreira Santos Alexandre Scalli Mathias Duarte Guilherme Machado de Carvalho Alexandre Caixeta Guimarães Carlos Eduardo Monteiro Zappelini

Linear epidermal nevus is an uncommon diagnosis of benign lesions of the oral cavity. It is characterized by a congenital malformation arising from the ectoderm cells, which are arranged according to a typical linear configuration known as Blaschko's lines. We report a case of linear epidermal nevus of oral cavity in a 51-year-old lady or woman. The linear epidermal nevus of the oral cavity, although rare, can be considered a differential diagnosis of oral papillomatosis (OP). The histopathological studies and detailed description are the center of the diagnostic and clinical evolution.

10.1155/2012/206836

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Citations (5)

Clinical Aspects and Risk Factors for Ocular Alterations in Patients Submitted to Hematopoietic Progenitor Cell Transplantation

Investigative Ophthalmology & Visual Science (2006)

Margarida Alves Suzana C. Leite Rui Castro Daniel A. Cunha Maria Elvira Pizzigatti Corrêa

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