FREDERICO LUIZ DULLEY
Projetos de Pesquisa
Unidades Organizacionais
4 resultados
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- Clusters of infection due to metallo-beta-lactamase-producing Pseudomonas aeruginosa in stem cell transplant and haematology units(2011) PAEZ, J.; LEVIN, A. S.; FU, L.; BASSO, M.; FONSECA, G. H. H.; DULLEY, F. L.; ROSSI, F.; GUIMARAES, T.; COSTA, S. F.
conferenceObject Oral leukoplakia in chronic graft versus host disease(2012) PAVESI, V. C. S.; FRANCA, C. M.; CASTELLI, J. B.; SABOYA, R.; DULLEY, F. L.; CORACIN, F. L.Introduction: Late complications of allogeneic hematopoietic stem cell transplantation (HSCT) include a risk of secondary malignancies and early diagnosis of oral premalignant or malignant lesions requires an assessment of potential predisposing risk factors. Patients with oral epithelial dysplasia after allogeneic HSCT include oral cGVHD as a potential risk factor for oral cancer. A better understanding of the clinical features and potential factors associated with secondary oral cancer, may be benefit predicting and identifying this late complication of allogeneic HSCT. Case details: A 37 years old male who had received an allogeneic hematopoietic stem cell transplantation in October/2002 was referred to a Oral Medicine Outpatient in August 2011 with a white-plaque lesion of the oral mucosa the conditioning regimen to HSCT comprised busulfan-melphalan and graft-versus-host disease prophylaxis was cyclosporine-methotrexate. The patient developed lichenoid-oral cGVHD around day 60 and treatment comprised corticosteroid-cyclosporine. Clinical examination revealeda non-symptomatic 2 cm white-plaque of the hard palate. Exfoliative cytology was performed and no atypical cells were seen. The lesion increased in size to 4 cm long during the next 10-days. An incisional biopsy was undertaken and histopathological analysis revealed an epithelial tissue with acanthosis, hypergranulosis, hyperkeratosis, papilomatosis and apoptosis plus lymphocyte exocitosis. No atypical, cell dysplasia or koylocites were present. Mild to moderate cGVHD activity was seen. In this case, the patient was monitored in our outpatient program and no changes were noted in the lesion. Conclusion: The associationbetweenchronic graftversus host disease andoralsquamous cell carcinoma suggests a close monitoring of patients for early diagnosis of possible secondaryneoplasmsanddemonstratestheaggressivebehaviourofthislatecomplication. Relevance: Due to this aggressive behaviour and the increase number of HSCT worldwide, careful long-term follow-up by a cancer team, including oral medicine expertise, is recommended, and patients should be aware of cancer risk.conferenceObject Patients oral conditions before hematopoietic stem-cell transplantation in Brazil(2012) CORACIN, F. L.; SOARES JUNIOR, L. A. V.; DULLEY, F. L.; SABOYA, R.; SILVA-SANTOS, P. S. da; TINOCO-ARAUJO, J. E.; COLTURATO, V. A. R.; ANTUNES, H. S.; FERREIRA, C. G.; BOUZAS, L. F. S.; PEREIRA, S. C. M.; MONTEIRO, M. C. P.; RAMPINI, M. P.; MAYHE, R.; LIME, E. M.; TANIMOTO, H. M.; PATON, E. J. A.; SILVA, G. B. L.; SACONO, N. T.; BATISTA, A. C.; BARIANI, C.; PERES, M. P. S. M.Objectives: This prospective multicenter study aims to conduct an epidemiologic survey of oral health status of the patients waiting for the hematopoietic stem cell transplantation (HSCT) in five Brazilian Centers to identify oral needs prior to HSCT. Methods: Patients enrolled in this study were submitted to a dental clinical evaluation whilst they were awaiting for HSCT, performed by a dentist from the participating Institution. Demographic and medical data were collated together with, gingival (GI) and plaque (PI) indexes and index of decay missed and filled teeth (DMFT) were evaluated. These indexes are indicators of oral health according to the World Health Organization (WHO). Results: During the period between April 2011 and April 2012, 101 (73 male and 48 female) patients were enrolled in this prospective study at five HSCT Brazilian Centers. Underlying diseases comprised 25 multiple myeloma, 24 non-Hodgkin lymphoma, 19 acute lymphoblastic leukemia, 16 acute myelogenous leukemia, 13 severe aplastic anemia, 11 Hodgkin lymphoma, six chronic myelogenous leukemia, three myelodisplastic syndrome, one testicular tumor, one retinoblastoma, one myelofibrosis and one chronic lymphoblastic leukemia. Median age was 40 years (range: 4–67). At the time of the survey, patients presented mean GI = 0.8, mean PI = 1.2. DMFT index were evaluated in 104/121 patients and showed mean of 16.1. Conclusion: Patients undergoing HSCT need comprehensive oral care in Brazil due a poor oral health at the time of transplantation, to avoid possible infections secondary to myelosuppression and mucosal barrier injury. Relevance: The patients’ status prior-HSCT may to lead to protocols of dental treatment before HSCT suggesting an important role in the maintenance of oral integrity. Prior dental intervention can lead a better quality of life and improve the results of transplantation, reducing time of mucositis and infections.conferenceObject Ciclosporine-induced fibrovascular polyps in the tongue(2012) TORRES-PEREIRA, C.; SABOYA, R.; CASTELLI, J. B.; ROCHA, A. C.; ROCHA, G. B. L.; BONFIM, C. S.; DULLEY, F. L.; CORACIN, F. L.Introduction: Cyclosporine (CsA) is used for chronic graft-versus-host disease (cGVHD) treatment and can lead to increased or synthesis of collagen and fibrous eposition. Gingival overgrowth is a common adverse effect of CsA, however it is rarely seen in patients using CsA for treatment of cGVHD. The development of CsA- associated nongingival growth is rare and represents polyps of granulation/fibrous tissue. These lesions have been referred as oral inflammatory polyps that may be aggravated in the presence of cGVHD. Case details: A 6 year old male with Fanconi Anemia underwent an unrelated hematopoietic stem-cell transplantation (HSCT) in March/2007. cGVHD was diagnosed in skin and oral mucosa and was treated with cyclosporine and corticosteroids. In August 2008 the patient was referred to the Oral Medicine Service for evaluation of a 3 cm growing polyps in the border of the tongue. Incisional biopsy was performed and revealed fibrous-vascular hyperplasia. While the patient waited for an excisional biopsy, the polyps increased in size to 10 cm. This biopsy revealed the same histopathological characteristic. In May 2011 the patient presented with other polyps of the middle side of tongue associated with other small nodules. These lesions were completely removed and again the diagnosis of fibrous-vascular hyperplasia was given immunohistochemistry examination revealed negativity to anti-cytomegalovirus (CMV)/anti-herpesvirus (HSV) and Ki-67 expression showed moderate to strong staining. No atypical cells were observed. Conclusions: Although it is an unusual reported lesion, fibrous-vascular polyps are a recent described pathological entity associated with the use of CsA. These lesions should be considered as a differential diagnosis of oral masses in post HSCT Fanconi Anemia patients, particularly to exclude malignancies in this high risk group of individuals. Relevance: Fanconi anaemia patients need to be closely monitored due to a high prevalence of secondary malignancies.