PAULO HENRIQUE BRAZ DA SILVA
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ODE, FO - Docente
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
LIM/52 - Laboratório de Virologia, Hospital das Clínicas, Faculdade de Medicina
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- Periodontal disease and detection of human herpesviruses in saliva and gingival crevicular fluid of chronic kidney disease patients(2020) PALLOS, Debora; RUIVO, Gilson F.; FERRARI-JUNIOR, Sabino H.; PANNUTI, Claudio S.; PEROZINI, Caroline; SARMENTO, Dmitry J. S.; PALMIERI, Michelle; SOUZA, Ana C. M. F.; TOZETTO-MENDOZA, Tania R.; DOGLIO, Alain; BRAZ-SILVA, Paulo H.Background Patients with chronic kidney disease (CKD) have inability to maintain the normal levels of protein metabolism products, blood pressure and hematocrit. Periodontal disease involves an inflammatory destructive process. Identification of opportunistic viruses is extremely important as they are associated with co-morbidities. The objective of this study was to analyse the presence of human herpesviruses in saliva and gingival crevicular fluid (GCF) from patients with CKD. Methods One hundred and thirty one individuals were divided depending on the stage of CKD: Group 1 (clearance of creatinine > 75 mL/min) patients with no renal disease (n = 24); Group 2 (clearance of creatinine of 11-75 mL/min) patients with renal disease (n = 67); Group 3 (clearance of creatinine < 10 mL/min) patients on hemodialysis (n = 40). The parameters of periodontal disease were evaluated. The viral detection was assessed by PCR. Results considering the three groups, the prevalence of herpes simplex virus 1 (HSV-1) were 9% in saliva and 5% in GCF; Epstein-Barr virus 36% in saliva and 39% in GCF; human cytomegalovirus (HCMV) 11% in GCF; varicella zoster virus 6% in saliva and 3% in GCF; of human herpesvirus-6 (HHV-6) 6% in saliva and 2% in GCF; and HHV-7 44% in saliva and 8% in GCF. Of these patients, 46.48% presented with severe periodontitis. A statistically significant association between HSV-1 and HCMV was found in hemodialysis patients and severe periodontitis was also more frequent among them. Conclusion These findings show the importance of evaluating the periodontal disease and detecting herpesviruses in patients with CKD as the inflammatory process observed in these clinical conditions may worsen the course of both periodontal disease and CKD.
- Longitudinal study on oral shedding of human betaherpesviruses 6 and 7 in renal transplant recipients reveals active replication(2020) RAPOSO, Jessica Vasques; SARMENTO, Dmitry Jose De Santana; PINTO, Rafaela Barbosa Da Silva; LOPES, Amanda Oliveira; GALLOTTINI, Marina; TOZETTO-MENDOZA, Tania Regina; BRAZ-SILVA, Paulo Henrique; PAULA, Vanessa Salete deBackgroung Roseolovirus latency and persistence in salivary glands that are frequently reactivated after renal transplantation to cause infection have been reported. However, limited information is available on the persistence and excretion of HHV-6 and HHV-7 during and after transplant. Methods 32 renal transplant recipients were followed up before (T1) and after transplant (T2 and T3) and viral replication (via assessment of mRNA) in oral fluid samples investigated. Roseolovirus DNA was detected and quantified via multiplex qPCR. For evaluation of mRNA replication, positive samples were subjected to nested RT-PCR. Results Viral replication of HHV-7 was significantly increased during T3 (72.9%), compared to the pre-transplant period T1 (25%; McNemar Test, p= 0.001). Analysis of the viral replicative to quantitative ratio disclosed ahigher number of DNA copies (>10(6)) in positive cases of replication (p < 0.001). Astrong positive correlation (Spearman correlation coefficient = 0.781; p< 0.001) was evident between viral quantities of Roseoloviruses. Conclusion Our findings consistently suggest that the salivary gland is an important site of active and persistent infection by roseoloviruses. In view of the increasing problem of Roseoloviruses, pre- and post-transplantation, viral surveillance and monitoring of active replication are pivotal steps for effective screening and treatment of renal transplant patients.
- Morphology, Volume, and Density Characteristics of the Parotid Glands before and after Chemoradiation Therapy in Patients with Head and Neck Tumors(2020) SANTOS, Wellington Pereira dos; GOMES, Joao Pedro Perez; NUSSI, Amanda Drumstas; ALTEMANI, Joao Mauricio; SANTOS, Maria Teresa Botti Rodrigues dos; HASSEUS, Bengt; GIGLIO, Daniel; BRAZ-SILVA, Paulo Henrique; COSTA, Andre Luiz FerreiraThe multimodal approach for patients with head and neck cancer (HNC) includes treatment with chemoradiation therapy (CRT). A common concern regarding CRT side effects is the occurrence of structural and physiological alterations of the salivary glands due to exposure to ionizing radiation. The aim of this study is to examine the morphology, volume, and density of the parotid glands before and after CRT in HNC patients. A total of 49 HNC patients treated exclusively with CRT were included in the study. Ninety-eight parotid glands were evaluated before and after treatment by using contrast-enhanced computed tomography (CECT). Shapiro-Wilk test was performed, and the variables (pre-CRT and post-CRT) presented normal distribution. Pearson's coefficient was used to assess the correlation between volume and density. CRT resulted in a significant decrease in the mean volume of the parotid glands (i.e., original volume reduced by 20.5%; P<0.0001). CRT induced a 30.0% (7 Hounsfield units) increase in density of the right parotid gland and a 24.9% (8 Hounsfield units) increase in density of the left parotid gland (P=0.0198 and P=0.0079, respectively). Changes in morphology and spatial configuration, increased density, and substantial loss of volume of the parotid glands were observed after CRT. There was also a difference in density (P=0.003) in the right-side parotid glands in comparison between xerostomic and nonxerostomic groups of patients. These facts lead to the need for a personalized CRT planning in order to minimize oral complications related to the treatment.
- Differentiation of periapical granuloma from radicular cyst using cone beam computed tomography images texture analysis(2020) ROSA, Catharina Simioni De; BERGAMINI, Mariana Lobo; PALMIERI, Michelle; SARMENTO, Dmitry Jose de Santana; CARVALHO, Marcia Oliveira de; RICARDO, Ana Lucia Franco; HASSEUS, Bengt; JONASSON, Peter; BRAZ-SILVA, Paulo Henrique; COSTA, Andre Luiz FerreiraObjective: This study aimed to investigate the use of texture analysis for characterization of radicular cysts and periapical granulomas and to assess its efficacy to differentiate between both lesions with histological diagnosis. Methods: Cone beam computed tomography (CBCT) images were obtained from 19 patients with 25 periapical lesions (14 radicular cysts and 11 periapical granulomas) confirmed by biopsy. Regions of interest were created in the lesions from which 11 texture parameters were calculated. Spearman's correlation analysis was performed and adjusted with Benjamini-Hochberg false discovery rate procedure (FDR <0.005). Results: The texture parameters used to differentiate the lesions were assessed by using a receiver operating characteristic analysis. Five texture parameters were predictive of lesion differentiation for eight positions: angular second moment; sum of squares; sum of average; contrast; correlation. Conclusion: Texture analysis of CBCT scans distinguishes radicular cysts from periapical granulomas and can be a promising diagnostic tool for periapical lesions. Clinical significance: Texture analysis can be used in diagnostic and treatment monitoring to provide supple-mentary information.
- Unusual giant complex odontoma: A case report(2020) BUENO, N. P.; BERGAMINI, M. L.; ELIAS, F. M.; BRAZ-SILVA, P. H.; FERRAZ, E. P.Odontomas are benign, non-aggressive, and the most common odontogenic tumor of the jaws. Composed of dental tissues, it can be classified as compound or complex odontomas depending on their radiological and histological features. Among them, complex odontomas are less common and usually is presented as a small and asymptomatic radiopaque mass surrounded by a radiolucent halo, found on routine radiographic examination. Although benign tumors, odontomas can reach large sizes leading to facial asymmetry and decreasing bone strength, which predisposes fractures and infection. Our aim was to present a case report of an unusual giant mandibular odontoma on the left mandibular angle and ramus successfully treated by surgical excision and highlight the importance of the earlier diagnostic to minimize damages.
- Introduction of human gammaherpesvirus 8 genotypes A, B, and C into Brazil from multiple geographic regions(2020) LOPES, Amanda de Oliveira; SPITZ, Natalia; MARTINELLI, Katrini Guidolini; PAULA, Anderson Vicente de; TOSCANO, Ana Luiza de Castro Conde; BRAZ-SILVA, Paulo Henrique; BARBOSA NETTO, Juliana dos Santos; TOZETTO-MENDOZA, Tania Regina; PAULA, Vanessa Salete deVariations in the open reading frame (ORF) K1 gene sequence of human gammaherpesvirus 8 (HHV-8) has led to the identification of 6 major genotypic clades (A, B, C, D, E, and F) in specimens isolated from around the world. These clades exhibit clear clustering among individuals in different ethnic groups and from different geographic regions. The human population of Brazil varies greatly in ethnicity because of multiple immigration events from Africa, Europe, Asia, and indigenous communities. However, there is scant information about the HHV-8 genotypes currently circulating in Brazil. Here, we describe HHV-8 genotypic diversity in isolates from Brazilian HIV-infected patients living with Kaposi's sarcoma (KS) by analysis of the complete ORF-K1 region. We also identified the most likely geographic origins of these different Brazilian genotypes. We extracted HHV-8 DNA (24 positive samples) from individuals with HIV/KS from the states of Sao Paulo and Rio de Janeiro, amplified the ORF-K1 gene using nested PCR (about 870 base pairs), performed sequencing and phylogenetic analysis, and then calculated the mean genetic distances of Brazilian sequences from sequences in other regions of the world (523 sequences analyzed). Phylogenetic analysis showed that genotypes C, A, and B were present in 45.8 %, 29.2% and 25 % of the isolates from Brazil, respectively. These isolates grouped into separate clades, rather than a single monophyletic cluster. Mean genetic distance analyses suggested that these genotypes were introduced into the Brazil multiple times from different geographical regions. HHV-8/A isolates appear to be from Ukraine, Russia, and the Tartar ethnic group; HHV-8/B isolates appear to be from Congo and Democratic Republic of the Congo; and HHV-8/C isolates appear to be from Australia, Algeria, England, and French Guiana. These results contribute to a better understanding of the genetic diversity and origins of HHV-8 strains circulating in Brazil, and will provide a foundation for further epidemiological and evolutionary studies of HHV-8.
- Herpesviruses in the oral cavity of patients subjected to allogeneic hematopoietic stem cell transplantation and its relationship with oral mucositis(2020) MIRANDA-SILVA, Wanessa; KNEBEL, Franciele Hinterholz; TOZETTO-MENDOZO, Tania Regina; PALMIERI, Michelle; FONSECA, Felipe Paiva da; CAMARGO, Anamaria Aranha; BRAZ-SILVA, Paulo Henrique; FREGNANI, Eduardo RodriguesObjectives This study was performed to characterise oral shedding of herpesviruses in patients who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) and to investigate its relationship with oral mucositis (OM). Materials and Methods PCR and enzymatic digestion were conducted to identify oral shedding of herpesviruses and its correlation with OM development in 31 patients. The samples were collected at three sites in the oral cavity and at 5 times during follow-up; two additional collections were made from patients who developed ulcerative OM. Results HSV-1, EBV, CMV, HHV-6A, HHV-6B, and HHV-7 were detected in 4.97%, 16.02%, 4.41%, 2.20%, 3.31%, and 68% of the oral mucosal samples, respectively; 4.41%, 16.57%, 5.52%, 2.20%, 5.52%, and 63.53% of supragingival samples, respectively, and 4.41%, 18.23%, 2.76%, 1.65%, 2.75%, and 35.91% of subgingival samples, respectively. OM was diagnosed in 13 patients. The presence of HHV-7 in C1 (oral mucosa: p = 0.032) and C2 (supragingival: p = 0.009; subgingival: p = 0.002) was significantly increased in patients who developed OM, and patients exhibiting HHV-7 shedding in the oral cavity were 3.32-fold more likely to develop OM. Conclusions Patients who developed OM showed higher HHV-7 shedding in the oral cavity at nadir (immediately prior to OM development), suggesting modifications to the inflammatory microenvironment.
- Oral manifestations of allograft recipients immediately before and after kidney transplantation(2020) SARMENTO, Dmitry Jose de Santana; ANTUNES, Rosana Saint Clair Correia Aires; CRISTELLI, Marina; BRAZ-SILVA, Paulo Henrique; MACIEL, Rafael; PESTANA, Jose Osmar Medina de Abreu; GALLOTTINI, MarinaObjective: To identify the oral lesions of individuals with kidney disease immediately before and shortly after kidney transplantation, taking into account the immunosuppressive regimen, antiviral prophylaxis and type of transplantation. Methods: A prospective observational cohort study was carried from January 2017 to January 2018. Eighty individuals aged 18 years or older who were admitted for kidney transplantation were eligible to participate. Clinical data regarding medical history, immunosuppressive therapy, antiviral prophylaxis, laboratorial data and oral examination were performed by the same trained researcher, in three different moments: 24 hours before transplantation (1st time point), 15-20 days (2nd time point) and 45-60 days (3rd time point) after transplantation. Results: In the first, second and third time points, it was found that 3.7% (3/80), 23.7% (18/76) and 25.7% (19/74) of the participants showed oral soft tissue lesions. Ulcers and candidiasis were the most frequent oral lesions, and they were associated with the use of everolimus (p = .005) and azathioprine (p = .034), respectively. Less patients reported xerostomia after transplantation than before (p < .001). Conclusions: Oral lesions are common in the short term after renal transplantation and are particularly related to both toxicities of immunosuppressive drugs and immunosuppression.
- Do bacteria contribute to formation and rupture of intracranial aneurysms?(2020) RABELO, Nicollas Nunes; RODRIGUES, Renan Salomao; SALAME, Arthur Araujo Massoud; BRAZ-SILVA, Paulo Henrique; TEIXEIRA, Manoel Jacobsen; FIGUEIREDO, Eberval Gadelha
- SARS-CoV-2 and dentistry(2020) ORTEGA, Karem L.; CAMARGO, Alessandra Rodrigues de; FRANCO, Juliana Bertoldi; AZUL, Antonio Mano; SAYANS, Mario Perez; SILVA, Paulo Henrique Braz