Background: Oxidative stress is involved in oral lichen planus (OLP) pathogenesis; meanwhile anthocyanins are natural antioxidants present in grapes skin. Objectives: The aim of this research was to verify the utility of anthocyanins, extracted from grapes skin, for the local treatment of oral lichen planus and to compare it with clobetasol propionate- neomycin -nystatin cream (CP-NN). Study Design: Prospective, non-randomized study, with control group. Fifty-two patients with OLP were included. We divided patients into two categories: erosive oral lichen planus (EOLP) and non erosive oral lichen planus (NEOLP). 38 had EOLP (17 cases and 21 controls) and 14 presented NEOLP types (9 cases and 5 controls).Cases received local treatment with anthocyanins from grapes and controls, were treated with CP-NN. The clinical evolution of patients was followed up during six months. Results: The patients had a therapeutic response with anthocyanins. This was better than CP-NN treatment for patients with EOLP, in improving the involvement score of the oral mucosa and in the morphometric study of the affected areas. In EOLP there were no statistically significant differences in: therapeutic response time, the evolution of pain, or the relapse rate between the two groups. With respect to the treatment of NEOLP there was improved pain relief in the group treated with anthocyanins. This was not observed with CP-NN. The resting analized variables showed no significant difference with both treatments. Conclusions: OLP has a favorable response to local treatment with anthocyanins from grapes. We found an equal to or better response than with CP-NN treatment. Many of our patients have systemic diseases, which may contraindicate the use of steroids. With regard to this particular group, the use of this natural antioxidant present in the diet is considered advantageous. Key words:Anthocyanins, antioxidants, chemoprevention, morphometry, oral lichen, oxidative stress.
Introduccion: Cytokeratins (CK) are molecules of the cytoskeleton that contribute to the cellular differenciation. We studied the expression of CK1, CK13 and CK14 in thirty-three patients with OLP. The biopsied lesions were located in the dorsal surface of the tongue, the palatal keratinized mucosa and the nonkeratinized buccal mucosa. Objectives: This study aimed to determine the expression of CK1, CK13 and CK14 in oral lichen planus (OLP) and its relations with: clinical patterns, prognosis, drugs and tobacco intake and histopathological features. Study Design: Immunohistochemical analysis, retrospective, descriptive, observational and no randomized study. Results: No significant difference was observed in the expression of CK1 in patients with or without drug treatment. No association was found with the amount of drugs intake or smoking nor with the histopathological features examined. Samples immunostained with CK13 were all positive in the suprabasal layers, and 13 of them in the basal layer. In these last ones, statistical analysis showed significance in the grade of vacuolization of the basal layer (p=0.023) and in the degree of exocytosis (p=0.0025), this, making the degree of affection higher for both parameters. Thirty-two tissue sections were immunostained with CK14. CK14 was expressed in the basal layer in 97% of samples and in the suprabasal layer in 94% of samples. Conclusions: The three CK were altered in OLP. CK1 does not have a direct connection with the presence of orthokeratosis. The finding of the CK13 in the basal layer is related to the agression of the lymphocytic infiltration in the epithelium, due to the basal stratum vacuolization and the increase in lymphocytic exocitosis. The presence of CK14 in the suprabasal stratums is not a parameter to predict malignancy. The CK in OLP do not follow the normal pattern of keratinized or non-keratinized mucosa. Key words:Basal cell vacuolization, CK1, CK13, CK14, cytokeratin, lymphocytic exocytosis, oral lichen planus.
El cáncer de mama es la enfermedad maligna más frecuente en mujeres adultas. Considerando la calidad de vida como bienestar en diferentes ámbitos de la vida, es de interés evaluar cómo incide la enfermedad en las pacientes. El objetivo fue determinar la calidad de vida durante el tratamiento. Estudio protocolizado, descriptivo, a través de encuesta validada, dirigida y anónima. Se incluyeron 56 mujeres con cáncer de mama en tratamiento oncológico, de la provincia de Mendoza. Edad promedio 54.2 años. El 41% estaban casadas. Comorbilidades: HTA 34%, tabaquismo 29%, obesidad 23%. El tipo histológico predominante: carcinoma ductal infiltrante 55%. Estadio II 62%. Tratamiento con quimioterapia 91%, radioterapia 4%, hormonoterapia 5%, cirugía 79%. FACT-G (Functional Assessment of Cancer Therapy-General): Bienestar físico: 1/3 sentían falta de energía, más del 50% sintió poco dolor, más del 75% no se sintió enferma. Bienestar social: 50% se sintió cerca de amigos, más de 85% sintió apoyo familiar y 60% estuvo satisfecha con su vida sexual. Bienestar emocional: 1/4 estaban tristes, casi 80% estuvo satisfecha con cómo afrontaban la enfermedad, a más del 50% no le preocupó que la enfermedad/tratamiento ponga en riesgo su vida. Bienestar funcional: más del 60% pudieron trabajar, 66% disfrutaban su vida y aceptaban la enfermedad, 70% se sentía contenta con su calidad de vida, 73% perdió el cabello, a la mitad no les preocupó. Las pacientes subestiman malestares, la mayoría no se sienten enfermas, están esperanzadas y satisfechas en cómo afrontaron su enfermedad. Sin embargo, la enfermedad y el tratamiento afectaron su calidad de vida, reflejándose en las esferas evaluadas.
Esta investigación analiza los procesos y metodologías docentes durante la pandemia y los espacios de enseñanza-aprendizaje-evaluación de la educación a distancia (EAD) en la educación superior en el equipo de salud. Se realizó una encuesta estructurada, autoadministrada y anónima, en línea a nivel nacional. Los docentes que contestaron trabajan más con estudiantes de grado, dan clases y evalúan con pantallas portátiles y celulares, un tercio compartidas, pagadas por ellos; más de la mitad no usaban TIC antes de la pandemia, y contaban con muy poca capacitación adecuada. Luego de la primera ola de la pandemia la mitad de los profesores responde estar capacitada en virtualidad y pedagogía; reconoció como fortalezas: “tiempo y espacio” y como debilidades: perfeccionamiento y la “dificultad del cara a cara en masividad”. A los docentes no les convence la EAD para el monitoreo ni para el acercamiento a estudiantes, consideran que se han cumplido objetivos indispensables: trabajando con mayor intensidad, más horas, desbordados y prefiriendo la presencialidad. Es más claro que nunca que el trabajo docente es irreemplazable y necesita revalorizarse. Se ha gestionado una crisis sin precedentes. La educación ha mutado. La información recabada en esta investigación propiciará la toma de decisiones para planificar mejores estrategias que faciliten el mejor uso de las tecnologías y la virtualidad que obviamente llegaron para quedarse.
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