Cirurxía e Especialidades Médico-Cirúrxicas

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Study of clinical characteristics of Desquamative Gingivitis in 60 patients in the North of Spain
(Wiley, 2026-03-16) Sanmartín Barragáns, Valeria; Gándara Vila, Pilar; Lorenzo Pouso, Alejandro Ismael; Pérez-Sayáns García, Mario; Reboiras López, María Dolores; Otero Rey, Eva María; García García, Abel; Blanco Carrión, Andrés; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Objectives The aim of this study is to know the clinical characteristics of desquamative gingivitis (DG) in a Spanish population in order to make an early diagnosis of this sign and, therefore, the underlying systemic disease. Methods A cross-sectional study was conducted. Patients who presented with DG and who met the established inclusion criteria were selected. The following variables were collected from the patient’s clinical history, examination, and pathological anatomy report: age at diagnosis, gender, underlying diseases, extent of lesions, intraoral lesions or extraoral involvement, form of appearance, and symptomatology. Results The sample comprised of 60 patients. The mean age was 62.18 ± 11.22 years. The most common associated disease was OLP. The most common form of onset was erythematous (55%). 56.7% of the lesions appeared in the anterior and posterior region, and 68.3% appeared in all quadrants. 53.3% of patients were asymptomatic. Conclusion Diversity exists in terms of the appearance and extension of DG. It is important to stress to dental hygienists the importance of a proper diagnosis of any gingival lesions.
Accuracy of cytological methods in early detection of oral squamous cell carcinoma and potentially malignant disorders: A systematic review and meta-analysis
(Wiley, 2025-08) Tayebi Hillali, Hoda; Lorenzo Pouso, Alejandro Ismael; Marichalar Mendía, Xabier; Gándara Vila, Pilar; Reboiras López, Dolores; Blanco Carrión, Andrés; Coppini, Martina; Alberto Caponio, Vito Carlo; Pérez-Sayáns García, Mario; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Instituto de Materiais (iMATUS)
Introduction: Oral squamous cell carcinoma (OSCC) carries significant global mortality rates. Brush cytology presents a potential adjunctive tool for early detection and monitoring of OSCC and oral potentially malignant disorders (OPMDs). This study aims to systematically evaluate the diagnostic accuracy of cytology for detecting OSCC and OPMDs compared to histopathology as the reference standard. We conducted a systematic review and meta-analysis following PRISMA-DTA guidelines. Material and methods: We searched PubMed, Embase, Scopus, Cochrane Library, and Web of Science from inception to January 2023 (updated in March 2025). Eligible studies included cohort studies evaluating cytology versus histopathological diagnosis. Two reviewers independently screened studies, extracted data, and assessed risk of bias using QUADAS-2. We used the Hierarchical Summary Receiver Operating Characteristic model for meta-analysis. Results: Of 2603 identified studies, 53 met inclusion criteria, comprising 13,249 patients. Cytology demonstrated a pooled sensitivity of 0.914 (95% CI: 0.878-0.941) and specificity of 0.960 (95% CI: 0.937-0.975). The diagnostic odds ratio was 137.502 (95% CI: 79.733-237.127), with a positive likelihood ratio of 11.970 (95% CI: 9.005-15.912) and negative likelihood ratio of 0.096 (95% CI: 0.059-0.158). Subgroup analysis showed improved performance when exfoliative cytology was combined with DNA analysis or when using a metal spatula. Both conventional and liquid-based cytology were effective, with the latter showing modest advantages. Heterogeneity was substantial across studies (I2 = 86.26%). Conclusion: Cytology demonstrates good diagnostic accuracy for detecting OSCC and OPMDs and may serve as a valuable adjunctive screening tool. However, it does not replace histopathological examination as the diagnostic gold standard. Further research should focus on standardizing collection techniques and interpretation criteria. Registration: PROSPERO CRD42023438610.
Case Report: From metabolic normalization to incidental type A aortic dissection in immune checkpoint inhibitor–associated aortitis
(Frontiers Media, 2026-03-13) Freijido Álvarez, Pablo; León Mateos, Luis Ángel; González García, Nerea; García González, Jorge; Huelga Zapico, Emilio; Garrido Pumar, Miguel; López López, Rafael; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Immune checkpoint inhibitors can precipitate large-vessel vasculitis. It remains unknown whether metabolic remission on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) reliably indicates long-term structural stability or absence of later complications. A 58-year-old man with KRAS-G12C–mutated stage IVB lung adenocarcinoma initiated first-line treatment with carboplatin + pemetrexed + pembrolizumab. After the fourth cycle he developed persistent fever with normal procalcitonin and negative cultures. Contrast-enhanced computed tomography showed concentric thickening of the aorta and major branches; 18F-FDG PET/CT demonstrated increased inflammatory uptake consistent with large-vessel vasculitis. Testing for autoimmune and infectious etiologies yielded no diagnostic findings. Given the strong clinicoradiologic agreement and the unfavorable risk–benefit profile of deep arterial biopsy, histologic confirmation was not pursued. Intravenous methylprednisolone led to rapid defervescence and biochemical improvement. On follow-up, 18F-FDG PET/CT demonstrated complete metabolic normalization. Subsequent surveillance imaging incidentally identified an asymptomatic Stanford type A aortic dissection. In the absence of indications for elective repair (diameter below surgical thresholds, no rapid expansion, malperfusion, or significant regurgitation) and after discussion within the multidisciplinary Heart Team, management consisted of structured imaging surveillance and optimal medical therapy. Thereafter, he initiated adagrasib, achieving a durable partial response. This case illustrates discordance between metabolic quiescence and later structural damage in immune checkpoint inhibitor-associated aortitis. This supports long-term structural surveillance, as 18F-FDG PET/CT normalization does not guarantee structural safety.
Relationship between anemia and oral lichen planus: New therapeutic perspectives based on anemia management: A systematic review and meta-analysis
(Multidisciplinary Digital Publishing Institute MDPI, 2026-01-11) Egido Moreno, Sonia; Valls Roca-Umbert, Joan; Schemel Suárez, Mayra; Vidal Bel, August; Blanco Carrión, Andrés; López López, José; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Anemia is a multifactorial condition influenced by nutritional deficiencies, chronic diseases, and inflammatory processes. These factors not only contribute to anemia but may also exacerbate oral conditions such as Oral Lichen Planus (OLP) by impairing epithelial integrity and immune function. By synthesizing published studies, this review seeks to clarify whether anemia is associated with OLP and to highlight biological mechanisms common to both conditions that could be relevant for future therapeutic development. Methods: A comprehensive literature search was conducted across the selected electronic databases: Medline/Pubmed, Scopus, and Cochrane. Methodological quality and potential bias of the included studies were evaluated using the Newcastle–Ottawa Scale (NOS), while the overall certainty of the evidence was appraised according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) framework. Forest plots were generated using the Cochrane RevMan software to evaluate and visually summarize the results of the included studies. Results: Application of the search strategy resulted in the identification of 549 articles; after applying exclusion and inclusion criteria, 11 papers were selected. The prevalence of anemia, iron deficiency, and folic acid deficiency was significantly increased in the study population (p < 0.05); whereas hemoglobin deficiency was observed exclusively in women with statistical significance (p < 0.00001), driven by a single large study. Conclusions: Patients with OLP show a higher prevalence of anemia and deficiencies in key hematologic micronutrients such as vitamin B12, folic acid, and iron. Routine laboratory evaluation is recommended to detect and manage these systemic alterations. In addition to corticosteroid therapy, micronutrient supplementation may serve as a useful complementary treatment approach.
Novel therapeutic strategies for atopic dermatitis: Biomarker modulation and clinical implications. A systematic review
(Springer Nature, 2026-01-29) Moreiras Arias, Noelia; Nieto Fontarigo, Juan José; Salgado Castro, Francisco Javier; González Vilas, Daniel; Paredes Suárez, Carmen; Combo García, Enma; Rodríguez Otero, Carmen; Flórez, Ángeles; Universidade de Santiago de Compostela. Departamento de Bioquímica e Bioloxía Molecular
Advances in the understanding of atopic dermatitis (AD) pathogenesis have driven the development of innovative systemic therapies targeting key immunologic pathways. This systematic review summarizes current evidence on the impact of biologic agents, Janus kinase (JAK) inhibitors, and other emerging treatments on AD-related biomarkers and their correlation with clinical outcomes. A comprehensive literature search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published between 2014 and 2024. Eighty studies met the inclusion criteria. Dupilumab was the most extensively investigated therapy, followed by tralokinumab, JAK inhibitors, and novel agents such as amlitelimab, stapokibart, and tezepelumab. Across drug classes, consistent reductions in CCL17/TARC, LDH, and total IgE levels were observed, generally paralleling clinical improvement in EASI and SCORAD scores. Transcriptomic and proteomic analyses revealed normalization of Th2/Th22 inflammatory signatures and restoration of barrier-related gene expression, while microbiome studies showed a reduction in Staphylococcus aureus colonization. Despite these advances, the heterogeneity of study designs and analytical techniques limits the comparability of results. CCL17 and LDH currently represent the most reliable biomarkers associated with disease severity and treatment response, although their limited specificity restricts clinical applicability. Future research should aim to validate integrated biomarker panels combining immunologic, transcriptomic, and microbiomic data to enable precision medicine approaches in atopic dermatitis management.
Avulsión del velo posterior durante reparación valvular mitral percutánea borde-a-borde
(Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE), 2025-04-14) Yebra, Carlos; Bastos-Fernández, María; Martínez Monzonís, Amparo; El-Diasty, Mohammad M.; Suárez Peñaranda, José Manuel; Fernández González, Ángel Luis; Universidade de Santiago de Compostela. Departamento de Ciencias Forenses, Anatomía Patolóxica, Xinecoloxía e Obstetricia, e Pediatría; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Gene expression analysis in circulating tumour cells to determine resistance to CDK4/6 inhibitors plus endocrine therapy in HR + /HER2- metastatic breast cancer patients
(BioMed Central, 2025-12-01) González Conde, Miriam; García-Caballero Parada, Tomás; López López, Rafael; Costa Nogueira, Clotilde; Universidade de Santiago de Compostela. Departamento de Ciencias Morfolóxicas; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Background: Metastatic breast cancer (BC) is the main cause of cancer-related mortality in women worldwide. HR + /HER2- BC patients are treated with endocrine therapy (ET), but therapeutic resistance is common. The combination of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with ET was approved for metastatic BC patients and extended the median progression-free survival to 24 months. This therapy is not always effective, and in every patient, resistance ultimately occurs, but the underlying resistance mechanisms remain unclear. To address this gap, we explored circulating tumour cells (CTCs) as biomarkers to assess treatment response and resistance in metastatic HR + /HER2- BC patients receiving CDK4/6i plus ET. Methods: In total, 53 HR + /HER2- metastatic BC patients who received a CDK4/6i plus ET as first-line treatment were analysed, including samples from internal and external validation cohorts. CTCs were isolated using the negative enrichment approach RosetteSep (STEMCELL Technologies) or positive immunomagnetic selection targeting EpCAM, EGFR, and HER2 (AdnaTest EMT-2/StemCell Select™, QIAGEN). RNA was extracted from CTCs and PBMCs for nCounter analysis (Pancancer pathways panel) in a discovery phase. Subsequent validation was performed by RT-qPCR. Results: CTC gene expression analysis revealed that non responder patients (those who experienced disease progression before 180 days) exhibited elevated PRKCB (p-value: 0.011), MAPK3 (p-value: 0.006) and STAT3 (p-value: 0.008) expression, while responders showed increased CDK6 (p-value: 0.011) and CCND1 (p-value: 0.035) expression at baseline. CTC transcriptional characterization revealed a gene expression signature (STAT3highPRKCBhighCDK6low) that accurately classified HR + /HER2- metastatic BC patients who responded to CDK4/6i plus ET, regardless of the CTC isolation method (AUC > 0.8). CTC characterization at progression also identified biomarkers linked to therapy resistance, including the epigenetic regulators EZH2 and HDAC6 and the cell cycle regulator CDC7, which could guide the selection of subsequent therapy lines. The expression of the CDK4 and STAT3 genes in CTCs was associated with progression-free survival and overall survival, respectively. Likewise, the presence of ≥ one CTC after one cycle of therapy predicts a worse prognosis. Conclusions: CTC gene expression provides information about treatment outcomes in HR + /HER2- metastatic BC patients receiving CDK4/6i plus ET and could guide personalized strategies and improve prognosis.
Effects of rapid chest compression technique on intracranial and cerebral perfusion pressures in acute neurocritical patients: a randomized controlled trial
(BioMed Central, 2025-04-23) Gomes, Ricardo Miguel Rodrigues; Prieto Campo, Ángela; Martinez Rolán, Rosa; Gelabert González, Miguel; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Background: Some studies refer to the increase in intracranial pressure (ICP) with chest physiotherapy techniques but without any randomized controlled trials that evaluate the safety of the manual rapid chest compression technique in patients with severe acute brain injuries on invasive mechanical ventilation. Our research question examines whether intracranial and cerebral perfusion pressures significantly change during rapid chest compression technique. Methods: A prospective, randomized, single-blinded controlled trial of acute neurocritical patients under mechanical ventilation was performed. The intervention group was subjected to rapid chest compression, and the control group received mechanical passive inferior limbs mobilization. The outcomes were intracranial pressure, cerebral perfusion pressure, blood partial pressure of oxygen and carbon dioxide, and inspiratory and expiratory peak flows. Results: Between May 2021 and December 2023, 50 patients (aged 56.3 years), 66% females, were randomized into two groups (25 controls and 25 interventions). The ICP and cerebral perfusion pressure (CPP) did not significantly differ between the groups at any of the studied times. Intragroup analysis revealed significant decreases in the ICP and CPP in the intervention group, with posterior recovery in both groups. The CPP significantly decreased in the control group but did not reach the preintervention values at the last measurement time. PaCO2 was significantly lower in the intervention group than in the control group at the end of the study. Conclusion: The rapid chest compression technique did not increase the ICP during its application or even 30 min after it. The ICP showed a slight significant decrease during the application of the rapid chest compression technique but reached the previous values in the posterior 30 min. CPP had a similar behavior but did not completely recover in both groups. Trial registration: NCT03609866. Registered on 08/01/2018.
Relationship Between Vertigo and Consumption of Psychotropic Drugs: A Prospective Case–Control Study
(MDPI, 2025-04-08) Sánchez Sellero, Inés; Soto Varela, Andrés; Universidade de Santiago de Compostela. Instituto de Ciencias Forenses "Luís Concheiro" (INCIFOR); Universidade de Santiago de Compostela. Departamento de Ciencias Forenses, Anatomía Patolóxica, Xinecoloxía e Obstetricia, e Pediatría; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Background/Objectives: The association between vestibular symptoms and psychological distress has been previously studied, mainly with the use of questionnaires. The purpose of this study is to compare the consumption of psychotropic drugs between a group of patients with vertigo and a control group. Methods: A prospective cross-sectional, observational, case–control study was carried out, including 506 patients (232 with Ménière’s disease, 79 with vestibular migraine, 34 with vestibular neuritis, and 161 with benign paroxysmal positional vertigo). In total, 253 participants were included in the control group. Both groups were comparable regarding age, sex, and history of previous psychiatric diseases. Results: The percentage of patients with vertigo who consumed psychotropic drugs (41.3%) was higher than the percentage of the control group who did so (26.9%) (Fisher’s exact test, p < 0.0001; OR = 1.914, CI95% (1.377; 2.662)). The mean number of psychotropic drugs consumed was also higher (Mann–Whitney test, p = 0.0003) in cases (0.68 ± 0.959) than in controls (0.47 ± 0.889). This higher consumption in the group of patients with vertigo was found for all pharmacological groups studied, being especially relevant regarding “anxiolytics and hypnotics and sedatives” and “antidepressants”. No statistically significant differences in the consumption of psychotropic drugs between types of vestibular disorders were observed. The longer the symptoms were present, the higher the prevalence of psychotropic drug use was observed. Conclusions: A relationship between vertigo and consumption of psychotropic drugs was found. Recording the consumption of these drugs is proposed as an objective method to better understand the psychological distress that patients with vertigo may suffer from.
Clinical insights into circulating free-DNA in patients with bone sarcomas and ewing sarcoma
(Elsevier, 2025-04-26) Aran, Veronica; Cavalcanti, Amanda Santos; Meohas, Walter; Canteri, Bruna; Perini, Jamila Alessandra; Pino Mínguez, Jesús; Guimarães, João Antônio Matheus; Moura-Neto, Vivaldo; Duarte, María Eugênia Leite; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Background and objectives: Sarcomas represent a heterogeneous group of malignancies characterized by varying clinical behaviors and treatment responses. Liquid biopsy has emerged as a promising non-invasive method for monitoring tumor dynamics by detecting actionable mutations in cancer patients. The emergence of circulating DNA as a non-invasive biomarker offers promising avenues for improving diagnostic accuracy and treatment monitoring in sarcoma patients. Methods: In this study, the authors employed mutation-specific droplet digital PCR (ddPCR) to analyze tumor-derived cell-free DNA, also known as circulating tumor DNA (ctDNA), belonging to plasma samples of sarcoma patients, aiming to characterize mutation profiles in the IDH2 and TP53 genes. Between July 2019 and June 2023, the authors collected and analyzed 38 samples from patients diagnosed with osteosarcoma, chondrosarcoma, or Ewing's sarcoma. Histopathological confirmation of diagnoses was performed, followed by ddPCR analysis on 36 valid plasma samples. Results: The results showed mutations in three out of thirty-six sarcoma patients. Patient 1 exhibited a 12.6 % mutant IDH2 (R172S) allele fraction, Patient 2 had a 0.27 % mutant TP53 (R175H), and Patient 3 showed a 17 % mutant IDH2 (R172K). Notably, Patients 1 and 2 were diagnosed with chondrosarcoma, while Patient 3 had osteosarcoma. Conclusions: The present study provided evidence for the feasibility of ctDNA detection in sarcoma patients, where mutations were found in IDH2 and TP53 genes, including a novel IDH2 mutation in osteosarcoma. The evaluation of ctDNA has the potential to transform clinical strategies in this challenging group of malignancies and this may be further confirmed in larger cohort studies. Continued research efforts are essential to optimize ctDNA detection methods and validate its utility across diverse sarcoma subtypes.
Salivary lactoferrin levels in Down Syndrome: a case-control study
(Elsevier, 2025-04-21) Antequera, Desireé; Sande López, Lucía; García Mato, Eliane; Romualdi, Deborah; Carrero, Laura; Municio, Cristina; Diz Dios, Pedro; Carro, Eva; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Individuals with Down Syndrome (DS) have a high age-dependent risk of developing Alzheimer's disease (AD). In addition to genetic causes, this high risk involves dysregulated immune-inflammatory system. Low lactoferrin levels, one of the main antimicrobial proteins present in saliva, has been associated with AD. Here, we evaluated whether salivary lactoferrin levels change across the life span of individuals with DS. The study included 152 participants, 72 subjects with DS and 80 euploid individuals, and were divided into those under and over 45 years of age, accordingly with the age-dependent risk of AD. Median of salivary lactoferrin were higher among DS individual, in parallel to salivary total protein, but there were no differences in the ratio of lactoferrin to total protein in saliva between groups. Only DS individuals had higher median salivary lactoferrin levels in the age group under 45 years. Meanwhile non-significant differences were detected for the ratio salivary lactoferrin levels to total salivary protein between groups under 45 years, those levels were lower in DS subjects over 45 years old compared with the age-matched control group. Furthermore, the ratio of salivary lactoferrin levels to total protein in DS was associated with cognitive decline being lower in demented groups compared with mild and moderate cognitive impairment groups. In summary, this study indicates that salivary lactoferrin was dysregulated in DS, with significant lower ratio of salivary lactoferrin levels to total salivary proteins in individuals with DS over 45 years old, a population with a gradually increasing risk of AD.
Cell Detection in Biomedical Immunohistochemical Images Using Unsupervised Segmentation and Deep Learning
(MDPI, 2025) Al Tarawneh, Zakaria A.; Tarawneh, Ahmad S.; Mbaidin, Almoutaz; Fernández Delgado, Manuel; Gándara Vila, Pilar; Hassanat, Ahmad; Cernadas García, Eva; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Centro de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS); Universidade de Santiago de Compostela. Departamento de Electrónica e Computación
Accurate computer-aided cell detection in immunohistochemistry images of different tissues is essential for advancing digital pathology and enabling large-scale quantitative analysis. This paper presents a comprehensive comparison of six unsupervised segmentation methods against two supervised deep learning approaches for cell detection in immunohistochemistry images. The unsupervised methods are based on the continuity and similarity image properties, using techniques like clustering, active contours, graph cuts, superpixels, or edge detectors. The supervised techniques include the YOLO deep learning neural network and the U-Net architecture with heatmap-based localization for precise cell detection. All these methods were evaluated using leave-one-image-out cross-validation on the publicly available OIADB dataset, containing 40 oral tissue IHC images with over 40,000 manually annotated cells, assessed using precision, recall, and 𝐹1-score metrics. The U-Net model achieved the highest performance for cell nuclei detection, an 𝐹1-score of 75.3%, followed by YOLO with 𝐹1 = 74.0%, while the unsupervised OralImmunoAnalyser algorithm achieved only 𝐹1 = 46.4%. Although the two former are the best solutions for automatic pathological assessment in clinical environments, the latter could be useful for small research units without big computational resources.
Decoding E-Cigarette Secrets: Unveiling Saliva and E-Liquid Composition through Fourier-Transform Infrared Spectroscopy
(American Chemical Society, 2025) Carvalho, Bruna Fernandez do Carmo; Pérez-Sayáns García, Mario; Almeida, Janete Dias; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Electronic cigarettes (e-cigs), initially introduced as smoking cessation aids, have given rise to a new wave of nicotine dependence. A critical question that has emerged is the potential adverse effects of e-cig use on oral health, particularly how the vapor emitted from these devices may alter the salivary composition of users. Here, we investigate the salivary composition of e-cig users and analyze the e-liquids (flavorings) using Fourier-transform infrared (FTIR) spectroscopy. Saliva samples were categorized into two groups: e-cigarette users (25 individuals) and nonsmokers/nonusers (25 individuals). Additionally, 26 e-liquid samples used by the e-cig users were collected, with 17 obtained before use and 9 after use. The analysis provided reliable results in distinguishing between the two groups. Notably, partial least-squares discriminant analysis (PLS-DA) demonstrated a high degree of accuracy (>90%) in differentiating the sample groups. Our findings revealed a higher concentration of polysaccharides, aromatic amino acids, and inorganic phosphates, along with a lower concentration of esterases in the saliva of e-cigarette users. These alterations in salivary composition may be linked to an increased risk of type 2 diabetes, hypertension, cardiovascular diseases, kidney diseases, and tumor formation, having a negative impact on oral immunity. In contrast, no significant molecular or compositional changes were observed in the e-liquids after use. Our results underscore the importance of continued research into potential biomarkers and the long-term health effects associated with the growing prevalence of e-cigarette use as a form of nicotine consumption.
Determination and diagnostic value of CA9 mRNA in peripheral blood of patients with oral leukoplakia
(Taylor & Francis, 2018-12) Torres López, Manuel; Pérez-Sayáns García, Mario; Chamorro Petronacci, Cintia; Barros Angueira, Francisco; Gándara Vila, Pilar; Lorenzo Pouso, Alejandro; García García, Abel; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Background: Oral leukoplakia is one of the most common oral premalignant disorder. The classical evaluation through tissue biopsy is not always valid to evaluate the risk of malignization. Material and methods: RT-qPCR was performed on 47 blood samples (21 patients with leukoplakia, 2 with oral squamous cell carcinoma (OSCC), and 24 healthy patients) and on 11 tissue samples (3 leukoplakia, 4 OSCC, and 4 samples of healthy tissue). Results: There are significant differences in expression between the different groups (F = 4.057, p = .006). The Duncan post hoc test shows that the only group that differentiates is the tumour tissue. Using Wilcoxon test, different covariables of patients with leukoplakia were analysed with respect to the group of healthy patients and no significant differences were observed. Conclusions: The diagnostic route through liquid biopsy has not been conclusive in this study, but there are significant differences in the levels analysed in the different tissue samples.
OralImmunoAnalyser: a software tool for immunohistochemical assessment of oral leukoplakia using image segmentation and classification models
(Frontiers Media, 2024-02-26) Abdullah AL Tarawneh, Zakarya; Pena Cristóbal, Maite; Cernadas García, Eva; Suárez Peñaranda, José Manuel; Fernández Delgado, Manuel; Mbaidin, Almoutaz; Gallas Torreira, María Mercedes; Gándara Vila, Pilar; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Departamento de Ciencias Forenses, Anatomía Patolóxica, Xinecoloxía e Obstetricia, e Pediatría; Universidade de Santiago de Compostela. Centro de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS)
Oral cancer ranks sixteenth amongst types of cancer by number of deaths. Many oral cancers are developed from potentially malignant disorders such as oral leukoplakia, whose most frequent predictor is the presence of epithelial dysplasia. Immunohistochemical staining using cell proliferation biomarkers such as ki67 is a complementary technique to improve the diagnosis and prognosis of oral leukoplakia. The cell counting of these images was traditionally done manually, which is time-consuming and not very reproducible due to intra- and inter-observer variability. The software presently available is not suitable for this task. This article presents the OralImmunoAnalyser software (registered by the University of Santiago de Compostela–USC), which combines automatic image processing with a friendly graphical user interface that allows investigators to oversee and easily correct the automatically recognized cells before quantification. OralImmunoAnalyser is able to count the number of cells in three staining levels and each epithelial layer. Operating in the daily work of the Odontology Faculty, it registered a sensitivity of 64.4% and specificity of 93% for automatic cell detection, with an accuracy of 79.8% for cell classification. Although expert supervision is needed before quantification, OIA reduces the expert analysis time by 56.5% compared to manual counting, avoiding mistakes because the user can check the cells counted. Hence, the SUS questionnaire reported a mean score of 80.9, which means that the system was perceived from good to excellent. OralImmunoAnalyser is accurate, trustworthy, and easy to use in daily practice in biomedical labs. The software, for Windows and Linux, with the images used in this study, can be downloaded from https://citius.usc.es/transferencia/software/oralimmunoanalyser for research purposes upon acceptance.
Bone Remodeling Around Implants with Different Macro-Design Placed in Post-Extraction Sockets: A Cone-Beam Computed Tomography (CBCT) Randomized Controlled Clinical Trial (RCT)
(MDPI, 2025-02-11) Grassi, Roberta; Vieira e Silva, Fábio França; Musella, Gennaro; Pettini, Francesco; Vianna Camolesi, Gisela Cristina; Coppini, Martina; Cantore, Stefania; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann–Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level (p-values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss.
Impact of Electronic Nicotine Delivery Systems on Oral Mucosa: A Cytopathological and Molecular Study
(Wiley, 2026-03) Pérez Jardón, Alba; Chamorro Petronacci, Cintia Micaela; Reboiras López, María Dolores; E Silva, Fábio França Vieira; Padín Iruegas, María Elena; Pérez-Sayáns García, Mario; Almeida, Janete Días; Universidade de Santiago de Compostela. Instituto de Materiais (iMATUS)
Background: The packaging and marketing of electronic cigarettes (e-cigs) often target younger demographics. This study aimed to evaluate gene expression in e-cig users through exfoliative cytology. Methods: Samples were collected from 17 e-cig users and 10 nonsmokers as controls. Clinical data included age, gender, heart rate, oximetry, capillary blood glucose, carbon monoxide levels, sialometry, alcohol-related risk scores, alcohol consumption, and e-cig use parameters. Smears from the left tongue edge were obtained using a Rovers Orcellex Brush. The Papanicolaou method assessed epithelial maturation and cytological features, categorized from normal to conclusive for malignancy. Cellular composition, inflammation, microbial presence, and atypia were evaluated using a semiquantitative scoring system. Gene expression (p16, IL1-beta, CXCL8, TNF, and KRT13) was analyzed by RT-PCR. Statistical comparisons used the Mann-Whitney test, and correlations were assessed via Spearman's test (p ≤ 0.05). Results: Fruit flavors were the most preferred. Some users were former smokers (average abstention: 3.15 months). Bacterial colonies were more prevalent in the e-cig group (64.7% vs. 20%, p = 0.085), mucus and inflammatory changes were found exclusively in e-cig users (p = 0.062). No significant differences were found in the Papanicolaou classification by gender (p = 0.904). Gene expression analysis showed a differential expression of p16 and TNF between the groups. Significant correlations were found between carbon monoxide and p16 expression (r = -0.41, p = 0.02), vaping sessions per day and p16 expression (r = -0.37, p = 0.02), and daily alcohol dose and TNF expression (r = -0.42, p = 0.04). Conclusion: E-cigarette use may induce early molecular and cytological changes in the oral mucosa, affecting inflammation, immunity, and epithelial differentiation.
Management of Pathological Dental Attrition in Prader–Willi Syndrome: A Case Report Using the Personalized Radboud Strategy
(Wiley, 2026) Tayebi Hillali, Hoda; Fernández Alonso, Pablo; Rivas Mundiña, Berta; Outumuro Rial, Mercedes; Diniz Freitas, Márcio; Fernández Feijoo, Javier; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Prader–Willi syndrome (PWS) is a rare genetic disorder characterized by obesity, hypotonia, intellectual disability, and behavioral disturbances that complicate dental management. Parafunctional habits such as bruxism often lead to severe tooth wear, while cooperation and anesthesia represent additional challenges. A 34-year-old woman with genetically confirmed PWS presented with generalized dental wear, poor oral hygiene, and multiple carious lesions. Preventive and splint therapies were initially proposed but not feasible. Two years later, she returned with pain due to pulp exposure. Because of limited cooperation and comorbidities, dental treatment under general anesthesia was planned in two sessions, including molar extractions and multiple root canal treatments. Complete acrylic dentures with metal reinforcement were fabricated, restoring vertical dimension, improving esthetics, and serving as protective splints. Caregivers were instructed on hygiene, and annual follow-up was established. After six years, bone atrophy and further wear were noted, but the patient continued using relined prostheses without sedation. This case demonstrates that a resolutive, interdisciplinary approach can successfully manage complex dental problems in PWS. General anesthesia minimized the number of interventions while ensuring comprehensive care. Reinforced acrylic dentures provided a functional, aesthetic, and cost-effective solution, despite the progressive nature of dental wear and bone loss.
Inflammatory Molecules in the Tears of Patients with Keratoconus
(American Academy of Ophthalmology | Elsevier, 2005) Lema Gesto, María Isabel; Durán, Juan A.; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas
Purpose: To determine levels of a panel of inflammatory molecules and matrix metalloproteinases in the tears of patients with keratoconus. Design: A prospective, case-control study. Participants: Twenty-eight patients (1 eye from each) diagnosed with keratoconus at the Instituto Galego de Oftalmoloxía, Santiago de Compostela, Spain, during the period from September 2001 to June 2002, and 20 normal control subjects (1 eye each) were studied. Methods: Patients with keratoconus were examined in a routine fashion, and keratometric readings were taken to monitor the degree of ectasia. Fifteen microliters of tears was collected by capillary flow from each eye. Main Outcome Measures: The concentrations of cytokines (interleukin-4 [IL-4], IL-6, IL-10, and tumor necrosis factor α [TNF-α]), cell adhesion molecules (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1), and matrix metalloproteinase 9 (MMP-9) were measured by enzyme-linked immunoadsorbent assay. Results: Patients with keratoconus initially had significantly higher levels of IL-6 (6.7 [4.8-10.8] pg/ml vs. 2.2 [1.0-4.1] pg/ml in control subjects [P<0.0001]), TNF-α (3.8 [2.9-14.4] pg/ml vs. 1.8 [1.5-2.3] pg/ml in control subjects [P<0.0001]), and MMP-9 (66.5 [49.2-139.3]ng/ml vs. 6.1 [3.9-8.3] ng/ml in control subjects. The extent of the increase was found to be associated with the severity of keratoconus. Conclusions: Interleukin-6, TNF-α, and MMP-9 are overexpressed in the tears of patients with keratoconus, indicating that the pathogenesis of keratoconus may involve chronic inflammatory events. © 2005 by the American Academy of Ophthalmology.
Proteomic analysis of the tear film in patients with keratoconus
(Molecular Vision, 2010) Lema Gesto, María Isabel; Brea López, David; Rodríguez González, Raquel; Diez-Feijoo Arias, Elio; Sobrino Moreiras, Tomás; Universidade de Santiago de Compostela. Departamento de Cirurxía e Especialidades Médico-Cirúrxicas; Universidade de Santiago de Compostela. Departamento de Psiquiatría, Radioloxía, Saúde Pública, Enfermaría e Medicina
Purpose: To identify proteins differentially expressed between the tear film of keratoconus (KC) patients and control subjects using two dimensional electrophoresis (2-DE) and mass spectrometry-based techniques. Methods: Twenty two patients (44 eyes) diagnosed with bilateral KC and 22 control subjects (44 eyes) were studied in a prospective case-control study. Keratoconus screening programs and Orbscan II topographies were performed on all participants. Tear samples were collected by the Schirmer I method using filter paper. Proteins were extracted from the Schirmer strips and separated by 2-DE. Comparison of protein patterns was performed using PDQuest Software and protein differences were identified by mass spectrometry. Finally, results were validated by western-blot. Results: Four spots were identified to be differentially expressed between KC patients and control subjects. Three of them were more expressed in healthy subjects and they were identified as zinc-α2-glycoprotein (ZAG), lactoferrin, and IGKC (immunoglobulin kappa chain). The other spot was more expressed in KC patients and it was identified as ZAG. Differences in ZAG seem controversial in two different spots because different posttranslational modifications, however, analysis of both spots revealed that globally, ZAG is overexpressed in healthy subjects. Founded differences in ZAG, lactoferrin, and IGKC expression were subsequently validated by western blot. Conclusions: IGKC protein, ZAG, and lactoferrin are under-expressed in the tears of patients diagnosed with bilateral KC compared with healthy subjects. These differences could contribute to the knowledge of the pathophysiology of this disease.

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