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Dos Santos Freire FM, Marques LC, da Silva NC, Cunha KS, Conde DC, Milagres A, Gonçalves LS, Junior AS. Oral candidiasis in patients hospitalised in the intensive care unit: Diagnosis through clinical and cytopathological examinations. Cytopathology 2023; 34:353-360. [PMID: 37114365 DOI: 10.1111/cyt.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To evaluate the prevalence and clinical aspects of oral candidiasis in patients hospitalised in the intensive care unit. METHODS This is a longitudinal and prospective study that included 48 participants hospitalised in the intensive care unit. Sociodemographic data, presence of systemic disorders, use of medications, laboratory tests, cause of hospital admission, type of breathing, and length of hospital stay were obtained from medical records. Oral clinical inspection and cytopathological examinations were performed on all participants. The diagnosis of clinical candidiasis was based on the presence of clinical alterations together with positive cytopathological examination results. The diagnosis of subclinical candidiasis was based on the absence of clinical lesions and a positive cytopathological examination. The absence of oral candidiasis was considered when the participant did not present oral lesions and had a negative cytopathological examination. RESULTS Clinical candidiasis was present in 18.8% of the 48 participants, and 45.8% of them had the subclinical form. Levels of urea (P = 0.005), creatinine (P = 0.009), haemoglobin (P = 0.009), haematocrit (P = 0.011), bands (P = 0.024), international normalised ratio (INR; P = 0.034), types of breathing (P = 0.017), length of hospital stay (P = 0.037), and outcome (P = 0.014) demonstrated statistically significant differences between the groups with and without oral candidiasis. CONCLUSIONS Clinical and subclinical forms of oral candidiasis are frequent in intensive care unit patients. Levels of urea, creatinine, haemoglobin, haematocrit, bands, INR, type of breathing, length of hospital stay, and outcome can be associated with the presence of candidiasis.
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Affiliation(s)
| | - Letícia Côgo Marques
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Natasha Camargo da Silva
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Karin Soares Cunha
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Adrianna Milagres
- Department of Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
| | - Lúcio Souza Gonçalves
- Postgraduation Program in Dentistry, Faculty of Dentistry, Universidade Estácio de Sá, Rio de Janeiro, Brazil
| | - Arley Silva Junior
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Brazil
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Safi Oz Z, Onak Kandemir N, Kokturk F, Ozdamar SO. Cytomorphometry and morphology analysis of human papillomavirus type 16 in liquid-based cervical cytology samples. Diagn Cytopathol 2021; 49:885-893. [PMID: 33904658 DOI: 10.1002/dc.24761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) is the main causal factor of cervical carcinoma. HPV 16 is one of the most prominent oncogenic types. We aimed to evaluate the cytomorphometric and morphological alterations caused by HPV 16 in liquid-based cytology (LBC). METHODS The Cobas 4800 HPV system was used for the detecting and typing HPV DNA in cervical specimens. In this study, 30 HPV 16 positive and 30 HPV 16 negative cervical samples were evaluated for micronuclei (MN), nonclassical cytologic abnormalities, and the nuclear-to-cytoplasmic ratio. Nuclear and cellular areas were evaluated using image analysis software and the nuclear-to-cytoplasm ratio was calculated. All analyses were performed blinded to the patients' HPV status. Statistical evaluation was carried out using the χ2 and Fisher test; P-values < .05 were considered significant. RESULTS The frequencies of micronucleated cells and koilocytes were higher in the HPV 16 infected group (P < .05). Cells with perinuclear halo in control group were higher than the HPV 16 infected group (P < .05). The mean nuclear-to-cytoplasm ratio in HPV 16 patients was higher than the control value, but the difference was not statistically significant. CONCLUSION LBC can be used to detect morphological and morphometric changes. HPV 16 induces the formation of MN and koilocytosis. The evaluation of MN could provide additional information in monitoring genomic instability and of koilocytes could provide information about damage to the cytoskeleton filaments in HPV infection. Further studies are needed to investigate the effects of HPV-18 and other high-risk HPV types on the cell size and nucleus-to-cytoplasm ratio.
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Affiliation(s)
- Zehra Safi Oz
- Faculty of Medicine, Department of Medical Biology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Nilufer Onak Kandemir
- Faculty of Medicine, Department of Pathology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Furuzan Kokturk
- Faculty of Medicine, Department of Biostatistics, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Sukru Oguz Ozdamar
- Faculty of Medicine, Department of Pathology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Pérez-de-Oliveira ME, Petersen Wagner V, do Amaral-Silva GK, Almeida Leite A, Ajudarte Lopes M, Santos-Silva AR, Jorge Júnior J, de Almeida OP, Agustin Vargas P. An audit of cytopathology in the oral and maxillofacial region: 18 years of experience. Cytopathology 2020; 31:555-563. [PMID: 32681691 DOI: 10.1111/cyt.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to perform an audit of oral and maxillofacial specimens submitted for cytological diagnosis to verify the importance of this complementary examination. METHODS A retrospective analysis of our institutional cytopathology database was performed over an 18-year period. Clinical information and cytological data were collected. Associations between independent variables and outcomes were assessed using the Pearson χ2 test or Fisher's test, with a 5% significance level. When available, the histological diagnosis was compared with cytological diagnosis to identify the percentage of agreement and the specificity, sensitivity and accuracy of cytology in identifying malignant neoplasms. RESULTS A total of 1082 cases were identified, which included 65 different cytological diagnoses. Exfoliative cytology (EC) was performed in 312 cases (29.1%) and fine needle aspiration cytology (FNAC) in 770 cases (70.9%). EC was mainly employed to diagnose oral infectious diseases (P < 0.001) and FNAC to diagnose neoplasms, cystic, reactive and miscellaneous lesions (P < 0.001). Cell-block was performed in 555 FNAC cases (51.3%). Panoptic, Papanicolaou and haematoxylin-eosin staining were performed in FNAC and periodic acid-Schiff in EC (P < 0.001). In 211 cases (19.5%), the histological diagnosis was available and the percentage agreement with the cytological diagnosis was 41.2%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to identify malignant neoplasms were 84.6%, 100%, 100%, 77.8% and 90.0%, respectively. CONCLUSIONS EC was mainly performed for diagnosis of infectious diseases and FNAC for diagnosis of salivary gland tumours, odontogenic lesions, reactive lesions and cervical metastasis.
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Affiliation(s)
- Maria Eduarda Pérez-de-Oliveira
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Vivian Petersen Wagner
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Gleyson Kleber do Amaral-Silva
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Amanda Almeida Leite
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Jacks Jorge Júnior
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Oral Pathology and Semiology Area, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
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Safi Oz Z, Doğan Gun B, Gun MO, Ozdamar SO. Cytomorphometric and Morphological Analysis in Women with Trichomonas vaginalis Infection: Micronucleus Frequency in Exfoliated Cervical Epithelial Cells. Acta Cytol 2015; 59:258-64. [PMID: 26112451 DOI: 10.1159/000431148] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/04/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of this study was to explore the cytomorphometric and morphological effects of Trichomonas vaginalis in exfoliated epithelial cells. STUDY DESIGN Ninety-six Pap-stained cervical smears were divided into a study group and two control groups as follows: T. vaginalis cases, a first control group with inflammation, and a second control group without inflammation. Micronucleated, binucleated, karyorrhectic, karyolytic, and karyopyknotic cells and cells with perinuclear halos per 1,000 epithelial cells were counted. Nuclear and cellular areas were evaluated in 70 clearly defined cells in each smear using image analysis. RESULTS The frequencies of morphological parameters in the T. vaginalis cases were higher than the values of the two control groups, and the difference among groups was found to be significant (p < 0.05). The nuclear and cytoplasmic areas of epithelial cells were diminished in patients with trichomoniasis. The mean nucleus/cytoplasm ratio in T. vaginalis patients was higher than the value in the control groups, and the difference between the study group and control group 1 was significant. However, there was no statistically significant increase between the study group and control group 2. CONCLUSIONS T. vaginalis exhibited significant changes in the cellular size and nuclear structure of the cells. The rising frequency of micronuclei, nuclear abnormalities, and changing nucleus/cytoplasm ratio may reflect genotoxic damage in trichomoniasis.
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Affiliation(s)
- Zehra Safi Oz
- Department of Medical Biology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
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Safi Oz Z, Dogan Gun B, Ozdamar SO. Evaluation of Micronuclei, Nuclear Anomalies and the Nuclear/Cytoplasmic Ratio of Exfoliated Cervical Epithelial Cells in Genital Candidiasis. Acta Cytol 2015; 59:180-6. [PMID: 25998009 DOI: 10.1159/000381615] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/09/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Candida is the most common cause of fungal infections. The aim of this study was to fill the gaps in the current knowledge on the frequencies of micronuclei and nuclear anomalies, and the nucleus/cytoplasmic ratio in genital candidiasis. STUDY DESIGN A total of 88 Papanicolaou- stained cervical smears, which comprised Candida spp. (n = 44) and control cases with no infectious agent (n = 44), were studied. In each smear, cells with micronuclei and nuclear anomalies were counted in 1,000 epithelial cells and also nuclear and cellular areas were evaluated using image analysis software at a magnification of ×400. RESULTS The frequencies of micronucleated and binucleated cells and cells with perinuclear halos, and the nucleus/cytoplasmic ratio of epithelial cells were higher in the Candida-infected group compared with the control group (p < 0.05). CONCLUSIONS Genital candidiasis is able to induce changes in the size and shape of epithelial cells. The nuclear/cytoplasmic ratio and the frequency of micronuclei may reflect the DNA damage in the cervical epithelium. Micronucleus scoring could be used to screen the genomic damage profile of epithelial cells in candidiasis.
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Affiliation(s)
- Zehra Safi Oz
- Department of Medical Biology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
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Cellular populations of periimplant tissues: cytological analysis with sulcular microbrushing. IMPLANT DENT 2014; 23:98-102. [PMID: 24384742 DOI: 10.1097/id.0000000000000029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Cellular populations of gingival crevicular fluid cytological analysis of integrated implants sites have been investigated by using sulcular cytological brushing, as a means of providing an objective and reproducible technique for monitoring periimplant tissue health. MATERIALS AND METHODS A total of 60 patients with osteointegrated implants bearing at least for 2 years were divided in 2 groups, A and B. Group A consisted of 30 subjects who presented scarce oral hygiene. In Group B, 30 subjects with a good oral hygiene were included. RESULTS Comparative analysis of the data obtained by sulcular microbrushing of the 2 groups put into evidence significative differences in the expression of the microbiological and the cytological parameters. CONCLUSION Clinical monitoring of parodontal and periimplant tissues makes use of several diagnostic tests ranging from clinical and radiological tests to biological assays. However, none of these techniques allows to evaluate periimplant tissue cytological status. This preliminary study suggested sulcular microbrushing might be a useful tool in the early diagnosis and in the micrological monitoring of peri-implantitis.
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Patel PV, Gujjari SK. Cytomorphometric analysis of the gingival epithelium in type 2 diabetic patients with and without smoking habit. J Cytol 2013; 30:109-15. [PMID: 23833400 PMCID: PMC3701334 DOI: 10.4103/0970-9371.112653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: It has been shown that cigarette smoking as well as diabetes mellitus can produce cytomorphometric alterations in oral epithelial cells with the significant increase in the nuclear area (NA) and significant decrease in the cytoplasmic/nuclear ratio in comparison to healthy control. However, the synergistic effect of tobacco smoking and diabetes on the morphology of gingival epithelial cells is not been explored until date. Aim: This study was carried out to investigate the effects of diabetes and the synergistic effects of smoking and diabetes on the cytomorphometry of gingival epithelium. Materials and Methods: Gingival smears were collected from 30 male subjects diagnosed with type 2 diabetes with (n = 10) or without history of smoking habit (n = 10). Healthy subjects with no history of smoking or diabetes served as the control group (n = 10). The smears were stained using Papanicolaou procedure. The cellular (CA) and nuclear areas (NA)
were measured using image analysis software. One-way ANOVA and Tukey-HSD procedure (at P = 0.05) were used to
analyze all the parametric variables. Results: A statistically significant (P < 0.001) increase in NA and N:C ratio in smoker diabetic group was observed compared to the non-smoker diabetic group and the control group. The non-smoker diabetic group also showed significant increase Conclusions: There were significant alterations in the cellular pattern of gingival mucosa cells in a non-smoker diabetic, but the alteration was to a greater extent in smoker diabetics demonstrating a synergistic effect of smoking and diabetes on gingival mucosa.
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Affiliation(s)
- Punit Vaibhav Patel
- Department of Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Kuyama K, Sun Y, Taguchi C, Endo H, Wakami M, Fukumoto M, Ito T, Yamamoto H. A clinico-pathological and cytological study of oral candidiasis. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/ojst.2011.14033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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