104 research outputs found
Queilitis granulomatosa de Miescher: presentación de cinco casos
La queilitis granulomatosa de Miescher (QG), consiste en la
aparición de edema labial recurrente en uno o ambos labios, el
cual puede llegar a ser persistente. Ha sido considerada tradicionalmente,
como una forma monosintomática del síndrome
de Melkersson Rosenthal, descrito como la asociación de
edema labial y/o facial recurrente, parálisis facial recidivante
y lengua fisurada. El objetivo de este trabajo es presentar una
serie de 5 casos diagnosticados clínica e histopatológicamente
de QG, que acudieron a la consulta de la Unidad Docente de
Medicina Bucal de la Universidad de Murcia. Se realizó un estudio
completo de estos pacientes, valoramos la edad y el sexo,
antecedentes familiares, localización y curso de los signos y
síntomas. Llevamos a cabo diversos exámenes complementarios,
estudiándose las características hemáticas (hemograma,
velocidad de eritrosedimentación, fórmula leucocitaria y estudio
inmunológico), e histopatológicas. El tratamiento consistió en
corticoides intralesionales, combinado en algunos casos con
fármacos antileprosos o corticoides sistémicos. En todos los
casos obtuvimos una buena respuesta al tratamiento.Miescher's cheilitis granulomatosa (CG) consists of the appearance
of recurrent labial edema on one or both lips, which
can become persistent. It has traditionally been considered as a
monosymptomatic form of the Melkersson-Rosenthal syndrome,
described as the association of recurrent labial and/or recurrent
facial edema, relapsing facial paralysis and fissured tongue.
The aim of this study is to present a series of five clinically and
histopathologically diagnosed cases of CG that came to our clinic
at the Teaching Unit of Oral Medicine, Faculty of Medicine and
Odontology, University of Murcia. A complete study of these
patients evaluated the age, sex, family history, and location and
course of the signs and symptoms. Various complementary examinations
were carried out, studying the hematic characteristics
(hemogram, erythrocyte sedimentation rate, leukocyte count),
including immunological and histopathological studies.
The treatment consisted of intralesional corticoids, combined
in some cases with anti-leprous drugs or systemic corticoids. A
good response to treatment was obtained in all cases
Sleep apnea and mandibular advancement device : revision of the literature
Sleep apnea and hypopnea syndrome (SAHS) is a disorder characterized by intermittent and repetitive obstruction of the upper airway provoking pharyngeal collapse. It is characterized clinically by a triad of daytime hypersomnia, snoring and pauses in breathing during sleep that are normally reported by the partner. Polysomnography is the chosen method for diagnosing this pathology. Patients with this disorder tend to have the following dental and orofacial signs: a retrognathic jaw, a narrow palate, a wide neck, deviation of the nasal septum and relative macroglossia, among others. Dentists should be ready to evaluate the risk-benefit of certain dental treatment options for this public health problem. The treatment of this problem will depend on its severity, with one of the options being the Mandibular Advancement Device (MAD) that is used especially in the treatment of slight or moderate SAHS and in the treatment of snoring, with results that are occasionally very successful. The objective of this study is to carry out an up-to-date literature review of SAHS and to evaluate the role of the dentist when faced with this pathology
Documento de consenso sobre el tratamiento antimicrobiano de las infecciones bacterianas odontogénicas
Las infecciones de la cavidad bucal son un problema de salud
pública frecuente y motivo constante de prescripción antibiótica;
el 10% de los antibióticos se emplean para tratar este problema.
Sin embargo, hasta la fecha son pocos los estudios realizados
para determinar su incidencia. Asímismo, su relación con ciertas
enfermedades sistémicas (cardiacas, endocrinas, etc...) confiere a
estas patologías una importancia vital. A pesar de la reconocida
frecuencia e importancia de las infecciones odontogénicas, llama
la atención la actual dispersión de criterio en varios aspectos
referentes a su clasificación, terminología y recomendaciones
terapéuticas. El objetivo principal de este documento, realizado
con el consenso de especialistas en microbiología y odontología,
es establecer unas recomendaciones útiles para todos los
profesionales implicados en el manejo clínico de estas patologías.
Recibe especial atención el aumento de la prevalencia
de resistencias bacterianas observado durante los últimos años
y, en concreto, la proliferación de cepas productoras de betalactamasas.
Otro factor causal importante de la aparición de
resistencias es la falta de cumplimiento terapéutico, en especial
en lo que respecta a la dosis y a la duración del tratamiento.
Así pues, estas patologías constituyen un problema complejo
cuyo abordaje requiere la instauración de antimicrobianos de
amplio espectro, con adecuados parámetros farmacocinéticos,
con buena tolerancia y una posología cómoda que permita que
el paciente reciba la dosis adecuada durante el tiempo necesario.
Amoxicilina/ácido clavulánico a dosis altas (2000mg/ 125mg)
ha demostrado buenos resultados y capacidad para superar
resistencias. Otros agentes como metronidazol y clindamicina,
seguidos de claritromicina y azitromicina han demostrado también ser activos frente a la mayoría de los microorganismos
responsables de las infecciones odontogénicas.The infection of the oral cavity is a common public health problem
and constant cause for antibiotic prescription, with 10%
of antibiotics used to treat this problem. However, few studies
have so far aimed to determine its incidence. Added to this, its
relationship with certain sytemic diseases (cardiac, endocrine,
etc') confers this pathology vital importance. In spite of the
frequency and importance of odontogenic infection, the current
dispersion in criteria regarding key aspects in classification,
terminology and therapeutic recommendations is noticeable.
The main objective of this document, compiled as a consensus
statement by specialists in microbiology and odontology, is to
establish useful recommendations for all of those involved in
the clinical management of this pathology. Special attention has
been placed on the rise in bacterial resistance observed over the
last years, specifically the proliferation of betalactamase producing
strains. Another important factor causing the resistance to
appear is lack of therapeutic compliance, specially what regards
dosage and treatment duration. Therefore, this pathology constitutes
a complex problem which requires the instauration of
broad spectrum antimicrobials, well tolerated and a convenient
posology so that patients receive the adequate dose over the
necessary period. High doses of amoxicillin/clavulanate (2000
mg / 125 mg) have showed good results and power to overcome
resistance. Other agents such as metronidazole and clindamycin,
followed by de claritromycin and azithromycin have also proved
to be active against most of microorganisms responsible for
odontogenic infection
Morphometric analysis of the dorsum linguae in patients with Oral Lichen Planus
Objective: Morphometric study of the dorsum linguae in patients with Oral Lichen Planus (OLP).Material and Method: In 236 patients with a clinicopathologic diagnosis of OLP, 111 were found to have involvement of the dorsum linguae. For the purposes of the study, 41 of these cases were used, due to the availability of photographic records fulfilling quality conditions according to objective criteria. The experimental variable was defined as the proportion of affected dorsum linguae measured and calculated using the MIP4(R) computer software.Results: In 236 patients with OLP, the mucosa of the dorsum linguae was affected in 47.6% of the cases (total 111). The proportion of affected area was studied in 41 of these cases, 8 men (19.5%) and 33 women (80.5%). In 73% of these cases, the affected area was less than 50% of the total surface of the dorsum linguae. There were no statistically significant differences (p=0.495) in relation to age and proportion of lingual surface affected. On the other hand, significant statistical differences were found between the period of disease evolution and area of lingual involvement (p=0.044).Conclusion: Lingual involvement is frequent in patients with OLP, and manifests as de-papillate areas to the left and right of the median sulcus of tongue (occasionally linked by an isthmus) and having a certain “ butterfly wing” symmetr
Homo sapiens, Chimpanzees and the Enigma of Language
ObjectivesThe present study explores the hypothesis that the anatomical bone structures of the oral cavity have probably evolved under the influence of language function. The possible changes have been evaluated by comparing two close species essentially differentiated from each other by spoken language.Materials and MethodsTwenty dry skulls and 20 mandibles of modern Caucasians were compared with 12 dry skulls and 12 mandibles of chimpanzees, with the analysis of 37 variables and the definition of new anatomical parameters.ResultsA number of highly significant differences were found between humans and chimpanzees. The human temporomandibular joint is comparatively less flat and has a more limited excursive movement range, with structural elements that seem to be lighter. A significant difference is noted in mandibular alveolar vergency and in the internal slope of the mandibular symphysis where the oral cavity’s morphology is modified, thereby increasing the free space for tongue movements in humans. The chin, which is unique to the human species, is quantified through the external slope of the mandibular symphysis with a lesser angle in humans.DiscussionIt is obvious that there are differences between humans and chimpanzees in the bone morphology of the oral cavity structures. This has been confirmed with the analysis of new variables. Together with other factors (bipedalism, habits, and genetics) speech in humans must have played an important role in the aforementioned differences between humans and chimpanzees. The number of mandibular movements involved in speech is far greater than those used in chewing, which must have conditioned the evolution of the oral structures implicated in the development of language. On average, humans weigh 70 kg and chimpanzees 44 kg. However, the majority of the variables studied in skulls and mandibles are greater in chimpanzees, which suggests that the evolution of the oral zone in humans has suffered a reduction in size with changes in shape. The refinement of the supralaryngeal vocal tract in the human species must have co-evolved with speech fairly recently. The human skull has temporomandibular joints that are comparatively less flat with a more limited movement. There is a greater lingual space and there is also a chin that suggests a muscular stimulant. This leads to the conclusion that, at least in part, speech is behind all these changes, although it is difficult to establish a cause-effect relationship
Validation of 3D neutronic-thermalhydraulic coupled codes RELAP5/PARCSv2.7 and TRACEv5.0P3/PARCSv3.0 against a PWR control rod drop transient
[EN] In nuclear safety field, neutronic and thermalhydraulic codes performance is an important issue. New capabilities implementation, as well as models and tools improvements are a significant part of the community effort in looking for better Nuclear Power Plants (NPP) designs. A procedure to analyze the PWR response to local deviations on neutronic or thermalhydraulic parameters is being developed. This procedure includes the simulation of Incore and Excore neutron flux detectors signals. A control rod drop real plant transient is used to validate the used codes and their new capabilities. Cross-section data are obtained by means of the SIMTAB methodology. Detailed thermalhydraulic models were developed: RELAP5 and TRACE models simulate three different azimuthal zones. Besides, TRACE model is performed with a fully 3D core, thus, the cross-flow can be obtained. A cartesian vessel represents the fuel assemblies and a cylindrical vessel the bypass and downcomer. Simulated detectors signals are obtained and compared with the real data collected during a control rod drop trial at a PWR NPP and also with data obtained with SIMULATE-3K code.The authors would like to acknowledge the economic support provided by Centrales Nucleares Almaraz-Trillo (CNAT) and IBERDROLA Ingeniería y Construcción (Iberinco) for the realization of this work, and express their great appreciation to Arturo López, Juan Antonio Bermejo and Alberto Ortego for their valuable collaboration and their willingness to develop this work. This work has also been supported by the Spanish Ministerio de Economía y Competitividad, through the projects NUC-MULTPHYS (ENE2012-34585) and VALIUN-3D (ENE2011-22823), and the Generalitat Valenciana (GVA), through the project PROMETEO II/2014/008.Garcia-Fenoll, M.; Mesado Melia, C.; Barrachina, T.; Miró Herrero, R.; Verdú Martín, GJ.; Bermejo, JA.; López, A.... (2017). Validation of 3D neutronic-thermalhydraulic coupled codes RELAP5/PARCSv2.7 and TRACEv5.0P3/PARCSv3.0 against a PWR control rod drop transient. Journal of Nuclear Science and Technology. 54(8):908-919. https://doi.org/10.1080/00223131.2017.1329035S90891954
Oral lichen planus: A retrospective study of 110 Brazilian patients
<p>Abstract</p> <p>Background</p> <p>Oral lichen planus (OLP) is a chronic autoimmune disease characterized by multiple clinical presentations and a relatively high prevalence in the population. This retrospective patient record study investigated the profile of OLP in a group of Brazilian patients seen between 1989 and 2009.</p> <p>Findings</p> <p>The clinical records were analyzed and data such as gender, age, race, clinical presentation of OLP, site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages were obtained. Among the 1822 records of patients with oral mucosal lesions, OLP was identified in 6.03%. Of these, 76.36% were females, with a mean age of 54 years, and 85% were whites. The reticular form was the most frequent (81.81%). Extraoral lesions were observed in 32.72% of the patients and painful symptoms were reported by 50.90%. The cheek mucosa was the site most affected (92.72%) and multiple oral lesions were observed in 77.27% of the patients. Among patients with OLP, 18.18% reported a smoking habit and 29.09% the consumption of alcoholic beverages.</p> <p>Conclusions</p> <p>This retrospective study showed a relatively high prevalence of OLP in the population studied, with a predominance of the disease among middle-aged white women and bilateral involvement of the cheek mucosa. Reticular lesions were the most frequent, followed by the erosive form which is mainly associated with painful symptoms. No relationship with tobacco or alcohol consumption was observed.</p
Documento de consenso sobre el tratamiento antimicrobiano de las infecciones bacterianas odontogénicas
Las infecciones de la cavidad bucal son un problema de salud pública frecuente y motivo constante de prescripción
antibiótica; el 10% de los antibióticos se emplean para tratar este problema. Sin embargo, hasta la fecha son
pocos los estudios realizados para determinar su incidencia. Asímismo, su relación con ciertas enfermedades sistémicas
(cardiacas, endocrinas, etc...) confiere a estas patologías una importancia vital. A pesar de la reconocida
frecuencia e importancia de las infecciones odontogénicas, llama la atención la actual dispersión de criterio en
varios aspectos referentes a su clasificación, terminología y recomendaciones terapéuticas. El objetivo principal
de este documento, realizado con el consenso de especialistas en microbiología y odontología, es establecer unas
recomendaciones útiles para todos los profesionales implicados en el manejo clínico de estas patologías. Recibe
especial atención el aumento de la prevalencia de resistencias bacterianas observado durante los últimos años y,
en concreto, la proliferación de cepas productoras de betalactamasas. Otro factor causal importante de la aparición
de resistencias es la falta de cumplimiento terapéutico, en especial en lo que respecta a la dosis y a la duración
del tratamiento. Así pues, estas patologías constituyen un problema complejo cuyo abordaje requiere la instauración
de antimicrobianos de amplio espectro, con adecuados parámetros farmacocinéticos, con buena tolerancia
y una posología cómoda que permita que el paciente reciba la dosis adecuada durante el tiempo necesario.
Amoxicilina/ácido clavulánico a dosis altas (2000mg/ 125mg) ha demostrado buenos resultados y capacidad
para superar resistencias. Otros agentes como metronidazol y clindamicina, seguidos de claritromicina y azitromicina
han demostrado también ser activos frente a la mayoría de los microorganismos responsables de las infecciones
odontogé[email protected]
Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis
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