Fibroma osificante maxilar: presentación de un caso y revisión de la literatura

Existe un conjunto de procesos que han sido denominados genéricamente lesiones fibroóseas benignas, entre las que se encuentran la displasia fibrosa, la osteomielitis esclerosante y el fibroma osificante o cementificante. Todos estos procesos tienen un estroma fibroblástico vascular y producen una matriz calcificada que comprende desde el hueso hasta el cemento. El fibroma osificante se caracteriza por presentar un crecimiento y una tumefacción deformante de evolución lenta que generalmente aparece en la mandíbula y puede producir desplazamiento dentario precoz. Desde el punto de vista radiológico aparece generalmente como un área radiotransparente unilocular bien definida y demarcada o como una radiotransparencia con opacidades centrales o como una radiolucidez multilocular. Excepcionalmente puede ser radioopaca. Presentamos el caso de un paciente varón de 22 años que acude a nuestro Servicio para valorar una tumoración de tres meses de evolución localizada en la zona anterior del maxilar superior, asintomática y que radiológicamente se presentaba como un área radiotransparente rodeada por un halo esclerótico mal delimitado. El diagnóstico definitivo tras la exéresis quirúrgica de la lesión fue el de fibroma osificante. Realizamos la discusión del caso presentado junto con una revisión de la literatura.A number of processes generically referred to as benign fibroosseous lesions comprise different disorders such as fibrous dysplasia, sclerotizing osteomyelitis and ossifying or cementing fibroma. These processes are all characterized by the existence of a vascular fibroblastic stroma, with the production of a calcified matrix ranging from bone to cementum. Ossifying fibroma involves slow-evolving growth with deforming swelling generally arising in the mandible, with possible early dental displacement. From the radiological perspective the disorder generally manifests as a well defined and delimited, unilocular radiotransparency, as a radiotransparent image with central opacifications, or as multilocular transparencies. The lesions exceptionally can be radiopaque. Wepresent the case of a 22-year-old male presenting for evaluation of a three-month, asymptomatic tumor mass in the anterior sector of the upper jaw. Radiologically, the lesion appeared as a radiotransparent zone surrounded by a poorly delimited sclerotic halo. The definitive diagnosis following surgical resection of the lesion was ossifying fibroma. The case is discussed, and a review is provided of the literature on the subject

AntagomiR directed against miR-20a restores functional BMPR2 signalling and prevents vascular remodelling in hypoxia-induced pulmonary hypertension

Aims Dysregulation of the bone morphogenetic protein receptor type 2 (BMPR2) is a hallmark feature that has been described in several forms of pulmonary hypertension. We recently identified the microRNA miR-20a within a highly conserved pathway as a regulator of the expression of BMPR2. To address the pathophysiological relevance of this pathway in vivo, we employed antagomiR-20a and investigated whether specific inhibition of miR-20a could restore functional levels of BMPR2 and, in turn, might prevent pulmonary arterial vascular remodelling. Methods and results For specific inhibition of miR-20a, cholesterol-modified RNA oligonucleotides (antagomiR-20a) were synthesized. The experiments in mice were performed by using the hypoxia-induced mouse model for pulmonary hypertension and animal tissues were analysed for right ventricular hypertrophy and pulmonary arterial vascular remodelling. Treatment with antagomiR-20a enhanced the expression levels of BMPR2 in lung tissues; moreover, antagomiR-20a significantly reduced wall thickness and luminal occlusion of small pulmonary arteries and reduced right ventricular hypertrophy. To assess BMPR2 signalling and proliferation, we performed in vitro experiments with human pulmonary arterial smooth muscle cells (HPASMCs). Transfection of HPASMCs with antagomiR-20a resulted in activation of downstream targets of BMPR2 showing increased activation of Id-1 and Id-2. Proliferation of HPASMCs was found to be reduced upon transfection with antagomiR-20a. Conclusion This is the first report showing that miR-20a can be specifically targeted in an in vivo model for pulmonary hypertension. Our data emphasize that treatment with antagomiR-20a restores functional levels of BMPR2 in pulmonary arteries and prevents the development of vascular remodellin

Morbilidad de la extracción de los terceros molares en pacientes entre los 12 y 18 años de edad

Objetivo: El propósito de este estudio fue analizar la incidencia de complicaciones después de la extracción quirúrgica de los terceros molares en pacientes de 12 a 18 años de edad. Pacientes y método: Se realizó un estudio retrospectivo de 390 extracciones quirúgicas de terceros molares superiores e inferiores en 173 pacientes en edades comprendidas entre los 12 y 18 años de edad, intervenidos bajo anestesia locorregional en el año 2000 en el Máster de Cirugía Bucal e Implantología Bucofacial de la Universidad de Barcelona. Los pacientes fueron divididos en tres grupos (A: 12-14 años, B:15-16 años, C: 17-18 años). Se registró la edad y el sexo del paciente, el motivo de la extracción, el grado de desarrollo dentario, la posición, la angulación y la inclusión del tercer molar. Finalmente se valoró la asociación entre dichas variables y la aparición de complicaciones postoperatorias. Resultados: La mayoría de los pacientes intervenidos fueron del sexo femenino (66,9%), y el grupo de edad en la que se realizó el mayor número de extracciones (62,8%) fue en el grupo C (17-18 años). El principal motivo de extracción fue la indicación por parte del ortodoncista (40,5%), seguido por la indicación profiláctica (39,5%). La presencia de clínica fue el motivo de extracción en un 20% de los casos. Se observó una incidencia del 15,6% de complicaciones postoperatorias tras la extracción de 390 terceros molares. En el grupo A el riesgo de complicaciones fue de 17,4%, en el grupo B de 19% y en el grupo C de 13,7%. Todas las complicaciones fueron reversibles y de corta duración como el dolor y la inflamación persistente, la infección, el trismo y la equimosis. Se presentó un caso de parestesia del nervio dentario inferior y un caso de parestesia del nervio lingual que remitieron a los 2 meses y al mes respectivamente. Conclusiones: este estudio demuestra que no hay diferencias significativas en las complicaciones observadas entre los tres grupos de edad, y por lo general, éstas son leves y reversibles. Se observó una mayor tendencia de complicaciones en las mujeres y el porcentaje de complicaciones aumenta cuanto menor es el espacio disponible para la erupción.Objective: An analysis is made of the incidence of complications following third molar surgical extraction in patients between 12 and 18 years of age. Patients and method: A retrospective study was conducted of 390 surgical extractions of upper and lower third molars in 173 patients operated upon under locoregional anesthesia during the year 2000 in the Master in Oral Surgery and Implantology of Barcelona University Dental School (Spain). The patients were divided into three age groups (A: 12-14 years, B: 15-16 years, C: 17-18 years). The reason for extraction, the degree of dental development, and third molar position, angle and impaction were recorded. Finally, the association of these variables to the appearance of postoperative complications was analyzed. Results: Most patients were females (66,9%), and the age group in which most extractions were carried out (62,8%) corresponded to Group C (17-18 years). The main reason for extraction was orthodontist indication (40,5%), closely followed by prophylaxis (39,5%). The existence of clinical manifestations was an indication for extraction in 20% of cases. The postoperative complications rate after the extraction of the global 390 molars was 15,6%. In Groups A, B and C the complication risks were 17,4%, 19% and 13,7%, respectively. All complications were reversible and of short duration. One case each of inferior alveolar nerve paresthesia and lingual nerve paresthesia was recorded, which subsided after one and two months, respectively. Conclusions: There were no significant differences in complications between the three age groups. An increased tendency towards complications was observed in females, and the percentage of postoperative problems increased

Cirugía Bucal Ambulatoria en pacientes pediátricos: casuística del año 2000 en la Clínica Odontológica de la Universidad de Barcelona

Objetivos: Este trabajo pretende demostrar que se pueden realizar la mayoría de las intervenciones quirúrgicas de la cavidad bucal en la población pediátrica en un medio ambulatorio, así como valorar y mostrar la actividad realizada en el Máster de Cirugía e Implantología Bucal de la Facultad de Odontología de la Universidad de Barcelona durante el año 2000. Diseño del estudio: Para la realización de este trabajo se ha contabilizado la actividad quirúrgica de las unidades de cirugía bucal y cirugía con láser en la población pediátrica en el Máster de Cirugía e Implantología Bucal de la Universidad de Barcelona. Resultados: De las 3187 intervenciones quirúrgicas realizadas en nuestro servicio, 489 fueron en pacientes menores de 18 años. La exodoncia quirúrgica de terceros molares inferiores fue la más frecuente (55Ê6%), seguida de otras extracciones dentarias (33Ê6%), quirúrgicas o no, y del resto de intervenciones (10Ê6%) que incluyeron: fenestraciones de caninos u otros dientes incluidos, exéresis de frenillos, de mucoceles y reubicaciones dentarias. Se presentaron complicaciones tras la extracción quirúrgica de los terceros molares en un 15Ê93% de los casos, siendo las más frecuentes el dolor (4Ê35%) y la tumefacción (4Ê35%), signos propios de la inflamación postoperatoria. Conclusiones: Nuestra experiencia muestra que la cirugía bucal ambulatoria puede practicarse de forma segura en la población pediátrica siempre y cuando se disponga de los medios y del personal sanitario adecuados.Aim: A study is made to show that most pediatric oral surgical interventions can be performed on a day case surgery or ambulatory basis, and to describe the activity of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain) in the year 2000. Design: The study documents the surgical activity of the Units of Oral Surgery and Laser Surgery in pediatric patients, in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Spain). Results: Of the 3187 operations carried out in our Service in this period, 489 involved patients under 18 years of age. The surgical removal of third molars was the most common intervention (55.6%), followed by other surgical or non-surgical tooth extractions (33.6%) and other interventions (10.6%) comprising fenestration of impacted canines or other teeth, frenectomies, the removal of mucoceles, and tooth relocations. Complications after surgical third molar extraction were recorded in 15.93% of cases the most frequent problem being the pain and swelling (4.35% each) characteristic of postoperative inflammation. Conclusions: Our experience shows that day case oral surgery can be safely performed in pediatric patients, provided the required means and health care personnel resources are available

Cyclic-β-glucans of Rhizobium (Sinorhizobium) sp. strain NGR234 are required for hypo-osmotic adaptation, motility, and efficient symbiosis with host plants

Cyclic-β-glucans (CβG) consist of cyclic homo-polymers of glucose that are present in the periplasmic space of many Gram-negative bacteria. A number of studies have demonstrated their importance for bacterial infection of plant and animal cells. In this study, a mutant of Rhizobium (Sinorhizobium) sp. strain NGR234 (NGR234) was generated in the cyclic glucan synthase (ndvB)-encoding gene. The great majority of CβG produced by wild-type NGR234 are negatively charged and substituted. The ndvB mutation abolished CβG biosynthesis. We found that, in NGR234, a functional ndvB gene is essential for hypo-osmotic adaptation and swimming, attachment to the roots, and efficient infection of Vigna unguiculata and Leucaena leucocephal

Caveolin-1 Expression and Hemodynamics in COPD Patients

Caveolin-1 is a regulator of both intracellular calcium homeostasis and endothelial nitric oxide synthase and may play a pathogenetic role in pulmonary hypertension. In the present study, we aimed to investigate the correlations between pulmonary hemodynamics and vessel morphology including the expression of Caveolin-1 in pulmonary arterioles from patients with chronic obstructive pulmonary disease (COPD) who underwent lung-volume reduction surgery. Staining and subsequent analysis was performed on paraffin-embedded lung tissue from COPD patients (n = 12). Pulmonary arteries with an external diameter of 100-500µm were analysed. Immunhistochemistry with antibodies against caveolin-1 was performed and intensity was assessed. Morphometric data were obtained by using computer-assisted imaging software. The findings were quantified and correlated to hemodynamic data obtained by right-heart catheterization. In COPD patients with pulmonary hypertension (n = 5), the expression of caveolin-1 within the medial smooth muscle cell layer was found to be increased, whereas the intimal caveolin-1 was more prominently expressed in COPD patients with normal pulmonary pressures (n = 7). The ratio between these expression patterns was positively correlated to the mean pulmonary artery pressure. Similar findings were observed for the ratio between intimal and medial thickness as well as for the expression of smooth muscle actin (SMA)

Influence of the teaching program on the learning in knowledge and practice of osteonecrosis of the jaws produced by antireasorptives in dental students of the Principality of Asturias (Spain)

This study aims to evaluate the influence of changes in the teaching contents on medication-related osteonecrosis of the jaw may have on the knowledge and the capacity for practical case resolution about this pathology. A cross-sectional descriptive study was conducted through a survey divided into four sections: degree of means of knowledge acquisition, habitual practice and ability to solve clinical cases. The total number of respondents (n = 225) was divided into two groups: Group A (Year 2015-2016) and Group B (Year 2016-2017). The students in Group B received more teaching content on the subject than group A. A total of 175 survey responses were collected. The internet was the preferred tool for continuing education in both groups. The best known bisphosphonates (BPs) were Alendronate (Fosamax®: 56.9% Group A, 67.5% Group B) and Zoledronic Acid (Zometa®: 56.9% Group A, 51.8% Group B). A low percentage of students (37.9% Group A, 43.4% Group B) acknowledged the existence of other drugs that could also cause osteonecrosis of the jaws. Regarding the correct resolution of practical cases, the respondents of Group B reached a significantly higher score (5.67) than the score observed in Group A (4.04). Training on medication-related osteonecrosis among dental students is susceptible to improvement. Introducing minor changes in the teachings allows this goal to be successfully achieved

Effects of disease activity on lipoprotein levels in patients with early arthritis: can oxidized LDL cholesterol explain the lipid paradox theory?

Background An increased risk of cardiovascular (CV) complications has been described in patients with rheumatoid arthritis (RA). It is the result of the combined effect of classic CV risk factors and others that are specific to the disease. Methods We assessed data from 448 early arthritis (EA) patients: 79% women, age (median [p25-p75]) at onset: 55 [44?67] years and disease duration at study entry 5 [3?8] months; and 72% fulfilled the 1987 RA criteria at 2?years of follow-up. Rheumatoid factor was positive in 54% of patients and anti-citrullinated peptide antibodies in 50%. The follow-up of patients ranged from 2 to 5?years with more than 1400 visits with lipoprotein measurements available (mean 2.5 visits/patient). Demographic- and disease-related variables were systematically recorded. Total cholesterol (TC), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) levels were obtained from routine laboratory tests. Oxidized-LDL (oxLDL-C) levels were assessed using a commercial ELISA kit. We fitted population-averaged models nested by patient and visit to determine the effect of independent variables on serum levels of TC, its fractions, and oxLDL-C. Results After adjustment for several confounders, high-disease activity was significantly associated with decreased TC, HDL-C, and LDL-C levels and increased oxLDL-C levels. Standardized coefficients showed that the effect of disease activity was greater on oxLDL-C and HDL-C. Interestingly, we observed that those patients with lower levels of LDL-C showed higher oxLDL-C/LDL-C ratios. Conclusions High-disease activity in EA patients results in changes in the HDL-C and oxLDL-C levels, which in turn may contribute to the increased risk of CV disease observed in these patients.Our manuscript was supported by grants RD16/0011/0012, RD16/0011/0009, RD16/0011/0004, PI05/2044, and PI18/0371 from the Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) and co-funded by Fondo Europeo de Desarrollo Regional (FEDER)