Osteonecrosis de los maxilares: Documento de consenso

Nuestro objetivo ha sido elaborar un documento de posición sobre el riesgo de desarrollar una osteonecrosis de maxilares (ONM) en los pacientes que reciben bifosfonatos para el tratamiento de la osteoporosis, identificando y valorando el grado de evidencia que apoyan las recomendaciones. Para ello se revisaron los estudios publicados sobre la definición, epidemiología, fisiopatología, clínica, diagnóstico y tratamiento de la ONM, elaborándose tras su análisis las presentes recomendaciones. Éstas se efectuaron tras un proceso pre-especificado y reproducible, que incluyó un modelo aceptado para la evaluación y la cita de la evidencia que las apoyaban. El documento, una vez elaborado por los coordinadores, fue revisado y discutido por todos los miembros del panel, elaborándose las recomendaciones provisionales que finalmente fueron estudiadas y aprobadas por los expertos de las sociedades médicas relacionadas con el metabolismo mineral óseo, que se muestran en el Anexo 2

A retrospective case-control study of hepatitis C virus infection and oral lichen planus in Japan: association study with mutations in the core and NS5A region of hepatitis C virus

<p>Abstract</p> <p>Background</p> <p>The aims of this study were to assess the prevalence of hepatitis C virus (HCV) infection in Japanese patients with oral lichen planus and identify the impact of amino acid (aa) substitutions in the HCV core region and IFN-sensitivity-determining region (ISDR) of nonstructural protein 5A (NS5A) associated with lichen planus.</p> <p>Methods</p> <p>In this retrospective study, 59 patients (group 1-A) with oral lichen planus among 226 consecutive patients who visited our hospital and 85 individuals (group 1-B, controls) with normal oral mucosa were investigated for the presence of liver disease and HCV infection. Risk factors for the presence of oral lichen planus were assessed by logistic regression analysis. We compared aa substitutions in the HCV core region (70 and/or 91) and ISDR of NS5A of 12 patients with oral lichen planus (group 2-A) and 7 patients who did not have oral lichen planus (group 2-B) among patients (high viral loads, genotype 1b) who received interferon (IFN) therapy in group1-A.</p> <p>Results</p> <p>The prevalence of anti-HCV and HCV RNA was 67.80% (40/59) and 59.32% (35/59), respectively, in group 1-A and 31.76% (27/85) and 16.47% (14/85), respectively, in group 1-B. The prevalence of anti-HCV (<it>P </it>< 0.0001) and HCV RNA (<it>P </it>< 0.0001) in group 1-A was significantly higher than those in group 1-B. According to multivariate analysis, three factors - positivity for HCV RNA, low albumin level (< 4.0 g/dL), and history of smoking - were associated with the development of oral lichen planus. The adjusted odds ratios for these three factors were 6.58, 3.53 and 2.58, respectively, and each was statistically significant. No significant differences in viral factors, such as aa substitutions in the core region and ISDR of NS5A, were detected between the two groups (groups 2-A and -B).</p> <p>Conclusion</p> <p>We observed a high prevalence of HCV infection in patients with oral lichen planus. Longstanding HCV infection, hypoalbuminemia, and smoking were significant risk factors for the presence of oral lichen planus in patients. It is advisable for Japanese patients with lichen planus to be tested for HCV infection during medical examination.</p

Pênfigo vegetante: relato de caso Pemphigus vegetans: case report

Pênfigo é uma doença bolhosa auto-imune. É uma doença rara, mas potencialmente fatal. Existem quatro variantes clínicas e patológicas: o pênfigo vulgar (PV), o pênfigo vegetante (PVg), o pênfigo foliáceo (PF), o pênfigo eritematoso. Ao exame histo-patológico o achado comum a todos os tipos de pênfigo é a acantólise. Relatamos o caso de um paciente de 43 anos com lesões ano-perineais cujo diagnóstico final foi de pênfigo vegetante, associado à HPV (Papiloma Vírus Humano), com revisão da literatura.<br>Pemphigus is a bollous auto-immune disease. It's a rare disease, but potentially fatal. There are four clinical and pathological variants: pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus and pemphigus erythematosus. Through the histopathological exam, the common characteristic to all types of pemphigus is the acantholyse. It's reported a case of a pacient of 43 years old with anal and perineal blesses witch final diagnosis was pemphigus vegetans, associated to HPV (Human Papilloma Virus), with literature review