Osteocalcin in serum, saliva and gingival crevicular fluid : their relation with periodontal treatment outcome in postmenopausal women

Antecedentes. Los niveles de osteocalcina se han propuesto como marcador de la inhibición de la formación ósea. El propósito de este trabajo es determinar las concentraciones de osteocalcina en plasma, saliva y fluido crevicular correlacionándolo con el resultado del tratamiento periodontal en mujeres postmenopáusicas. Pacientes y métodos. El estudio se realizó en treinta y nueve mujeres postmenopáusicas (57.8 ±8.5 años de edad). El examen periodontal incluyó el control de placa, el sangrado al sondaje, la profundidad de sondaje (PS) y la pérdida de inserción (CAL). Se determinaron los niveles de osteocalcina en suero, saliva y fluido crevicular. A continuación se llevó a cabo el tratamiento periodontal. Pasados seis meses tras la primera cita se llevó a cabo un segundo examen periodontal. Resultados. Las medias de la PS y del CAL disminuyeron significativamente en el segundo examen periodontal en el grupo de mujeres con osteocalcina en suero < 10 ng/ml (15.8± 15.8% y 15.3± 21.2%, respectivamente; p < 0.05). La PS media disminuyó significativamente en el segundo exámen en los grupos con concentraciones de osteocalcina en saliva < 3 ng/ml (17.1± 15.9%; p < 0.05) y 3 ? 7 ng/ml (16.2 ± 18.1%; p < 0.05). Conclusiones. Los niveles bajos de osteocalcina en suero se asocian significativamente a un mayor porcentaje de disminución de la PS y del CAL tras el tratamiento periodontal en mujeres postmenopáusicas. Las bajas concentraciones de osteocalcina en saliva se asociaron significativamente a un mayor porcentaje de disminución de la PS

Papular-purpuric gloves-and-socks syndrome : presentation of a clinical case

Papular-Purpuric Glove-and-Sock Syndrome is a rare, infectious disease, of viral etiology, characterized by the presence of pruritus, edema and symmetrical erythema, very well defined at the wrists and ankles with a gloves-and-socks distribution. Other areas can be affected, with a moderate erythema appearing in cheeks, elbows, knees, armpits, abdomen, groin, external genitalia, internal face of the thighs and the buttocks. Erosions, small ulcers, enanthema and blisters can be observed in the oral cavity and lips, and less frequently in other mucous membranes. Complications are rare, although they can be severe, 50% of the published cases are related with the Parvovirus B19. Due to its oral involvement stomatologists should be aware of this syndrome in order to carry out a correct diagnosis of the disease

Oral lichenoid lesions related to contact with dental materials : a literature review

Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed® and Cochrane® databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC

Parotid sialolithiasis in Stensen´s duct

Salivary duct lithiasis is a condition characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions or sialoliths resulting in salivary ectasia and even provoking the subsequent dilation of the salivary gland. Sialolithiasis accounts for 30% of salivary diseases and most commonly involves the submaxillary gland (83 to 94%) and less frequently the parotid (4 to 10%) and sublingual glands (1 to 7%). The present study reports the case of a 45-year-old male patient complaining of bad breath and foul-tasting mouth at meal times and presenting with a salivary calculus in left Stensen´s duct. Once the patient was diagnosed, the sialolith was surgically removed using local anesthesia. In this paper we have also updated a series of concepts related to the etiology, diagnosis and treatment of sialolithiasis

Effectiveness and safety of guselkumab for the treatment of psoriasis in real-world settings at 24 weeks : A retrospective, observational, multicentre study by the Spanish Psoriasis Group

Altres ajuts: Acord transformatiu CRUE-CSICData on the effectiveness and safety of a drug in real-world clinical practice complement the evidence from clinical trials, which are carried out in a different setting. Little has been published on the effectiveness and safety of guselkumab in the treatment of psoriasis in clinical practice. The ojective of this study was to assess the effectiveness and safety of guselkumab at 24 weeks in patients with moderate to severe plaque psoriasis in routine clinical practice. A retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis treated with guselkumab for at least 24 weeks was carried out in Spain. We studied 343 patients, 249 of whom were followed for 24 weeks. By week 24, the mean (SD) psoriasis area severity index (PASI) had decreased from 11.1 (7.3) to 1.7 (2.8) (−9.3; [−10.2;-8.4]), 85.9% of the patients had achieved PASI score of 4 or less and 77.9% a PASI score of 2 or less. In terms of relative PASI response, 59.4% of the patients achieved a PASI-90 response and 49.0% a PASI-100 response. On multivariate analysis, two factors reduced the probability of a PASI of 2 or less at 24 weeks: a BMI ≥30 (OR, 0.44; 95% CI, 0.22-0.88) and a greater previous exposure to biologic therapy (OR, 0.69; 95% CI, [0.56-0.84]). Adverse events were rare (9.9%) and led to withdrawal from treatment in only nine patients (2.6%) by the end of the follow-up period. The results of this study confirm the high efficacy and safety of guselkumab indicated by the clinical trial data. In clinical practice, the absolute PASI score appears to be a better marker of response to treatment than the relative value

Hyperkalemia in Heart Failure Patients in Spain and Its Impact on Guidelines and Recommendations: ESC-EORP-HFA Heart Failure Long-Term Registry

[Abstract] Introduction and objectives: Hyperkalemia is a growing concern in the treatment of patients with heart failure and reduced ejection fraction because it limits the use of effective drugs. We report estimates of the magnitude of this problem in routine clinical practice in Spain, as well as changes in potassium levels during follow-up and associated factors. Methods: This study included patients with acute (n=881) or chronic (n=3587) heart failure recruited in 28 Spanish hospitals of the European heart failure registry of the European Society of Cardiology and followed up for 1 year. Various outcomes were analyzed, including changes in serum potassium levels and their impact on treatment. Results: Hyperkalemia (K+> 5.4 mEq/L) was identified in 4.3% (95%CI, 3.7%-5.0%) and 8.2% (6.5%-10.2%) of patients with chronic and acute heart failure, respectively, and was responsible for 28.9% of all cases of contraindication to mineralocorticoid receptor antagonist use and for 10.8% of all cases of failure to reach the target dose. Serum potassium levels were not recorded in 291 (10.8%) of the 2693 chronic heart failure patients with reduced ejection fraction. During follow-up, potassium levels increased in 179 of 1431 patients (12.5%, 95%CI, 10.8%-14.3%). This increase was directly related to age, diabetes, and history of stroke and was inversely related to history of hyperkalemia. Conclusions: This study highlights the magnitude of the problem of hyperkalemia in patients with heart failure in everyday clinical practice and the need to improve monitoring of this factor in these patients due to its interference with the possibility of receiving optimal treatment.[Resumen] Introducción y objetivos. La hiperpotasemia es una preocupación creciente en el tratamiento de los pacientes con insuficiencia cardiaca y fracción de eyección reducida, pues limita el uso de fármacos eficaces. Este trabajo ofrece estimaciones de la magnitud de este problema en la práctica clínica habitual en España, los cambios en las concentraciones de potasio en el seguimiento y los factores asociados. Métodos. Pacientes con insuficiencia cardiaca aguda (n = 881) y crónica (n = 3.587) seleccionados en 28 hospitales españoles del registro europeo de insuficiencia cardiaca de la European Society of Cardiology y seguidos 1 año para diferentes desenlaces, incluidos cambios en las cifras de potasio y su impacto en el tratamiento. Resultados. La hiperpotasemia (K+ > 5,4 mEq/l) está presente en el 4,3% (IC95%, 3,7-5,0%) y el 8,2% (6,5-10,2%) de los pacientes con insuficiencia cardiaca crónica y aguda; causa el 28,9% de todos los casos en que se contraindica el uso de antagonistas del receptor de mineralocorticoides y el 10,8% de los que no alcanzan la dosis objetivo. Del total de 2.693 pacientes ambulatorios con fracción de eyección reducida, 291 (10,8%) no tenían registrada medición de potasio. Durante el seguimiento, 179 de 1.431 (12,5%, IC95%, 10,8-14,3%) aumentaron su concentración de potasio, aumento relacionado directamente con la edad, la diabetes mellitus y los antecedentes de ictus e inversamente con los antecedentes de hiperpotasemia. Conclusiones. Este trabajo destaca el problema de la hiperpotasemia en pacientes con insuficiencia cardiaca de la práctica clínica habitual y la necesidad de continuar y mejorar la vigilancia de este factor en estos pacientes por su interferencia en el tratamiento óptimo

Comparative study of classical and numerical taxonomic methods for infraspecific taxa of Triticum aestivum L. traditionally cultivated in Galicia (NW Spain)

Application of classical taxonomic methods of Trificurn es! •!i L. to traditional Galician wheats suggests the existence of four varieties. However, morphological characters used for identification of varieties are not well delimited and display frequently a continuity which makes it difficult to establish limits among them. Numerical taxonomic methods consisted of an Analysis of Principal Components and an Association Analysis using the routines Factor and Quick cluster from the statistics package SPSS-PC+. This analysis indicates the poor discriminatory power of morphological characters_ Three classes were obtained by numerical taxonomic methods and no one would agree with the level of variety. Since traditional varietal differentiation for Galician wheats cannot be justified by numerical taxonomy neither classical taxonornics methods, it should be advisable not to use the level of variety for Galician wheat