Oral manifestations during chemotherapy for acute lymphoblastic leukemia: A case report

A 14-year-old, male patient was referred for the treatment of mucositis, idiopathic facial asymmetry, and candidiasis. The patient had been undergoing chemotherapy for 5 years for acute lymphoblastic leukemia. He presented with a swollen face, fever, and generalized symptomatology in the mouth with burning. On physical examination, general signs of poor health, paleness, malnutrition, and jaundice were observed. The extraoral clinical examination showed edema on the right side of the face and cutaneous erythema. On intraoral clinical examination, generalized ulcers with extensive necrosis on the hard palate mucosa were observed, extending to the posterior region. Both free and attached gingivae were ulcerated and edematous with exudation and spontaneous bleeding, mainly in the superior and inferior anterior teeth region. The tongue had no papillae and was coated, due to poor oral hygiene. The patient also presented with carious white lesions and enamel hypoplasia, mouth opening limitation, and foul odor. After exfoliative cytology of the affected areas, the diagnosis was mixed infection by Candida albicans and bacteria. Recommended treatment was antibiotics and antifungal administration, periodontal prophylaxis, topical application of fluor 1.23%, and orientation on and control of proper oral hygiene and diet during the remission phase of the disease.

Injeção epidural de cetamina ou cetamina levógira no controle da dor pós-incisional, em eqüinos

The aim of this study was to evaluate the pre-emptive effect of epidural ketamine S (+) (SK) or racemic ketamine (RK) administration, in post-incisional pain in horses. Were used in a blinded, randomized experimental study, sixteen mixed breed mares, 6±2 years old, weighting 273.2±42.0 kg. An epidural catheter was inserted 24 hours before the trials. The thigh region was shaved bilaterally, and mechanical cutaneous sensibility was measured using von Frey filaments (T-30). Using the left side as the control one, local anesthesia was performed at the right side. Twenty-five minutes later, SK was injected in G1 or RK in G2 through the epidural catheter. Five minutes after the ketamine injection, a 10 cm skin incision was made on the right side, and then sutured. Mechanical post-incisional pain was measured using von Frey filaments, at 1, 3 and 5 cm around the incision at 15 minutes intervals, for 2 hours, then 4, 6 and 8 hours after suturing. No changes were observed in the heart and respiratory rate and rectal temperature among groups or times of each group. Hind limb ataxia was observed in 62.5% and 12.5% of G1 and G2 respectively. SK and RK reduced cutaneous sensibility in the right and the left sides to mechanical postincisional pain during all time of experiment. Epidural SK and RK produce similar post-incisional analgesic effects, did not interfere in the cardio-respiratory parameters. The SK induces more intense ataxia in mares and presents a larger analgesic potency in the first 60 minutes after the administration.

Anatomia do nervo isquiático em mocós (Kerodon rupestris WIED, 1820) aplicada a clínica de animais silvestres

To know the origin of the ischiatic nerve in mocos (Kerodon rupestris Wied,1820) near by intervertebral forames and the muscling belonging to its routes were used 10 adult animals, from CEMAS-ESAM. After natural obit, they were fixed in formol (10%) and dissected to exposition and to singt of the ischiatic nerve. The results were indicated in percentage. Variations in the quantity of the lumber and sacral vertebras nere observed, five animals (50,00%) reveled seven lumbar vertebras and three sacral ones; two animals recrealed seven lumbar vertebras and four sacral ones, and two animals reveled six lumbar vertebras and three sacral ones. An animal (10,00%) revealed six lumbar vertebras and four ones. Therefore, the origin of the nerve was differentiated five animals (50,00%) had the participation of L 7,S 1,S 2; two animals (20,00%) with L 7,S 1; and a little part of S 2. Two animals (20,00%) with L 6,S 1,S 2, and an animal (10,00%) with L 6,S 1, and a little part of S 2. The last root of the ischiatic nerve in all its origins, contribute to the constitution of the first root of pudental nerve. It was verified that in all its route, the ischiatic nerves (100,00%) ceded branches to the muscles: medial gluteus, deep gluteus, superficial gluteus, emiting muscular branches to the femoral biceps or to thigh, and to the semimembranous and semi-tendinous muscles, that is continuous with a high calibre trunk, originating the fibular nerve(sideways), the tibial nerve(medial) and the lateral plantar sural cutaneous nerve (caudal).

Modelagem molecular aplicada ao desenvolvimento de moléculas com atividade antioxidante visando ao uso cosmético

Some hypotheses and constants studies are made with intention to elucidate the aging process. To prevent and to attenuate the cutaneous aging it becomes necessary to strengthen our endogenous antioxidant natural defenses. Diverse exogenous antioxidant substances, as vitamins, vegetal extracts and others, have been used by the Cosmetology in antiaging products. The objective of this paper is to show how the Molecular Modeling can be an useful tool in the research for new antioxidant cosmetic substances to face the cutaneous aging.

Sporotrichosis in an HIV-positive man with oral lesions: A case report

Background: Sporotrichosis is a granulomatous fungal infection caused by Sporothrix schenckii, which frequently causes cutaneous or lymphocutaneous lesions and rarely has oral manifestations. Case: A 38-year-old, white, HIV-positive man complained of a 5.0-cm, symptomatic, ulcerated lesion with thin, superficial granulation in the soft palate extending to the uvula. Exfoliative cytology of this oral lesion showed chronic granulomatous inflammatory alterations and extracellular fungal structures consisting of periodic acid-Schiff-positive budding cells and spherical or elongated (cigar bodies) free spore forms. Conclusion: The clinical and cytologic findings allowed the diagnosis of sporotrichosis, demonstrating the importance of cytodiagnosis in fungal diseases. © The International Academy of Cytology.

Conservative treatment of patients with periapical lesions associated with extraoral sinus tracts

This paper describes the clinical courses of three cases with extra-oral sinus tract formation, from diagnosis and treatment to short-term follow-up and evaluation. All teeth involved had periradicular radiolucent areas noted on radiographic examination and extra-oral sinus tracts appearing on the chin with exudation and unpleasant aesthetic appearance. The adopted treatment protocol included treating the sinus tract surface simultaneously with the root canal therapy. After root canal shaping using 5.25% sodium hypochlorite solution, calcium hydroxide-based pastes associated with different vehicles were inserted into the root canal for 4 months, and were changed monthly. All the sinus tracts healed in 7 to 10 days. The apical lesions were completely repaired in a maximum period of 24 months. The treatment adopted provided a complete healing of the periapical lesions in a short follow-up period. Surgical repair of the cutaneous sinus tract was therefore unnecessary. © 2007 The Authors. Journal compilation © 2007 Australian Society of Endodontology.

Flebotomíneos (Diptera, Psychodidae) de área de cerrado no Município de Corumbataí, Centro-leste do Estado de São Paulo, Brasil.

Distribution and ecology knowledge of sandfly species is essential for epidemiology vigilance and risk determination for transmission of leishmaniasis. Sandfly trapping was carried out in a cerrado strictu sensu vegetation fragment in a rural area of Corumbataí Municipality, São Paulo State, Brazil, during July to November 2004. Two CDC light traps were used from 18h to 8h, once a month, resulting in 112 total hours of capture. During this period, 60 sandfly specimens of ten different species were sampled. The most abundant species and the one found in all captures was Pintomyia monticola totalizing 15 (25.0%) specimens, the second more abundant one was P. pessoai with 14 (23.3%) and the third one was Brumptomyia guimaraesi with 12 (20.0%) individuals collected. Other captured species were Psathyromyia aragaoi, B. avellari, B. brumpti, B. cunhai, P. bianchigalatiae, Evandromyia termitophila and Nyssomyia whitmani which corresponded to 19 (31.2%) specimens captured. Pintomyia pessoai and N. whitmani presence indicates transmission risk of American Cutaneous Leishmaniasis in the area.

Paracoccidioidomicose é esporotricose associada à imunossupressão

Paracoccidioidomycosis is caused by Paracoccidioides brasiliensis, a dimorphic fungus, prevalent in tropical and subtropical America. It is rare in the United States of America, Canada, Asia and Europe and in these countries it is related to immigrants from endemic areas. Paracoccidioidomycosis associated with immunosuppression runs a course with rapid progression and dissemination of the disease, with many cutaneous lesions. The mortality rate is up to 35% when associated with HIV infection or AIDS. The diagnosis depends on visualization of the agent through direct examination, histopathology, or culture. First choice treatment is done with Amphotericin B deoxycholate. Itraconazole is an option for long term treatment. Sporotrichosis is caused by Sporothrix schenckii, the species of reference. Other species have been considered such as: Sporothrix brasiliensis, S.globosa and S.mexicana and the S.schenckii var. lurei. It is a ubiquitous disease although more prevalent in tropical and subtropical areas. Currently, it has been reported as a zoonotic disease of cats and dogs, with transmission to their owners in the city of Rio de Janeiro (Brazil). Sporotrichosis associated to immunosuppression is uncommon or underreported. There were 34 cases in association with HIV infection or AIDS reported so far. Presenting with disseminated disease and non cutaneous lesions including joints, lungs and central nervous system. Amphotericin B deoxycholate is the first choice for treatment and itraconazol considered an alternative.

Oral stomatitis induced by endogenous progesterone: Case report

Oral stomatitis induced by endogenous progesterone is a rare clinical condition which may be associated with cutaneous involvement. That is probably due to the peak of progesterone production during the luteal phase of the menstrual cycle. In the present case report, a 21-year-old patient displayed recurrent ulcerative lesions located on the buccal mucosa or the upper lip, on a monthly basis since the age of 15. Such lesions would always manifest themselves on the second day until the end of the menstrual cycle. © 2009 Informa UK Ltd All rights reserved.

Incontinentia pigmenti presenting as hypodontia in a 3-year-old girl: A case report

Introduction. Incontinentia pigmenti or Bloch-Sulzberger syndrome is a rare X-linked dominant disease that mainly affects the skin, eyes, hair, central nervous system and teeth. The disease is predominant among women. Although dermatologic manifestations are among the most important aspects for the diagnosis of the syndrome, they are less damaging to the patient and do not require treatment. However, oral involvement characterized by hypodontia of deciduous and permanent teeth is important for the diagnosis and treatment of the patient. Case presentation. We report the case of a 3-year-old girl with ophthalmologic and neurologic disturbances, cutaneous manifestations and hypodontia. Since the patient did not present more damaging manifestations such as neurologic and/or ophthalmologic problems, her most severe complications were related to dental anomalies. The importance of integrated dental treatment, which combines pediatric dentistry, orthodontics and conventional prosthesis, is emphasized. Conclusion. Hypodontia is a frequent finding in incontinentia pigmenti, and dentists should be aware of this condition in order to help with the diagnosis. © 2009 Kitakawa et al; licensee BioMed Central Ltd.

Eficácia do extrato aquoso do Triticum vulgare no tratamento de radiodermatites geradas pelo uso da radioterapia em gatos

The use of ionizing radiation in the treatment of oncological diseases in veterinary medicine has grown in recent years. In general, these animals are very well tolerated by the treatment with radioactive elements; however, the harmful effects that may occur are not always able to be controlled, particularly those relating to skin burns. Then, the purpose of this study was to evaluate the effects of aqueous extract of Triticum vulgare in treat of 10 cats radiodermatitis with squamous cell carcinoma (SCC), which were treated with radiotherapy as single modality treatment. The drug was used topically and daily until complete healing of wounds. Based on the findings, it may concluded beneficial effects of the drug, because it allowed the formation of granulation tissue and epithelization of wounds with epidermal repair not exuberant, good-quality cosmetics and, considering the deleterious effects that can result from cancer treatments.

Avaliação histológica e morfométrica do retalho axial oris angularis e da terapia por ondas de choque aplicados a defeito palpebral experimental em cães

Considering that the cutaneous flap can be affected by isquemic complications the extra corporeal shock wave therapy (ESWT) was described as rescue techniques. The present study was developed to analyze histological and with morfometry, twenty one skin samples treated or not with the shock wave therapy, obtained from flap's distal border, used in this study to repair eyelids' experimental defects in dogs. The flap with or without ESWT did not show any histological sign of inflammatory or atrophic alterations. Both group treated showed similar morphometrical characteristics. The ESWT with the protocol used in this study (2500 impulses at 0,15 mJ/mm 2) did not demonstrate significant clinical outcomes as a rescue technique when applied over the oris angularis flap, however results showed no signals of collateral deleterious effects.

Aparecimento de psoríase durante o tratamento das doenças inflamatórias intestinais com infliximabe: A terapia biológica deve ser suspensa?

Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

Ocorrência de anticorpos contra Leishmania spp., Neospora caninum e Toxoplasma gondii em soros de cães atendidos no Hospital Veterinário da Universidade Estadual de Londrina-Pr

The aim of this study was to detect the presence of IgG antibodies anti-Leishmania spp., Toxoplasma gondii and Neospora caninum in dogs from a Veterinary Hospital from Universidade Estadual de Londrina. Blood samples from 112 animals were obtained by jugular venipuncture to obtain sera. The samples were tested by indirect immunofluorescence to detect antibodies anti-Leishmania spp., anti-N. caninum and anti-T. gondii. Thirteen (11.61%), 25 (22.32%), and 57 (50.89%) samples were positive for Leishmania spp., N. caninum, and T. gondii, respectively. The co-presence of anti-Leishmania spp. and N. caninum was observed in 6 (5.36%), anti-Leishmania spp. and anti-T. gondii in 8 (14.7%), and anti-N. caninum and anti-T. gondii in 18 (16.07%) samples. The co-presence of anti-Leishmania spp., anti-N. caninum and anti-T. gondii was observed in 5 (4.46%) dogs. There was a higher prevalence of Leishmania in Toxoplasma and Neospora positive animals, however, these results were not statistically significant (range p = 0.052 p = 0.06). The dogs have an important role in the epidemiological cycle of these diseases, which are important in animal and public health. The northern state of Paraná is an endemic area for human cutaneous leishmaniasis, therefore, studies should be conducted to uncover the real role of dogs as reservoirs of Leishmania to humans in the state.

Paraventricular nucleus of the hypothalamus glutamate neurotransmission modulates autonomic, neuroendocrine and behavioral responses to acute restraint stress in rats

In the present study, the involvement of paraventricular nucleus of the hypothalamus (PVN) glutamate receptors in the modulation of autonomic (arterial blood pressure, heart rate and tail skin temperature) and neuroendocrine (plasma corticosterone) responses and behavioral consequences evoked by the acute restraint stress in rats was investigated. The bilateral microinjection of the selective non-NMDA glutamate receptor antagonist NBQX (2 nmol/ 100 nL) into the PVN reduced the arterial pressure increase as well as the fall in the tail cutaneous temperature induced by the restraint stress, without affecting the stress-induced tachycardiac response. On the other hand, the pretreatment of the PVN with the selective NMDA glutamate receptor antagonist LY235959 (2 nmol/100 nL) was able to increase the stress-evoked pressor and tachycardiac response, without affecting the fall in the cutaneous tail temperature. The treatment of the PVN with LY235959 also reduced the increase in plasma corticosterone levels during stress and inhibited the anxiogenic-like effect observed in the elevated plus-maze 24 h after the restraint session. The present results show that NMDA and non-NMDA receptors in the PVN differently modulate responses associated to stress. The PVN glutamate neurotransmission, via non-NMDA receptors, has a facilitatory influence on stress-evoked autonomic responses. On the other hand, the present data point to an inhibitory role of PVN NMDA receptors on the cardiovascular responses to stress. Moreover, our findings also indicate an involvement of PVN NMDA glutamate receptors in the mediation of the plasma corticosterone response as well as in the delayed emotional consequences induced by the restraint stress. © 2012 Elsevier B.V. and ECNP.