158 resultados para Gengivite ulcerativa necrosante
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The case of a patient with ulcerative colitis and isolated sacro-ileitis is presented. She suffered reactivation of the intestinal disease with diclofenac. The patient was allergic to sulfasalazine and was using fish oil fatty acid. The possible mechanisms of reactivation of the inflammatory bowel disease with non-steroidal anti-inflammatory drugs are discussed. It is suggested when necessary the utilization of non-steroidal anti-inflammatory drugs that inhibits the lipoxygenase in these patients.
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Disease activity was assessed in 10 (five males and five females) ulcerative colitis patients through the following parameters: clinical, laboratory, sigmoidoscopic and histological. Protein metabolism was also assessed with 15N-glycine and urinary ammonia as end product. Only one patient had exacerbation of the disease two months after the study started. This patient presented in the beginning of the study protein synthesis and breakdown of 4.51 and 3.47 g protein/kg/day, respectively, values higher than all other patients, showing an hypermetabolic state, suggesting an increase of the disease activity. However, this increase was not detected by others indicators and indexes utilised. These data allow to suggest the hypothesis that protein metabolism predicts precociously the exacerbation of disease activity in ulcerative colitis patients.
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The first option for the treatment of UC is both: salicylates or corticoids. Recently, in late November of 2006, the Brazilian Ministry of Health has approved infliximab (Remicade c, Mantecorp, Brazil) to treat ulcerative colitis. We report the use of infliximab as a first option for the treatment of two patients with severe ulcerative colitis. Case report: Patient 1: AZF, 52 years-old, female, was first diagnosed with UC after history and clinical examination; colonoscopy showed pancolitis with positive biopsy (crypt microabscess). Her Mayo score was 10 (range: 0 to 12/asymptomatic to severe colitis). She received intra venous infusion of infliximab at a dose of 5mg/Kg of body weigh at week 0, 2, 6 and 14. Then, patient was given mesalazine 4.5 g/day for maintenance therapy. Clinical response was defined as a decreased from baseline in the total Mayo score of at least 3 points. At present, patient is asymptomatic with Mayo score of 3 one moth after the last dose of infliximab. Patient 2: MLA, 45 years-old, female was first diagnosed with bloody diarrhea; colonoscopy showed left colitis and the biopsy was positive for ulcerative colitis. Her Mayo score was 9. She was offered and accepted the step down treatment. She was given infliximab 5mg/Kg of body weight at week 0, 2, 6 and 14. After initial treatment with infliximab, she received mesalazine 4.2 g/day. At present, she is asymptomatic with Mayo score of 2 eighteen days after the last dose of infliximab. At our knowledge, this is the first Brazilian report of the use of infliximab as fist-line therapy in ulcerative colitis. Few days after the begging of the infusion, an impressive clinical and colonoscopy improvement was seen in these two patients. Recently, it has been reported the use of infliximab as first-line therapy in pediatric Crohn disease. Infliximab could be a good option in cases of moderate and severe UC to avoid the side effects of the use of high doses of corticoids in patients with moderate and severe UC. However, the question if step-down therapy in ulcerative colitis is better then conventional therapy with salicylates and corticoids needs to be answered by randomized trials.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The aim of this case report is present a case in which the patient had plasma cell gingivitis induced by consumption of pepper. Patient A.M.S., male, 23 years, presented himself at the Clinic of Periodontology, complaining of severe pain, bleeding gums and tooth mobility. Interview was conducted not observing anything relevant. In oral evaluation, we observed in the anterior swollen gums, bleeding, suppuration and great touch, and tooth mobility. Being an aggressive framework in relation to patient age, we performed the following laboratory tests: complete blood count, blood sugar, and coagulation, and biopsy in the anterior inferior, because a diagnosis of lymphoma. At the end of antibiotic therapy, a significant improvement of clinical symptoms, pain relief, less swollen gums and reduce the suppuration and mobility. Laboratory tests showed no change. Fifteen days later, the patient returned with worsening of clinical status. The pathological diagnosis was plasma cell gingivitis and then performed a new history by placing greater emphasis on dietary habits, and the patient reported consumption of pepper in their meals, and relate this to clinical presentation. After elimination of pepper diet the patient showed remission of clinical data.
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Ulcerative colitis is a chronic disease characterized by inflammation in the intestinal mucosa, in most cases affects the colon and rectum. The therapeutic drugs are used as aminosalicylates and glucocorticosteroids, but due to the low response and the various side effects caused by them, reveals the need to search for new sources of useful compounds in the treatment of this disease.The species Anacardium occidentale popularly known as cashew, has been used for centuries in folk medicine in the healing aid of skin and mucosa lesions.Recent studies show its expressive antiulcerogenic effect, what we instigated to assess the effect of the extract of A. occidentaleleaves in rats with acute ulcerative colitis, therefore, 42 rats were used male Wistar, divided into 06 groups, and Negative Control (C) Positive Control (C +), treated with Sulfasalazine (Sz500) and treated with Extract A. occidentale at doses of 50 (Ao50), 100 (Ao100) and 200 mg / kg (Ao200).All groups were submitted to experimental colitis Ulcerative except C-, moreover, C- and C + received saline via gavage for 7 consecutive days while the other groups received their respective treatments.Euthanasia of animals took place on the 8th day in which it was collected intestinal colon sample for later analysis macroscopic, histopathological, morphometric and biochemistry, as well as complementary collection of blood and liver tissue. The extract is rich in saponins and phenolic compounds such as flavonoids (quercetin and kaempferol) and tannins.When the Sz500 groups and 100 showed significant protection to damage to lipids and proteins, among the groups subjected to experimental ulcerative colitis, the animals Ao100 group obtained the lowest score in all parameters analyzed.Treatment with 100 mg / kg of A. occidentale extract seems to have a combination of antiinflammatory, antioxidant, bactericidal and anabolic promoted by the bioactive compounds present in the extract.However, it is necessary to investigate harder treating dose of 100mg / kg to higher doses compared to elucidate more properly the best therapeutic dosage ulcerative colitis.
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Inflammatory bowel diseases is composed by a set of chronic and inflammatory disorders, among them is ulcerative colitis (UC). UC treatment is based on anti-inflammatory administration; however, this group of drugs clearly leads to development of undesirable side effects, what stimulate the search for new therapies alternatives. The aim of this study was to evaluate the effect of hydroalcholic Turnera subulata extract on acetic acid-induced acute UC in rats. UC was induced by 1 mL injection of 4% acetic acid via rectal in Wistar mouse. 42 animals were distributed among 6 experimental groups: Control, UC, Sulfasalazine 500 mg/Kg/day (SSZ), T. subulata 50mg/Kg/day (TS 50), T. subulata 100mg/Kg/day (TS 100), T. subulata 200mg/Kg/day (TS 200). Throughout the experiment, body weight, food and water ingestion was daily evaluated. At the end of the experiment, the animals were euthanized and a colon fragment was observed by macroscopic analysis. Colon fragments were also collected for microscopic analysis and oxidative stress evaluation. The means from each group was compared by ANOVA test with a significance level of 5% (p<0.05) using GraphPad Prism Software. As results, we can clearly observe that SSZ group had the greater body weight decrease among the groups throughout the experiments, 14.78%, as well as, the lowest food intake, 6.23 g of food/day. The animals treated with T. subulata extracts showed no important body weight loss when compared to control. UC group showed the highest tissue damage macroscope score, 6.5, while TS 50 showed the lowest tissue damage score: 1. Microscope evaluation showed the presence of edema, haemorraghia and ulceration in all group of animals, except for Control. Nevertheless, TS 50 showed the lowest inflammatory damage among all groups. Oxidative stress analysis revealed that T. subulata treatment modulate catalase and superoxide dismutase activity, we also observed a decrease in protein and lipid peroxidation in response to extract administration. Taken together, these results shows that T. subulata extract exerts anti-inflammatory and anti-oxidant effects on experimental UC.
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Inflammatory bowel diseases is composed by a set of chronic and inflammatory disorders, among them is ulcerative colitis (UC). UC treatment is based on anti-inflammatory administration; however, this group of drugs clearly leads to development of undesirable side effects, what stimulate the search for new therapies alternatives. The aim of this study was to evaluate the effect of hydroalcholic Turnera subulata extract on acetic acid-induced acute UC in rats. UC was induced by 1 mL injection of 4% acetic acid via rectal in Wistar mouse. 42 animals were distributed among 6 experimental groups: Control, UC, Sulfasalazine 500 mg/Kg/day (SSZ), T. subulata 50mg/Kg/day (TS 50), T. subulata 100mg/Kg/day (TS 100), T. subulata 200mg/Kg/day (TS 200). Throughout the experiment, body weight, food and water ingestion was daily evaluated. At the end of the experiment, the animals were euthanized and a colon fragment was observed by macroscopic analysis. Colon fragments were also collected for microscopic analysis and oxidative stress evaluation. The means from each group was compared by ANOVA test with a significance level of 5% (p<0.05) using GraphPad Prism Software. As results, we can clearly observe that SSZ group had the greater body weight decrease among the groups throughout the experiments, 14.78%, as well as, the lowest food intake, 6.23 g of food/day. The animals treated with T. subulata extracts showed no important body weight loss when compared to control. UC group showed the highest tissue damage macroscope score, 6.5, while TS 50 showed the lowest tissue damage score: 1. Microscope evaluation showed the presence of edema, haemorraghia and ulceration in all group of animals, except for Control. Nevertheless, TS 50 showed the lowest inflammatory damage among all groups. Oxidative stress analysis revealed that T. subulata treatment modulate catalase and superoxide dismutase activity, we also observed a decrease in protein and lipid peroxidation in response to extract administration. Taken together, these results shows that T. subulata extract exerts anti-inflammatory and anti-oxidant effects on experimental UC.
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Antecedentes: la enterocolitis necrosante es la enfermedad gastrointestinal médica y quirúrgica más frecuente de la etapa neonatal. Objetivo: conocer su prevalencia y sus factores de riesgo en recién nacidos de 1,000 a 1,500 g en la unidad de cuidados intensivos eonatales del Hospital Universitario Dr. José Eleuterio González. Material y métodos: estudio observacional, analítico, retrospectivo de casos y controles. Se recopilaron los datos de los expedientes clínicos de los pacientes nacidos en el Hospital Universitario durante el periodo del 1 de agosto del 2005 al 31 de julio del 2006 con peso de 1,000 a 1,500 g. Se excluyeron pacientes que nacieron en otro hospital o que tuvieran malformaciones congénitas. Se analizaron los datos mediante las pruebas de la χ2, la t de Student y razón de momios. Resutados: de los 55 pacientes que reunieron los criterios de inclusión, 18% tuvieron enterocolitis necrosante grado II o mayor. Se encontraron como factores de riesgo con significación estadística al Apgar de 0 a 6 al primer minuto, uso de presión positiva continua nasal, uso de aminofi lina y sepsis tardía (p < 0.05). Conclusiones: su prevalencia es mayor en el hospital en donde se efectuó el presente estudio que la reportada en países desarrollados o en hospitales privados de países en vías de desarrollo, pero con menor mortalidad. Los factores de riesgo con significación estadística fueron los relacionados con episodios de isquemia, reperfusión e infección.
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O objetivo deste estudo foi determinar os níveis de interleucina-1β (IL-1 β), IL-2, IL-4, IL-8, interferon-γ (IFN-γ) e a atividade de elastase no fluido gengival (FG) de pacientes com periodontite crônica generalizada (PCG) e periodontite agressiva generalizada (PAgG), e correlacionar com indivíduos de um grupo controle com gengivite apenas. Um objetivo secundário foi analisar o perfil microbiológico subgengival destes indivíduos. Dados clínicos transversais foram obtidos de 20 pacientes com PCG, 17 pacientes com PAgG e 10 indivíduos com gengivite. Amostras de FG foram coletadas com tiras de papel e os níveis de: IL-1β, IL-2, IL-4, IL-8 e IFN-γ foram medidos, utilizando um imunoensaio do tipo multiplex (Luminex). Atividade da elastase foi avaliada por um ensaio enzimático. Amostras de placa subgengival foram analisadas através do checkerboard DNA-DNA hybridization. As diferenças de significância entre os grupos para dados imunológicos e microbiológicos foram realizadas utilizando o teste Kruskal-Wallis, ajustando para múltiplas comparações. As médias dos parâmetros clínicos e os volumes de FG foram maiores nos pacientes com PCG e PAgG comparados ao grupo gengivite. Níveis mais elevados de IL-1β e atividade de elastase foram encontrados em sítios profundos quando comparado a sítios rasos em ambos os grupos com periodontite (p <0,05). Os dados microbiológicos apresentaram níveis significativamente mais elevados das espécies do complexo vermelho em pacientes com PCG e PAgG, quando comparados aos indivíduos com gengivite (p <0,05). Não houve diferença estatisticamente significante nos níveis de biomarcadores no FG e nos níveis de espécies bacterianas subgengivais entre pacientes com PCG e pacientes com PAgG. Sendo assim, concluímos que os dados do presente estudo não mostraram diferença estatisticamente significante nos parâmetros imunológicos e microbiológicos medidos entre indivíduos com PCG e PAgG.