Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study.

BACKGROUND: To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. METHODS: Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. RESULTS: Forty-one children (31 girls and 10 boys) from 6 pediatric hospitals in Switzerland diagnosed between 1995 and 2010 were included in the study. The diagnosis was multifocal CNO (n = 33), unifocal CNO (n = 4) and SAPHO syndrome (n = 4). Mean age at onset of CNO was 9.5 years (range 1.4-15.6) and mean follow-up time was 52 months (range 6-156 months). Most patients (n = 27) had a chronic persistent disease course (>6 months), 8 patients had a course with one or more relapses and 6 patients had only one episode of CNO. Forty nine percent had received at least one course of antibiotics. In 57% treatment with nonsteroidal anti-inflammatory drugs (NSAID) was sufficient to control the disease. Twelve out of 16 children with NSAID failure subsequently received corticosteroids, methotrexate, TNF α inhibitors, bisphosphonates or a combination of these drugs. CONCLUSIONS: In a multicenter cohort of 41 children 22% started with unifocal lesion with a significant diagnostic delay. A higher proportion presented with chronic persistent disease than with a recurrent form. An osteomyelitis in the pelvic region is significantly associated with other features of juvenile spondylarthritis.

A comparative study of the intercellular connections between parasite/host in two Gelidiocolax/Gelidium algal parasitic systems

Comparative ultrastructural study of the intercellular connections between parasite and host cells in two algal parasitic systems, Gelidiocolax christianae Feldmann and Feldmann/Ge/iV/ium spathulatum (Kutz.) Bornet and Gelidiocolax deformans Seoane Camba/Gelidium sesquipedale (Clem.) Thur, shows quantitative and structural differences. The number of free conjunctor cells (before fusión with the adjacent host cells) differs between the two parasitic systems and is inversely related to the number of complex pit connections. The fibrillar cell wall structure of the conjunctor cells and the lamellar structure of the complex pit plugs in the two systems are also different A hypothesis concerning the different activity of the conjuntor cell wall in the two parasitic systems, related with the different structural appearance, is proposed.

El costo de la atención ambulatoria del lupus eritematoso sistémico en Colombia. Contrastes y comparaciones con otras poblaciones.

Introducción: el lupus eritematoso sistémico (LES) es considerado una enfermedad de alto costo. La expresión clínica de la enfermedad depende de la ubicación geografía y la etnicidad. El objetivo de este estudio fue el calcular los costos ambulatorios relacionado al LES en una cohorte colombiana, identificar los predictores de costos y comparar nuestro resultados con otras poblaciones. Métodos: Se realizó una aproximación de tipo prevalencia en 100 pacientes LES en quienes se evaluaron los costos directos médicos, directos no médicos, indirectos e intangibles. Todos los costos médicos fueron evaluados usando una metodología abajo hacia arriba. Los costos directos fueron valorados desde una perspectiva social usando una metodología de micro-costeo. Los costos indirectos se evaluaron mediante una aproximación de capital humano, y los costos intangibles calculados a partir de los años de vida ajustados por calidad (AVAC). Se analizaron los datos por medio de un análisis multivariado. Para comparaciones con otras poblaciones todos los costos fueron expresados como la razón entre los costos y producto interno bruto nacional per cápita. Resultados: La media de costos totales fue 13.031±9.215 USD (ajustados por el factor de conversión de paridad del poder adquisitivo), lo cual representa el 1,66 del PIB per capita de Colombia. Los costos directos son el 64% de los costos totales. Los costos médicos representan el 80% de los costos directos,. Los costos indirectos fueron el 10% y los costos intangibles el 25% de los costos totales. Los medicamentos representaron el 45% de los costos directos. Mayores costos se relacionaron con el estrato socioeconómico, seguro médico privado, AVAC, alopecia, micofenolato mofetilo, y terapia anticoagulante. Los costos directos ajustados de los pacientes con LES en Colombia fueron mayores que en Norte América y en Europa. Conclusiones: el LES impone una carga económica importante para la sociedad. Los costos relacionados con la atención médica y AVAC fueron los principales contribuyentes al alto costo de la enfermedad. Estos resultados pueden ser referencia para determinar políticas en salud pública así como comparar el gasto en salud de forma internacional.

Clinical, radiographic, biochemical and histological findings of florid cemento-osseous dysplasia and report of a case

A displasia cemento-óssea florida tem sido descrita como uma condição que afeta tipicamente os maxilares de mulheres negras de meia idade. Ela geralmente se manifesta como múltiplas massas radiopacas semelhantes ao cemento distribuídas nos maxilares. Esta condição também tem sido classificada por vários autores como cementoma gigantiforme, osteomielite esclerosante crônica, osteíte esclerosante e massas de cemento escleróticas. Os autores apresentam um caso de displasia cemento-óssea florida não complicada em uma mulher negra de 48 anos de idade. Múltiplas massas escleróticas com bordas radiolúcidas na mandíbula foram identificadas radiograficamente. Os achados histopatológicos revelaram formação de massas escleróticas densas calcificadas semelhantes ao cemento. Todos os aspectos clínicos, radiográficos, bioquímicos e histológicos foram sugestivos do diagnóstico de displasia cemento-óssea florida.

Advancements in the knowledge of induced tooth movement: idiopathic osteosclerosis, cortical bone and orthodontic movement

Movimentar ortodonticamente os dentes por áreas densas do trabeculado ósseo e pelas corticais pode requerer uma redução na intensidade e/ou na concentração das forças aplicadas. em parte, as forças ortodônticas aplicadas são dissipadas e reduzidas pela deflexão óssea que ocorre pelo discreto grau de elasticidade do tecido ósseo em condições de normalidade. Nas áreas de trabeculado denso e nas corticais, essa deflexão deve ser irrisória ou inexistente. Se não houver uma redução na intensidade das forças nessas regiões citadas, toda a força incidirá sobre a estrutura do ligamento periodontal, aumentando o risco de morte dos cementoblastos, hialinização e reabsorções radiculares. Novos trabalhos poderiam avaliar a prevalência dessas consequências em casuísticas selecionadas para essa finalidade, que, assim, deixariam de ser observações aleatórias.

Unusually rapid growth of brown tumour in the mandible after parathyroidectomy associated with the presence of a supernumerary parathyroid gland

The aim of this study is to report the case of a quick growing brown tumour in the jaw after a parathyroidectomy due to the presence of a rare fifth parathyroid gland. The patient had chronic renal disease and the diagnosis was tertiary hyperparathyroidism. Thirty days after the parathyroidectomy, the patient returned with a significant increase in the tumour size. The suspicion of a supernumerary gland was confirmed by parathyroid scintigraphy. The treatment of brown tumour is dependent on the treatment of the hyperparathyroidism. However, curettage should be considered if a large lesion is disturbing mastication. In conclusion, this case should attract the attention of general practitioner dentists, since they may be the first professionals who have contact with the patient with a brown tumour in the jaws. Likewise, this case emphasises the importance of knowing the type of hyperparathyroidism involved to allow for effective treatment planning. © 2011 European Association for Cranio-Maxillo-Facial Surgery.

Avaliação clínica da pasta de metronidazol a 10% e lidocaína a 2% no tratamento da alveolite

Pós-graduação em Odontologia - FOA

Importância do casqueamento e ferrageamento no cavalo atleta

The trimming and shoeing are of great significance in the performance and longevity of the athlete horse, and if not done or done incorrectly, cause a variety of limb injuries, which may make unusable the animal for sport, a fact of frequent occurrence, due to the small number of trained professionals in this area. The anatomy of the hoof and its functions should be maintained by maintaining the balance of the same (correct hoof trimming) and, if necessary, proper shoeing, all to avoid the hull balance alterations that lead to osteoarthritis, musculoskeletal disorders, chronic pain at the bead, synovitis, pedal osteitis, navicular disease, in addition to increase tension in the flexor tendons, suspensory ligament and proximal sesamoid causing tendinitis, desmitis and sesamoiditis proximal

Avaliação física e radiográfica dos carpos, tarsos e articulações interfalangeanas de touros de raças zebuínas em regime de colheita de sêmen

Pós-graduação em Medicina Veterinária - FCAV

Antibiotic prophylaxis for third molar extraction in healthy patients: current scientific evidence

Third molar extraction is one of the most frequently performed procedures in the dental clinic, and it is associated with innumerable trans- and postoperative complications, such as pain, trismus, edema, localized alveolar osteitis, and surgical site infection. Some authors advocate the use of local or systemic antibiotics to reduce the incidence of these postoperative complications. However, several studies have revealed an insignificant gain after using antibiotics. Despite the risks of allergic reactions, toxicity, and the development of resistant microorganisms, about 50% of dentists routinely prescribe the use of prophylactic antibiotics for this purpose. The goal of this paper is to evaluate the scientific evidence that justifies antibiotic prescription to healthy patients undergoing third molar extraction.

Facial lesions caused by renal osteodystrophy in a patient with chronic renal insufficiency: a case report

PURPOSE: Chronic renal insufficiency (CRI) is the last stage of a chronic renal condition in which the kidney loses its filtration and endocrine functions. Chronic endocrine hypofunction causes generalized damage to the body known as Uremic Syndrome, which affects the central nervous system as well as the cardiovascular, hematologic, dermatologic, ophthalmic, endocrine, respiratory, gastrointestinal and skeletal systems. The present study reports the case of a female patient with CRI who presented facial osteodystrophy of the osteitis fibrosa type, and highlights the main features of this condition. CASE DESCRIPTION: A 24-year old, female, Caucasian patient presented chronic glomerulonephritis recurrence and lost the transplanted kidney five years before, undergoing arteriovenous fistula hemodialysis three times a week. She presented swelling of the left masseter area with a hard consistency on palpation, covered by intact skin, swelling at the bottom of the left atrium, with a hard consistency on palpation, a mucosa-like color and absence of inflammation signs, suggesting expansive bone lesions on the face. These features were compatible with hyperparathyroidism brown tumor and/or osteodystrophy. The CT scan showed expansive bone lesions of heterogeneous appearance on the left jaw, maxilla/nasal floor, and right frontotemporal suture areas. The clinical and histopathological characteristics of the lesion, in association with PHT hormone high serum levels led to renal osteodystrophy diagnosis. The patient was referred to the nephrology services. CONCLUSION: Osteodystrophic bone alterations have a high prevalence in renal disease patients, and the dentist must take these alterations into consideration in bone lesion diagnosis for this specific group of patients.

Middle Miocene to Quaternary diatom biostratigraphy of DSDP Site 90-594

A diatom biostratigraphy is presented for middle Miocene through Quaternary sediments recovered from the Chatham Rise east of New Zealand's South Island. The upper 590 m of the 639.5-m composite-section Site 594 represents approximately 16 m.y. and is characterized by moderately to very poorly preserved diatoms of antarctic to temperate affinity. Pliocene through Quaternary assemblages are poorly preserved and dominated by antarctic-subantarctic species which provide detailed biostratigraphic control. Recognized are 11 of 14 zones of the middle upper Miocene to Quaternary Neogene Southern Ocean diatom zonation (NSD 7-NSD 20) of Ciesielski (1983; this chapter). Four Neogene Southern Ocean diatom zones (NSD 3-NSD 6) are recognized in the lower middle Miocene to middle upper Miocene of Site 594. Assemblages of this interval have a mixed high-latitude and temperate affinity; however, poor preservation limits correlation to high- and temperate-latitude zonal schemes. Neogene North Pacific diatom zones and subzones of NNPD 3 through NNPD 5 (Barron, in press, b) are correlated to Neogene Southern Ocean diatom zones NSD 3 through NSD 7: the upper portions of the Actinocyclus ingens Zone (NNPD 3) is correlative to the upper Nitzschia maleinterpretaria Zone (NSD 3); the Denticulopsis lauta Zone (NNPD 4) and Subzones a and b are correlative to the lower Coscinodiscus lewisianus Zone (NSD 4); and the D. hustedtü-D. lauta Zone (NNPD 5) and its Subzones a through d encompass the upper C. lewisianus Zone (NSD 4), N. grossepunctata Zone (NSD 5), N. denticuloides Zone (NSD 6), and the lower D. hustedtii-D. lauta Zone (NSD 7). A major disconformity spans the late Gilbert to early Gauss Chron (3.9-2.8 Ma). A second disconformity brackets the Miocene/Pliocene boundary; the section missing covers late Chron 5 and the early Gilbert chron (5.5-4.6 Ma). The remainder of the siliceous-fossil-bearing Miocene sediments at Site 594 appear to be correlative to lower paleomagnetic Chronozone 5 through upper Chronozone 16. Uppermost lower Miocene or lowermost middle Miocene sediments in the basal 50 m of Hole 594A are barren of diatoms.