Management of Osteonecrosis of the Jaws in Patients With History of Bisphosphonates Therapy

Bisphosphonates are compounds used in the treatment of various metabolic and malignant bone diseases. The relation between the use of bisphosphonates and ostenonecrosis of the jaws as an adverse effect of the drug has been intensely discussed during the last few years, and up to this moment, there is no consensus concerning an ideal treatment modality for this condition. Nevertheless, there is an agreement among researchers that the standard goal for controlling jaw osteonecrosis is to prevent it. Otherwise, the rationale for a randomized controlled trial is that current treatment has proven to be suboptimal, and no consensus has been reached yet on the best strategies to repair the exposed bone once bone necrosis is developed. This article is focused on reporting a case of moderate osteonecrosis of the upper jaw induced by bisphosphonates and discusses a possible role for surgical debridement associated to platelet-rich plasma, hyperbaric oxygen therapy, and the cessation of the bisphosphonate use in managing this type of lesion. Moreover, the dentist, the oral surgeon, and the oncologist need to work together to reach better outcomes.

Denudation history of the Bocaina Plateau, Serra do Mar, southeastern Brazil: Relationships to Gondwana breakup and passive margin development

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The natural history of carpal tunnel syndrome: A study of 20 hands evaluated 4 to 9 years after initial diagnosis

Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy. In the last decade several papers have been published on epidemiology, clinical aspects, diagnosis, and treatment, but little is known about its natural history. The objective of this work was to study the natural history of CTS syndrome. From 358 patients with clinical and conduction study diagnosis of CTS, 12 cases were identified that had refused surgical treatment, had not used anti-inflammatory medications, and had not undergone orthopaedic procedures, such as immobilization or anaesthetic infiltration. These 12 patients have 20 compromised hands which have been followed up for between 4 and 9 years. In all cases sensory and motor conduction studies were performed on the median nerve, at the beginning and end of follow-up period. Electrical improvement was marked in 5 hands and slight in 3; there was no significant change in 10, and deterioration in 2. As 8 hands (7 patients) showed improved clinical symptoms and conduction studies over several years, this brings the universally accepted procedure of surgical treatment into doubt.

Mitochondrial genome sequence of the Brazilian luminescent click beetle Pyrophorus divergens (Coleoptera: Elateridae): Mitochondrial genes utility to investigate the evolutionary history of Coleoptera and its bioluminescence

The Coleoptera order is the richest group among Metazoa, but its phylogenetics remains incompletely understood. Among Coleoptera, bioluminescence is found within the Elateroidea, but the evolution of this character remains a mystery. Mitochondrial DNA has been used extensively to reconstruct phylogenetic relationships, however, the evolution of a single gene does not always correspond to the species evolutionary history and the molecular marker choice is a key step in this type of analysis. To create a solid basis to better understand the evolutionary history of Coleoptera and its bioluminescence, we sequenced and comparatively analyzed the mitochondrial genome of the Brazilian luminescent click beetle Pyrophorus divergens (Coleoptera: Elateridae). © 2007 Elsevier B.V. All rights reserved.