Clinical features of oral lichen planus. A retrospective study of 65 cases

Objectives: To describe the clinical features of patients diagnosed with oral lichen planus (OLP) and to establish the prevalence of its malignant transformation in our setting. Study design: A retrospective study was made of 65 patients clinically and histologically diagnosed with OLP in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain) in the period 1990-2005. A descriptive and bivariate statistical analysis was made. Results: The mean patient age was 59 years (SD ± 14.9). Most of the patients (61%) were women, and the most frequent location of the lesions was the buccal mucosa (90.8%). White forms of OLP were noted in 66% of the cases, and 46.2% of the patients reported symptoms of some kind. The patients diagnosed with diabetes mellitus (20%) showed a larger proportion of red lesions (p=0.088). No statistically significant association was observed between chronic liver disease and the OLP lesion types or symptoms. Two cases of squamous cell carcinoma were identified in two patients previously or simultaneously diagnosed with OLP. A statistically significant correlation was observed between dysplastic changes / malignization of the lesions and smoking habit (p=0.019). An association to alcohol abuse was also noted, though in this case statistical significance was not reached (p=0.085). Conclusions: The clinical features of our study population were similar to those described in other studies. Diabetic patients with OLP were seen to be more susceptible to the development of atrophic-erosive lesions. Smokers and/or patients with alcohol abuse in turn showed a greater tendency to develop dysplastic changes / malignization in the histopathological study of the lesions

Complications following an accidental sodium hypochlorite extrusion: A report of two cases

Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae. This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.

Use of Bichat"s buccal fat pad for the sealing of orosinusal communications. A presentation of 8 cases

Objectives: To determine the efficacy of the pediculate flap with the buccal fat pad in the sealing of orosinusal communications, describe the surgical technique used, and report the main complications. Patients and method: A retrospective study was made of 8 patients seen in the Service of Oral Surgery of the University of Barcelona Dental Clinic (Spain) for the treatment of orosinusal communications between the years 2007 and 2009. In all cases a pediculate flap with the buccal fat pad was used to solve the problem. Results: All of the orosinusal communications were successfully resolved with this technique. The immediate postoperative complications were pain (37.5%), inflammation (37.5%), edema (32.5%), trismus (37.5%), halitosis (14.3%), suppuration (12.5%) and rhinorrhea (12.5%). Conclusions: The use of Bichat"s buccal fat pad is not regarded as the technique of choice for sealing small to medium sized orosinusal communications. However, in the case of large communications, it is a good option, and the results obtained are optimum.

Traumatic bone cyst: a retrospective study of 21 cases

Objective: To describe the clinical and radiological characteristics, and surgical findings of traumatic bone cysts. Study Design: A retrospective observational study was made of 21 traumatic bone cysts. The diagnosis was based on the anamnesis, clinical examination, and complementary tests. Panoramic and periapical X-rays were obtained in all cases, together with computed tomography as decided by the surgeon. A descriptive statistical analysis was made of the study variables using the SPSS v12.0 for Windows. Results: There was a clear female predominance (14:7). The mean age was 26.5 years (range 8-45 years). The cysts in all cases constituted casual findings during routine radiological exploration. In those cases where computed tomographic images were available, preservation of the vestibular and lingual cortical layers was observed. Five of the 21 patients (23.8%) reported a clear antecedent of traumatism in the affected zone. All the lesions were subjected to surgery, and the cavities were found to be vacant in 90.5% of the cases. In only two patients were vascular contents seen within the cavity. Two of the patients presented postoperative paresthesia of the inferior dental nerve that subsided within two weeks. The 19 patients in whom adequate postoperative follow-up proved possible all showed complete bone healing. Conclusions: Traumatic bone cysts were a casual finding. During the surgery, most cases showed to be vacant cavity without an ephitelial lining. Careful curettage of the lesion favors progressive bone regeneration, offering a good prognosis and an almost negligible relapse rate. Other treatment options only would be justified in cases of relapse.

Lateral periodontal cysts: a retrospective study of 11 cases

Objective: To describe the clinical, radiological and histopathological features of lateral periodontal cysts among patients diagnosed in different centers (Vall d"Hebron General Hospital, Granollers General Hospital, the Teknon Medical Center, and the Master of Oral Surgery and Implantology of the University of Barcelona Dental School; Barcelona, Spain). Study design: A retrospective observational study was made of 11 lateral periodontal cysts, all of which were diagnosed following a thorough clinical examination, radiological study and posterior histological study. Results: The mean patient age was 37 years, and males predominated over females. The mean lesion size was 1.25 cm. A single relapse was recorded 7 years after removal of the initial lesion. All the cysts were surgically removed. Discussion and conclusions: Lateral periodontal cysts are very infrequent, and are characterized by the preserved vitality of the adjacent teeth. Identification of the lesion is initially based on the clinical findings, though histological study is required to confirm the diagnosis. The treatment of choice is the surgical removal, though occasional relapses have been documented

On Commutation and Conjugacy of Rational Languages and the Fixed Point Method

The research on language equations has been active during last decades. Compared to the equations on words the equations on languages are much more difficult to solve. Even very simple equations that are easy to solve for words can be very hard for languages. In this thesis we study two of such equations, namely commutation and conjugacy equations. We study these equations on some limited special cases and compare some of these results to the solutions of corresponding equations on words. For both equations we study the maximal solutions, the centralizer and the conjugator. We present a fixed point method that we can use to search these maximal solutions and analyze the reasons why this method is not successful for all languages. We give also several examples to illustrate the behaviour of this method.

L'activitat quotidiana d'un mestre de cases medieval. Bernat Gual, 1405-1453

[cat] En aquest article es repassa l'activitat del mestre de cases Bernat Gual, des que va signar un contracte d'aprenentatge amb el mestre d'aixa Domingo Ferrer, l'any 1405, fi ns que desapareix de la documentació municipal, l'any 1453. En aquests quaranta-vuit anys d'activitat, Gual es va fer càrrec de grans obres (com ara l'assut de Xerta-Tivenys), però també d'una gran quantitat de petits treballs, sempre al servei del Consell de la Ciutat. La seva tasca s'emmarca en el context arquitectònic de la Tortosa medieval, determinat per la catedral i el palau del bisbe, però també pel Pont de Barques, una important infraestructura de fusta que era conservada per artesans especialitzats.

Further insights in trichothiodistrophy: a clinical, microscopic, and ultrastructural study of 20 cases and literature review

Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

Further insights in trichothiodistrophy: a clinical, microscopic, and ultrastructural study of 20 cases and literature review

Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

O uso de radiação ultravioleta para o pré-tratamento de amostras em análise inorgânica

The basic principles of UV irradiation as sample pre-treatment step and its potential for inorganic analysis are illustrated and discussed through significant examples from the literature. Not only does this overview cover the classical applications of this technique in the decomposition of organic matter in electroanalysis, but it also presents recent trends, including the increasing interest in employing UV irradiation in flow analytical systems, successful attempts to enhance its effectiveness and the coupling with chromatographic and spectroscopic methodologies. Furthermore, a number of relevant cases of UV-driven derivatization reactions involving photo-sensitive inorganic species are presented, showing some convenient options to perform fast and reliable determination of inorganic and organic analytes.

Epidemiology of measles virus outbreaks in Catalonia: importance of immunization in the elimination era

Eradicating measles represents a major public health achievement, yet outbreaks still occur in territories where endemic measles virus (MV) had been eliminated. In Catalonia from the year 2000 cases have occurred as isolated cases or small outbreaks, both linked to imported cases up to the end of 2006 when a large outbreak started out affecting mainly children ≤15m. In consequence, immunization schedule was amended lowering first dose to 12m. Again new MV importations from neighboring countries triggered another outbreak on November 2010 with a different age distribution sparing small children from infection. Differences in incidence (IR), rate ratio (RR) and 95% CI and hospitalization rate (HR) by age group were determined. Statistic z was used for comparing proportions. Total number of confirmed cases was 305 vs 381 in 2006; mean age 20 yrs (SD 14.8yrs; 3m -51yrs) vs 15m (SD13.1yrs; 1m-50yrs). Highest proportion of cases was set in ≥25yrs (47%) vs 24.2% in 2006 (p<0.001). Difference in IR for ≤ 15m was statistically significant (49/100,000 vs 278.2/100,000; RR:3.9; 95%CI 2.9-5.4) and in HR 30.2% vs 15.7% (p<0.001). The change of the month of administration of the first dose proved successful. Given the current epidemiological situation, continued awareness and efforts to reach young adult population are needed to stop the spread of the virus.

Epidemiology of measles virus outbreaks in Catalonia: importance of immunization in the elimination era

Eradicating measles represents a major public health achievement, yet outbreaks still occur in territories where endemic measles virus (MV) had been eliminated. In Catalonia from the year 2000 cases have occurred as isolated cases or small outbreaks, both linked to imported cases up to the end of 2006 when a large outbreak started out affecting mainly children ≤15m. In consequence, immunization schedule was amended lowering first dose to 12m. Again new MV importations from neighboring countries triggered another outbreak on November 2010 with a different age distribution sparing small children from infection. Differences in incidence (IR), rate ratio (RR) and 95% CI and hospitalization rate (HR) by age group were determined. Statistic z was used for comparing proportions. Total number of confirmed cases was 305 vs 381 in 2006; mean age 20 yrs (SD 14.8yrs; 3m -51yrs) vs 15m (SD13.1yrs; 1m-50yrs). Highest proportion of cases was set in ≥25yrs (47%) vs 24.2% in 2006 (p<0.001). Difference in IR for ≤ 15m was statistically significant (49/100,000 vs 278.2/100,000; RR:3.9; 95%CI 2.9-5.4) and in HR 30.2% vs 15.7% (p<0.001). The change of the month of administration of the first dose proved successful. Given the current epidemiological situation, continued awareness and efforts to reach young adult population are needed to stop the spread of the virus.

Successful therapies for Alzheimer's disease: why so many in animal models and none in humans?

Peering into the field of Alzheimer's disease (AD), the outsider realizes that many of the therapeutic strategies tested (in animal models) have been successful. One also may notice that there is a deficit in translational research, i.e., to take a successful drug in mice and translate it to the patient. Efforts are still focused on novel projects to expand the therapeutic arsenal to 'cure mice.' Scientific reasons behind so many successful strategies are not obvious. This article aims to review the current approaches to combat AD and to open a debate on common mechanisms of cognitive enhancement and neuroprotection. In short, either the rodent models are not good and should be discontinued, or we should extract the most useful information from those models. An example of a question that may be debated for the advancement in AD therapy is: In addition to reducing amyloid and tau pathologies, would it be necessary to boost synaptic strength and cognition? The debate could provide clues to turn around the current negative output in generating effective drugs for patients. Furthermore, discovery of biomarkers in human body fluids, and a clear distinction between cognitive enhancers and disease modifying strategies, should be instrumental for advancing in anti-AD drug discovery.

A questão da inovação em fármacos no Brasil: proposta de criação do programa nacional de fármacos (Pronfar)

Medicines are essential instruments to the preservation, maintenance and promotion of Health. The access to the medicine represents an important factor of social inclusion, depending on the availability of the pharmaceutical - active principle contained in the medicine that in 85% of the cases has a synthetic origin. In this scenario the importance of knowing how to make pharmaceuticals and medicines plays a significant role for the viability of the autonomous Health politics necessary for the demands of the major Nations. In this context, this work describes concisely the main aspects involved in the interdisciplinary drug discovery process, identifying the possible gorges for the successful development of innovative drugs in Brazil.

Managing through measurement : A framework for successful operative level performance measurement

The research around performance measurement and management has focused mainly on the design, implementation and use of performance measurement systems. However, there is little evidence about the actual impacts of performance measurement on the different levels of business and operations of organisations, as well as the underlying factors that lead to a positive impact of performance measurement. The study thus focuses on this research gap, which can be considered both important and challenging to cover. The first objective of the study was to examine the impacts of performance measurement on different aspects of management, leadership and the quality of working life, after which the factors that facilitate and improve performance and performance measurement at the operative level of an organisation were examined. The second objective was to study how these factors operate in practice. The third objective focused on the construction of a framework for successful operative level performance measurement and the utilisation of the factors in the organisations. The research objectives have been studied through six research papers utilising empirical data from three separate studies, including two sets of interview data and one of quantitative data. The study applies mainly the hermeneutical research approach. As a contribution of the study, a framework for successful operative level performance measurement was formed by matching the findings of the current study and performance measurement theory. The study extents the prior research regarding the impacts of performance measurement and the factors that have a positive effect on operative level performance and performance measurement. The results indicate that under suitable circumstances, performance measurement has positive impacts on different aspects of management, leadership, and the quality of working life. The results reveal that for example the perception of the employees and the management of the impacts of performance measurement on leadership style differ considerably. Furthermore, the fragmented literature has been reorganised into six factors that facilitate and improve the performance of the operations and employees, and the use of performance measurement at the operative level of an organisation. Regarding the managerial implications of the study, managers who operate around performance measurement can utilise the framework for example by putting the different phases of the framework into practice.