Evaluation of the antibacterial and inhibitory activity of NorA and MepA efflux pumps from Staphylococcus aureus by diosgenin.

The increase in bacterial resistance to available antibiotics has driven several researchers to search for new agents with therapeutic properties. Diosgenin is a naturally occurring steroidal saponin that has demonstrated several pharmacological properties. In the present study, we report the antimicrobial activity of diosgenin against the standard and multidrug-resistant bacteria of Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus, in addition to the efflux pump inhibitory activity against Staphylococcus aureus strains carrying NorA and MepA pumps. For this purpose, the broth microdilution method was used, from which the value of the Minimum Inhibitory Concentration (MIC) was obtained, and this was associated with subinhibitory concentration (MIC/8) with antibiotic of clinical use and ethidium bromide for strains carrier by efflux pump. Diosgenin showed antimicrobial activity for standard S. aureus bacteria and potentiating activity in association with gentamicin and ampicillin for P. aeruginosa multidrug-resistant bacteria, it also showed potentiation in association with norfloxacin against the E. coli strain and gentamicin against the S. aureus strain. Antimicrobial activity against efflux pump-bearing strains revealed that saponin did not interfere with the efflux pump mechanism or intervened antagonistically. Thus, saponin has shown to be very promising against bacterial resistance in association with aminoglycoside, fluoroquinolones and beta-lactam, however additional studies should be carried out to better elucidate the mechanism of action of diosgenin.

Escleroterapia de Hemangioma Intraoral guiada por ultrassonografia: caso clínico / Ultrasound-guided intraoral hemangioma sclerotherapy: a case report

O hemangioma é uma neoplasia benigna que se caracteriza pela proliferação anormal de vasos sanguíneos, comum na região de cabeça e pescoço, e é relativamente raro na cavidade oral; porém, quando essa região é acometida, comumente, atinge lábios, língua e mucosa jugal. O objetivo deste trabalho foi descrever um caso clínico de hemangioma em mucosa jugal direita, o qual foi tratado através de escleroterapia com Oleato de Etanolamina (Ethamolin®), e ultras sonografia para guiar as aplicações intralesionais. No momento, a paciente está com 2 anos de acompanhamento, o que possibilitou observar a fibrose da lesão. A escleroterapia com Ethamolin® guiada por ultrassom é um procedimento seguro que pode ser realizado em lesões mais profundas, minimizando a possibilidade de complicações e favorecendo a recuperação do paciente.

Hemangioma is a benign neoplasm characterized by an abnormal proliferation of blood vessels, common in the head and neck region. It is relatively rare in the oral cavity, but if this region is affected, it occurs more commonly in the lips, tongue, and oral mucosa. The aim of this study was to describe a clinical case of hemangioma in the right jugal mucosa, which was treated through sclerotherapy with Ethanolamine Oleate (Ethamolin®), and the use of ultrasonography to guide the intralesional applications. Now, the patient has a 2-year follow-up, which allowed the observation of the involution of the lesion. The ultrasound-guided sclerotherapy with Ethamolin® is a safe procedure that can be performed in deeper lesions, minimizing the possibility of complications, and favoring the patient's recovery.

Abordagem minimamente invasiva para tratamento de adenoma pleomórfico em palato: caso clínico / Minimally invasive approach for pleomorfic adenoma treatment in palate: clinical case

Introdução: O adenoma pleomórfico (AP) ou tumor misto benigno é a neoplasia de glândula salivar mais comum. A glândula parótida geralmente é a mais acometida com 80% dos casos, e, quando surge em glândulas salivares menores, o palato é a região mais afetada. O objetivo deste trabalho é relatar um caso clínico de AP em palato duro, tratado de forma conservadora. Relato de caso: Paciente 35 anos, gênero masculino, apresentando aumento de volume em palato, aos 6 meses de evolução, foi submetido à realização de procedimento cirúrgico, realizado sob anestesia local, para enucleação da lesão, seguido por curetagem de periósteo e com preservação de tecido mucoso sobrejacente. Considerações Finais: No momento, o paciente encontra-se com 1 ano de acompanhamento e não apresenta sinais de recidiva... (AU)

Introduction: Pleomorphic adenoma (PA) or benign mixed tumor is a more common salivary gland neoplasia. The parotid gland is usually the most affected with 80% of the cases and when they appear in smaller salivary glands, the palate is a region more affected. The objective of this study is to report a case of PA in the hard palate, treated conservatively. Case report: Patient 35 years old, male, presenting a palate volume increase with 6 months of evolution and submitted to surgical surgery performed under local anesthesia for enucleation of the process followed by periosteum cures and preservation of overlying mucosal tissue. Final considerations: At the moment, the patient is 1 year of follow-up and shows no signs of relapse... (AU)

Proximity of the maxillary artery to the neck of the mandibular condyle: anatomical study.

PURPOSE: The objective of this study was to evaluate the anatomical distance of the maxillary artery, the most superior portion of the condyle and subcondyle in standardized coronal sections, acquired from 16 hemifaces in 8 cadavers. METHODS: Measurements were taken to evaluate the distance between the uppermost portion of the mandibular condyle and the height of the maxillary artery (AB) and between the lateral (CD) and medial (EF) sides of the condylar neck to the artery. RESULTS: The mean for AB was 21.1 mm hemiface right and 22.9 mm left on the anterior face, 22.5 mm and 20.7 mm, respectively, on the rear face. The CD measurement presented 6.7 mm right side in the anterior face and 6.3 mm left, and the posterior face was 6.3 mm right side and 5.4 mm left; EF presented a mean of 2.2 mm right and 1.5 mm left on the anterior face and 1.6 mm for both sides on the posterior face. CONCLUSIONS: There was no statistically significant difference between hemifaces. The proximity of the maxillary artery to the medial face of the neck of the mandibular condyle is millimetric and presents risks of severe hemorrhage for interventions in the infratemporal fossa.

Efficacy of proportional versus high condylectomy in active condylar hyperplasia - A systematic review.

OBJECTIVE: To perform a systematic literature review to test the efficacy of proportional condylectomy versus high condylectomy in patients with active condylar hyperplasia, in terms of avoiding secondary surgeries. METHOD: Following a search of Medline (Pubmed), Embase, Scopus, Web of Science and Cochrane databases, ten studies were included for qualitative analysis, and two studies were included for meta-analysis. Quality assessment was performed using the Newcastle-Ottawa scale for cohort studies and the 18-item modified Delphi technique for case series. RESULTS: 259 patients were included in the qualitative analysis, with a weighted arithmetic mean age of 20.4 years, and a female:male ratio of 2:1. Meta-analysis was carried out for 52 patients, and it was found that proportional condylectomy reduced the need for secondary surgery (p = 0.0003). Although this evidence had limitations, excised bone on proportional condylectomy was superior when compared with excised bone on high condylectomy, re-establishing the occlusal plane, resulting in fewer asymmetries, and therefore reducing the need for further surgery. CONCLUSIONS: This systematic review showed a tendency for proportional condylectomies to avoid additional surgeries; however, more comparative studies are necessary.

Abordagem sistêmica do pênfigo vulgar com acometimento oral / Systemic approach of the vulgar penfigure with oral accomplishment

O termo "pênfigo" remete a um grupo de doenças autoimunes raras, caracterizadas pela formação de bolhas, que afetam o epitélio escamoso estratificado da pele, mucosa ou ambos. Cinco tipos principais de pênfigo foram descritos: vulgar (PV), vegetante, eritematoso, foliáceo e paraneoplásico. O PV é a variante mais comum e frequentemente acomete a mucosa oral. Este artigo relata um caso de Pênfigo Vulgar, com acometimento da mucosa oral e com 10 anos de evolução. Paciente de gênero masculino, 70 anos, procurou o serviço, queixando-se de úlceras na mucosa que causavam ardência e não cicatrizavam. Foi realizada uma biópsia incisional da lesão e, após exame histopatológico, estabelecido o diagnóstico de PV, sendo instituído um regime terapêutico com 60 mg de prednisona por via oral, até a remissão dos sintomas. O PV é uma doença sistêmica de caráter imunológico, de grande importância para a odontologia, tendo em vista que geralmente as manifestações orais antecedem as sistêmicas. Essa doença não tem cura, mas pode ser controlada, como no referido caso. Embora o diagnóstico nesse caso não tenha sido precoce, o prognóstico foi favorável... (AU)

The term "pemphigus" refers to a group of rare autoimmune diseases, characterized by the formation of blisters that affect the squamous epithelium stratified of the skin, oral mucosa or both. Five main types of pemphigus were described: pemphigus vulgaris (PV), vegetative, erythematous, foliaceous and paraneoplastic pemphigus. PV is a more common variant and often affects an oral mucosa. This article reports a case of Pemphigus vulgaris, with involvement of the oral mucosa and 10 years of evolution. A male patient, 70 years old, sought the service complaining of ulcers in the mucosa that caused burning and did not heal. An incisional biopsy of the lesion was performed and after histopathological examination, the diagnosis of PV was established, a therapeutic regimen with oral prednisone 60 mg was instituted util remission of symptoms. PV is a systemic disease of immunological character that has great importance for dentistry, since oral manifestations usually precede the systemic ones. This disease has no cure, can be controlled, as in this case, although the diagnosis in this case was not early, the prognosis was favorable... (AU)

Adenomatoid odontogenic tumor simulating periapical cyst: case report / Tumor odontogênico adenomatóide simulando cisto periapical: relato de caso clínico

ABSTRACT The adenomatoid odontogenic tumor is a benign, non-invasive tumor and has a slow growth. Its preferred location is the anterior maxillary area, most often causing root displacement, more rarely resorption and mostly affects young women. Being asymptomatic, this injury is discovered upon routine radiographic examination, in which, in most cases, a unilocular, radiolucent image is observed and it may have some degree of calcification within the lesion. This work aims to report the case of a 14-year-old patient who attended the Lauro Wanderley University Hospital (UFPB), complaining of increased volume over a period of 8 months, in the region of non-vital tooth 21. The CT scan showed well-delimited unilocular, radiolucent lesion, with buccal cortex resorption. The proposed treatment plan involved enucleation, followed by peripheral ostectomy and bone graft with alloplastic materials. Because of its benign character, encapsulated and slow growing, the treatment of choice for adenomatoid odontogenic tumor is conservative, the surgical enucleation of the injury being advocated. The excised piece was sent for histopathological analysis, where the AOT diagnosis was confirmed. After 7 months, new bone formation was observed without signs of recurrence.

RESUMO O Tumor Odontogênico Adenomatóide é um tumor benigno, não invasivo e de crescimento lento. Acomete principalmente mulheres jovens, na região anterior da maxila, causando na maioria das vezes deslocamento radicular e raramente reabsorção. Por ser assintomática, essa lesão é geralmente descoberta em exames radiográficos de rotina, no qual se observa na maioria dos casos uma imagem radiolúcida unilocular, podendo apresentar algum grau de calcificação no interior da lesão. Este trabalho tem como objetivo relatar o caso clínico de um paciente de 14 anos, gênero feminino, que compareceu ao Hospital Universitário Lauro Wanderley - Universidade Federal da Paraíba, com queixa de aumento de volume de 8 meses de evolução, em região de elemento 21 não vital. Ao exame tomográfico observou-se lesão radiolúcida, unilocular, bem delimitada, com reabsorção da cortical vestibular. O plano de tratamento proposto foi a enucleação seguida de ostectomia periférica e enxerto ósseo com material aloplásico. A análise histopatológica confirmou o diagnóstico de Tumor Odontogênico Adenomatóide. Após sete meses observa-se nova formação óssea e sem sinais de recidiva.

Distúrbios neurossensoriais associados ao nervo alveolar inferior após a osteotomia vertical intraoral dos ramos mandibulares / Neurosensory disturbances of the inferior alveolar nerve after intraoral vertical ramus osteotomy

O objetivo deste estudo foi avaliar os índices de lesão ao nervo alveolar inferior (NAI), após a realização da osteotomia vertical intraoral dos ramos mandibulares (OVIRM) para correção do prognatismo mandibular, comparando-os com os relatos da literatura. A amostra foi composta de dez pacientes, escolhidos aleatoriamente, submetidos à OVIRM, associada ou não à osteotomia da maxila. Não houve casos de danos ao NAI na amostra após um ano de acompanhamento. A OVIRM demonstrou ser uma técnica cirúrgica segura e previsível em relação ao NAI, desde que suas peculiaridades sejam respeitadas.

The aim of this study was to evaluate the impairment in the inferior alveolar nerve (IAN) after performing the intraoral vertical ramus osteotomy (IVRO) for the correction of mandibular prognathism, and compare with the literature reports. The sample was composed of ten patients, randomly chosen, undergoing OVIO, associated or not to the maxillary osteotomy. There were no cases of impairment to the IAN after one year of follow-up. The OVIO proved to be a safe and predictable surgical technique as long as its peculiarities are respected.