RESUMO
Myelodysplastic syndrome (MDS) is characterized by failure to initiate hematopoiesis or impaired maturation of cells, often presenting with pancytopenias with or without associated fatigue, infections, or inappropriate bleeding and bruising. Karyotype analyses of MDS patients commonly show deletion of the q arm of chromosome 7, suggesting loss of this region is likely implicated in the insufficient hematopoiesis seen in MDS. The predisposition to deletion of 7q is commonly inherited, with clinical presentation in early childhood associated with pancytopenia or hematological malignancy. In this case, we present a 66-year-old female who was incidentally found to be pancytopenic in the emergency department while being evaluated for dyspnea, with a bone marrow biopsy later confirming a diagnosis of MDS with monosomy 7. Sporadic loss of 7q can occur at any stage in life without any family history of hematological disease. Our patient has no known personal or family history of MDS, with normal blood counts during hospitalization three years prior, suggesting de novo loss of 7q occurring at greater than 60 years of age.
RESUMO
INTRODUCTION: JET-Fresh (Dentsply International, York, PA), a new airpolishing powder that contains aluminum trihydroxide as the abrasive agent, has been introduced for use with Prophy-Jet trade mark (Dentsply International). PURPOSE: The aim of this study was to investigate the surface effects of aluminum trihydroxide airpolishing powder on a series of restorative materials. MATERIALS AND METHODS: A total of 6 Class V preparations with enamel margins were created on the buccal surface of extracted human molars. The preparations were restored with Type III gold, a high copper spherical alloy amalgam, porcelain, a light-activated hybrid composite material, a light-activated microfilled composite material, and a light-activated, resin-modified glass ionomer material. The distal half of each restoration was covered with fiberglass tape and the mesial half subjected to treatment with the aluminum trihydroxide powder via the Prophy-Jet for 5 seconds. After removal of the protective tape, the buccal surface of each treated tooth was replicated with impression material. Replicas were generated using epoxy resin and prepared for evaluation with scanning electron microscopy. RESULTS: The aluminum trihydroxide produced surface alterations that were apparent visually and when viewed by a scanning microscope of the hybrid and microfilled composites and the glass ionomer restorations. The surfaces of the amalgam and gold restorations were altered, but not to the extent that the resin-based materials were. No disruption of the surface characterization of the porcelain was detected; however, with gold and porcelain materials, the aluminum trihydroxide removed notable amounts of the luting cements (the results are consistent with the data gathered with sodium bicarbonate powder). CONCLUSION: Aluminum trihydroxide as the abrasive agent in an airpolishing system should be avoided on resin composites, resin-modified composites, and around the margins of cemented restorations.