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1.
Schweiz Arch Tierheilkd ; 165(6): 385-399, 2023 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-37255245

RESUMO

INTRODUCTION: In the present study, risk groups for infectious foot disorders were identified on two large Swiss cattle mountain pastures by analyzing animal and treatment data of a total of 3256 animals of the bovine species. Both mountain pastures were part of the Federal Office for Agriculture (FOAG) consultancy project «Healthy animals, attractive herdsmen positions and less medication on large cattle mountain pastures¼. The project was launched in 2020 following the increased incidence of lameness on these mountain pastures. Bacteriological and histological analyses were to provide information as to whether the most common foot disorder was interdigital phlegmon (IP) or whether digital dermatitis also occurred. Further, the temporal distribution of cases over the mountain pasture season and the influence of mountain pasture and year were investigated and interpreted for the project years 2020 to 2022, and treatment incidences were compared between years. Multiple treatment cycles in the same individual were classified into persistent infections and new infections. Nineteen of 394 first-treated cattle were clinically examined, 12 of them were additionally sampled for bacteriological and histological analyses. All cases examined showed, both clinically and following laboratory analyses, typical characteristics for IP. In contrast, there was no specific evidence for the presence of digital dermatitis. No persistent infections occurred during treatment with benzylpenicillin. Multivariate logistic regression analyses identified > 365-730-day-old cattle (odds ratio OR 8,29), as well as inseminated (OR 5,30) and non-inseminated (OR 7,85) heifers as risk groups for the disease studied (p < 0,05). Association with the oestrus activity of non-inseminated heifers and a generally higher locomotor activity in heifers compared to cows - with a correspondingly increased risk of injury - is conceivable. Meat breeds had a reduced risk compared to dairy breeds (OR 0,29). Breed differences in behavior and/or the effectiveness of the local immune response might have an impact. Knowing about these risk groups can be put to use in the future when selecting animals to be taken to the mountain pastures and/or when planning pasture management in order to reduce the prevalence of infectious foot disorders and thereby the use of antibiotics.


INTRODUCTION: Dans la présente étude, nous avons identifié, grâce à l'analyse des données concernant les animaux et les traitements d'un total de 3256 animaux de l'espèce bovine, des groupes à risque pour les maladies infectieuses des onglons sur deux grands alpages bovins en Suisse. Les deux alpages faisaient partie du BLW-projet de conseil «Animaux sains, postes de bergers attractifs et moins de médicaments sur les grands alpages bovins¼. Le projet a débuté en 2020 suite à l'accumulation de problèmes de boiteries sur ces alpages. Des analyses bactériologiques et histologiques devaient fournir des indications afin de savoir si la maladie des onglons majoritaire était le phlegmon interdigité (PI) ou si la dermatite digitale était également présente. La répartition temporelle des cas de maladies durant la saison d'estivage et l'influence de l'alpage et de l'année pour les années de projet 2020 à 2022 ont été évaluées et interprétées, et les incidences des traitements comparées entre les années. Les cycles de traitement multiples chez le même individu ont été répartis en deux groupes: les infections persistantes et les nouvelles infections. Dix-neuf des 394 bovins primo-traités ont été évalués cliniquement. Douze de ces 19 animaux ont également été soumis à un échantillonnage bactériologique et histologique. Tous les cas étudiés présentaient, aussi bien cliniquement que suite à l'analyse technique en laboratoire, les caractéristiques typiques d'un PI. Par contre, il n'y a pas eu d'indication quant à la présence de dermatite digitale. Aucune infection persistante n'a été constatée après traitement avec de la Benzylpénicilline. Les bovins âgés > 365­730 jours (OR 8.29), ainsi que les génisses inséminées (odds ratio OR 5.30) et non inséminées (OR 7.85) ont été identifiés, suite à une analyse de régression logistique multivariée, comme faisant partie de groupes à risque pour la maladie étudiée (p < 0.05). Un lien avec l'activité en période de chaleurs des génisses non inséminées et une activité locomotrice généralement plus intensive des génisses par rapport aux vaches ­ avec par conséquent un risque accru de blessures ­ est concevable. Le risque était réduit pour les races à viande par rapport aux races laitières (OR 0.29). Des différences de comportement et/ou d'efficacité de l'immunité locale entre les races pourraient avoir une influence. Le fait de connaître ces groupes à risque pourrait être mis à profit à l'avenir lors de la sélection des animaux à monter à l'alpage et/ou lors de la planification de la gestion des prairies, afin de diminuer la prévalence des maladies infectieuses des onglons et ainsi l'utilisation d'antibiotiques.


Assuntos
Doenças dos Bovinos , Dermatite Digital , Doenças do Pé , Animais , Bovinos , Feminino , Fatores de Risco , Doenças do Pé/epidemiologia , Doenças do Pé/etiologia , Doenças do Pé/veterinária , Estações do Ano , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/etiologia , Coxeadura Animal/epidemiologia , Coxeadura Animal/etiologia , Indústria de Laticínios
2.
Schweiz Arch Tierheilkd ; 164(11): 753-766, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34758951

RESUMO

INTRODUCTION: Matrices that can be collected non-invasively for quantification of a stress response in sheep have received little attention in the veterinary literature. This study examines the suitability of blood, tears and saliva for determining a stress response in sheep undergoing sham foot trimming on a tilt table. The cortisol concentration of blood, tears and saliva and the concentration of cortisol metabolites in faeces were measured in 13 healthy Meat Merino ewes once a day for six days. Sham foot trimming on a tilt table was used as the stressor and was done during a one-hour period on day 4; cortisol concentrations of blood and tears were measured at 0, 10, 20, 30, 40 and 60 minutes. Cortisol concentrations of blood (maximum at 30 minutes) and tears (maximum at 40 minutes) increased during the procedure and then decreased. There were significant correlations between cortisol concentrations of blood and tears (p = 0,04) during sham foot trimming (area under the curve, 0 to 60 minutes). Over the entire 6-day study period, significant correlations were seen between the cortisol concentrations of blood and tears (r = 0,55; p.


INTRODUCTION: Les marqueurs qui peuvent être collectés de manière non invasive pour quantifier une réponse au stress chez le mouton ont fait l'objet de peu d'attention dans la littérature vétérinaire. Cette étude examine la pertinence du sang, des larmes et de la salive pour déterminer une réponse au stress chez des moutons subissant un parage fictif des pieds sur une table basculante. La concentration de cortisol dans le sang, les larmes et la salive ainsi que la concentration de métabolites de cortisol dans les fèces ont été mesurées chez 13 brebis Meat Merino saines une fois par jour pendant six jours. Le parage fictif des pieds sur une table inclinable a été utilisé comme facteur de stress et a été effectué pendant une période d'une heure le jour 4; les concentrations de cortisol dans le sang et les larmes ont été mesurées à 0, 10, 20, 30, 40 et 60 minutes. Les concentrations de cortisol dans le sang (maximum à 30 minutes) et les larmes (maximum à 40 minutes) ont augmenté au cours de la procédure puis ont diminué. Il y avait des corrélations significatives entre les concentrations de cortisol dans le sang et les larmes (p = 0,04) lors du parage fictif des onglons (aire sous la courbe, 0 à 60 minutes). Sur l'ensemble de la période d'étude de 6 jours, des corrélations significatives ont été observées entre les concentrations de cortisol dans le sang et les larmes (r = 0,55 ; p < 0,001), le sang et la salive (r = 0,53 ; p < 0,001) et les larmes et la salive (r = 0,78 ; p < 0,001). La concentration fécale de métabolites de cortisol était significativement augmentée au jour 5 (p 0,05), mais la concentration de cortisol des autres supports n'a pas changé de manière significative au cours de la période d'étude de 6 jours. Le parage fictif des pieds sur une table basculante a été considéré comme un facteur de stress aigu chez les moutons en raison de l'augmentation des concentrations de cortisol dans le sang, des larmes et de l'augmentation des concentrations de métabolites de cortisol dans les selles. La concentration de cortisol dans les larmes était similaire à celle du sang et, par conséquent, la collecte de larmes représente une alternative viable et non invasive au sang pour les tests de cortisol. Le délai des pics entre la concentration maximale de cortisol dans les larmes et le sang doit être pris en compte lors de l'interprétation des résultats.


Assuntos
Hidrocortisona , Saliva , Animais , Fezes , Feminino , Ovinos
3.
J Dairy Sci ; 104(8): 9205-9226, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34024600

RESUMO

Dairy cows in modern production systems are at risk to develop metabolic disorders during the transition period. Reasons for individual differences in susceptibility, as well as the underlying pathomechanisms, are still only partially understood. The development of metaphylactic treatment protocols is needed. In this context, an on-farm prospective 3-fold blinded randomized study involving 80 German Holstein cows was performed throughout 1 yr. The trial involved a thorough recording of the production and clinical traits, clinical chemistry, and liver biopsies and blood and urine sampling at d 14 (mean: 12 d, range: 1-26 d) antepartum (AP), and d 7 (7, 4-13) and 28 (28, 23-34) postpartum (PP) for metabolomics analyses. Two groups received a treatment with butaphosphan and cyanocobalamin (BCC) at either the dosage recommended by the manufacturer or the double dosage (5 or 10 mL/100 kg of body weight 10% butaphosphan and 0.005% cyanocobalamin (Catosal, Bayer Animal Health), n = 20 in each group, parity: 4.2 ± 2.0 and 3.4 ± 1.3, respectively (mean ± SD)] and one group a placebo treatment (NaCl 0.9%, n = 40, parity: 4.0 ± 1.9). The animals were treated at 6 time points (7, 6, and 5 d AP, and 1, 2, and 3 d PP) via intravenous injection. Mass spectroscopy-based targeted metabolomics analysis of blood plasma and liver samples were performed using the AbsoluteIDQ p180 kit (Biocrates Life Sciences), whereas the urine samples were analyzed by nuclear magnetic resonance spectroscopy. Statistical analysis was performed using multivariate [partial least squares discriminant analysis (PLS-DA)] and univariate methods (linear mixed model). Multivariate data analysis (PLS-DA plots) of the liver metabolome revealed 3 different metabotypes (A = medium, B = minor, C = large alterations in liver metabolome profile between AP and PP status). Metabotype B animals were characterized by higher PP lipomobilization (stronger PP body condition decrease and higher blood bilirubin, fatty acids, gamma-glutamyltransferase, and triglyceride levels) and a higher occurrence of transition cow diseases, compared with the animals in metabotype C. Analysis of the feeding data showed that the period of metabotype B animals (calving in a distinct time frame) was characterized by a decreased grass silage quality. The PP liver metabolome of the metabotype C animals was characterized by higher concentrations of AA, acylcarnitines, lysoPC and sphingomyelins compared with metabotype B. For the metaphylactic treatment with BCC a dose-dependent effect was confirmed, differing between the metabotypes. In all matrices and metabotypes at various time points significant treatment effects were observed, with different profiles in clinical chemistry and as well in metabolomics data. The most clear-cut treatment effect was observed in metabotype B in the liver at 7 d PP, characterized by an increase in several acylcarnitines and phosphatidylcholines, indicating a more efficient influx and oxidation of fatty acids in mitochondria and thereby an increase in energy supply and more efficient triglyceride export in the liver. The results from the liver metabolomics analysis support the application of an indication-based metaphylactic treatment with BCC.


Assuntos
Lactação , Metaboloma , Animais , Butilaminas , Bovinos , Dieta/veterinária , Feminino , Fígado , Metabolômica , Leite , Ácidos Fosfínicos , Período Pós-Parto , Gravidez , Estudos Prospectivos , Vitamina B 12
4.
J Dairy Sci ; 104(8): 9227-9244, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34024602

RESUMO

The aims of this study were to evaluate histopathologic changes during the transition period, describe the histopathological features of the metabotypes identified in Part I (Schären et al., 2021b), and investigate effects of a metaphylactic treatment with butaphosphan and cyanocobalamin (BCC) on the liver parenchyma. Eighty German Holstein cows (mean 305-d production: 10,957 kg, range: 6,480-15,193 kg; mean lactation number: 3.9, range: 2-9) from a commercial dairy farm in Saxony, Germany, were enrolled in a randomized, prospective, triple-blinded study. Two groups received a treatment with BCC (5 or 10 mL/100 kg of body weight 10% butaphosphan and 0.005% cyanocobalamin, Catosal, Bayer Animal Health, n = 20 each) and one group a placebo treatment (NaCl 0.9%, n = 40). Liver biopsy specimens were collected 14 d antepartum (AP) and 7, 28, and 42 d postpartum (PP), routinely processed for histologic examination, and stained with hematoxylin and eosin, Sudan III, periodic acid-Schiff, and picrosirius red stains. The sections were assessed for fat and glycogen content and degenerative, inflammatory, fibrotic, and proliferative changes. The statistical analysis included the effects of the sampling day, the lactation number, the treatment, and the metabotype (A = medium, B = minor, C = large alterations in the liver metabolome profile between AP and PP status). There was mild to moderate fat infiltration in the liver of 37% of cows in the last 2 wk AP, and moderate to severe fat infiltration in 66% of cows in the first days PP. The degree of fat infiltration increased from 2 wk AP until the end of the first week PP, and then decreased until the end of the study period, at which time about 25% of cows had moderate to severe fatty infiltration. Lipidosis was positively correlated with the severity of liver cell degeneration, and negatively correlated with the degree of glycogen deposits. Complete glycogen depletion of hepatocytes was not observed in cows, even in the presence of severe hepatic lipidosis. Moderate to severe lymphocytic hepatitis was seen in 39% of cows throughout the study period, and cows with lactation numbers 5 or greater had perisinusoidal fibrosis more often than younger cows. Severe fibrosis and cirrhosis of the liver did not occur. Metabotype B animals exhibited a higher chance of fatty infiltration, lower glycogen storage, and perisinusoidal fibrosis and for this metabotype positive correlations were calculated between increased fat deposition in the liver and marked glycogen depletion, and increased degenerative, inflammatory, fibrotic, and proliferative changes of hepatic tissue. For the treatment with BCC, no significant effect was observed. In summary, during the transition period, the liver of dairy cows is characterized by fat accumulation and glycogen depletion and histologic signs of hepatitis and hepatocyte degeneration. These histomorphologic changes were accentuated in animals exhibiting little alterations in their liver metabolome profile across the transition period (metabotype B) and support the assumption of a decreased grass silage quality as a causative factor.


Assuntos
Lactação , Período Pós-Parto , Animais , Butilaminas , Bovinos , Dieta/veterinária , Feminino , Alemanha , Fígado , Metabolômica , Leite , Ácidos Fosfínicos , Estudos Prospectivos , Vitamina B 12
5.
J Dairy Sci ; 104(8): 9245-9262, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34024605

RESUMO

The liver plays a central role in the postpartum (PP) energy metabolism of the transition dairy cow; however, studies describing the liver metabolome during this period were lacking. The aim of the presented study was therefore to compare the alterations in the liver and blood metabolome of transition dairy cows. For this purpose, an on-farm trial with 80 German Holstein cows (mean lactation number: 3.9; range: 2-9) was performed, with thorough documentation of clinical traits and clinical chemistry, as well as production data. Liver biopsies and blood samples were collected at d 14 (mean: 12 d, range: 1-26 d) antepartum (AP), d 7 (7, 4-13) and 28 (28, 23-34; mean, earliest-latest) PP for targeted mass spectroscopy-based metabolomics analysis using the AbsoluteIDQ p180 kit (Biocrates Life Sciences). Statistical analysis was performed using multivariate (partial least squares discriminant analysis) as well as univariate methods (linear mixed model). Multivariate data analysis of the liver metabolome revealed 3 different metabotypes (A = medium, B = minor, C = large alterations in the liver metabolome profile between AP and PP). In metabotype C, an increase of almost all acylcarnitines, lysophosphatidylcholines (lysoPC), sphingomyelins, and some phosphatidylcholines (PC, mainly at 7 d PP) was observed after calving. In contrast to metabotype C, the clinical data of the metabotype B animals indicated a higher PP lipomobilization and occurrence of transition cow diseases. The liver metabolome profile of these animals most likely mirrors a failure of adaptation to the PP state. This strong occurrence of metabotypes was much less pronounced in the blood metabolome. Additionally, differences in metabolic patterns were observed across the transition period when comparing liver and blood matrices (e.g., in different biogenic amines, acylcarnitines and sphingolipids). In summary, the blood samples at 7 d PP showed lower acylcarnitines and PC, with minor alterations and a heterogeneous pattern in AA, biogenic amines, and sphingomyelins compared with 14 d AP. In contrast to 7 d PP, the blood samples at 28 PP revealed an increase in several AA, lysoPC, PC, and sphingomyelins in comparison to the AP state, irrespective of the metabotype. In the liver biopsies metabotype B differed from metabotype C animals ante partum by following metabolites: higher α aminoadipic acid, lower AA, serotonin, taurine, and symmetric dimethylarginine levels, lower or higher concentrations of certain acylcarnitines (higher: C2, C3, C5, C4:1; lower: C12:1, C14:1-OH, C16:2), and lower lysoPC (a C16:0, C18:0, C20:3, C20:4) and hexose levels. In blood samples, fewer differences were observed, with lower serotonin, acylcarnitine C16:2, lysoPC (a C16:0, C17:0, C18:0 and C18:1), PC aa C38:0, and PC ae C42:2. The results show that the use of only the blood metabolome to assess liver metabolism may be hampered by the fact that blood profiles are influenced by the metabolism of many organs, and metabolomics analysis from liver biopsies is a more suitable method to identify distinct metabotypes. Future studies should investigate the stability and reproducibility of the metabotype and phenotypes observed, and the possible predictive value of the metabolites already differing AP between metabotype B and C.


Assuntos
Metaboloma , Metabolômica , Animais , Bovinos , Feminino , Lactação , Fígado , Período Pós-Parto , Reprodutibilidade dos Testes
6.
Neuroscience ; 158(2): 524-36, 2009 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-19015004

RESUMO

The dorsal vagal complex (DVC) is the brainstem integrative center that mediates the satiety reflex and relays autonomic neural responses to stress. The DVC displays adult neurogenesis, intrinsic neural stem cells and a high brain-derived neurotrophic factor (BDNF) content, effectors of plasticity that are modulated by stress in the hippocampus. In this study we asked whether neurogenesis and BDNF expression in the DVC are altered by stress, in parallel with food intake reduction. To this end, neurogenesis was assessed in adult rats in vivo by repetitive 5-bromo-2'-deoxyuridine (BrdU) administration without (controls) or with daily sessions of immobilization stress (1 h/day), and were allowed to survive for 2 weeks after the end of BrdU treatment. Neurogenic proliferation in the brainstem was detected by immunohistochemistry and confocal microscopy mainly in the area postrema and the nucleus tractus solitarius; newly formed neurons amounted to about 35% of all BrdU-labeled cells in the DVC of control rats. Chronic immobilization stress induced a significant decrease in neurogenic proliferation in the DVC which reached 50% in the area postrema. The number of newly-formed neurons was also decreased by chronic immobilization stress in the DVC, and this effect was again maximal in the area postrema; the proportion of BrdU-labeled cells that were neurons was unchanged. In vitro neurosphere assay was then performed on microdissected DVC tissue from another cohort of chronically stressed and control rats. Chronic immobilization stress induced a significant decrease of the total neurosphere number per rat DVC in both primary and secondary cultures, indicating that intrinsic neural stem cell frequency was decreased by chronic stress in DVC tissue. Tissue BDNF concentration in the DVC, as assessed by enzyme-linked immunosorbent assay, was not significantly altered when compared with controls after 3, 6, 9 or 13 days of chronic immobilization stress. These results further characterize neurogenesis in the DVC and suggest its involvement in the long-term regulation of food intake.


Assuntos
Área Postrema/fisiopatologia , Neurogênese/fisiologia , Restrição Física/métodos , Núcleo Solitário/fisiopatologia , Estresse Psicológico/patologia , Animais , Peso Corporal/fisiologia , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Bromodesoxiuridina/metabolismo , Proliferação de Células , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Ensaio de Imunoadsorção Enzimática/métodos , Masculino , Análise Multivariada , Proteínas do Tecido Nervoso/metabolismo , Ratos , Ratos Wistar , Estresse Psicológico/fisiopatologia , Fatores de Tempo
7.
Rev Stomatol Chir Maxillofac ; 106(5): 308-10, 2005 Nov.
Artigo em Francês | MEDLINE | ID: mdl-16292227

RESUMO

INTRODUCTION: The ankylosing spondylitis is a chronic inflammatory rheumatoid disease with predilection in the axial structures. The temporomandibular joint (TMJ) is involved in 10 to 24% of cases. Ankylosis of the TMJ is exceptional, only 11 cases being reported to date. OBSERVATION: A 48-year-old patient had been followed since 1987 for severe ankylosing spondylitis. The patient, known to be positive for tissue antigen HLA B27, was admitted for limitation of mouth opening. At physical examination, mouth opening was reduced to 1cm with no mandibular movements and a stiffness of the cervical spine in flexion. Computed tomography of the TMJs highlighted a bilateral lesion with ankylosis of the left joint and of C1-C2. Surgical treatment consisted in block resection of the two TMJs using a cartilaginous rib. With a follow up of 9 months, results have been satisfactory. DISCUSSION: Complementary explorations should be undertaken in ankylosing spondylitis patients with clinical symptoms suggestive of TMJ lesions in order to establish the diagnosis and initiate treatment and avoid the development of ankylosic forms.


Assuntos
Anquilose/etiologia , Espondilite Anquilosante/complicações , Transtornos da Articulação Temporomandibular/etiologia , Anquilose/diagnóstico por imagem , Anquilose/imunologia , Anquilose/cirurgia , Transplante Ósseo , Vértebras Cervicais/diagnóstico por imagem , Antígeno HLA-B27/análise , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/imunologia , Transtornos da Articulação Temporomandibular/cirurgia , Tomografia Computadorizada por Raios X
8.
Rev Stomatol Chir Maxillofac ; 99(4): 192-8, 1998 Nov.
Artigo em Francês | MEDLINE | ID: mdl-10088190

RESUMO

Jaw osteoradionecrosis (ORN) is one of the most serious complications of cervico-facial cancer irradiation. Severity is related to major bone lysis and the difficult medical and surgical treatment. We report our experience in seven cases over a ten-year period. Mandibular localization was predominant (85%). The mean age of the patients was 36 years. The average delay to development of ORN was 5.5 years. The treatment was medico-surgical, based on wide surgical exeresis (6/7), frequently via endobuccal surgical approach (4/7). Prevention remains the best treatment of ORN associated with an accurate management of all patients who need radiotherapy.


Assuntos
Doenças Mandibulares/etiologia , Doenças Maxilares/etiologia , Osteorradionecrose/etiologia , Adulto , Fatores Etários , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Radioisótopos de Cobalto/efeitos adversos , Curetagem , Quimioterapia Combinada/uso terapêutico , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Mandíbula/cirurgia , Doenças Mandibulares/tratamento farmacológico , Doenças Mandibulares/prevenção & controle , Doenças Mandibulares/cirurgia , Maxila/cirurgia , Doenças Maxilares/tratamento farmacológico , Doenças Maxilares/prevenção & controle , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Osteorradionecrose/tratamento farmacológico , Osteorradionecrose/prevenção & controle , Osteorradionecrose/cirurgia , Compostos Radiofarmacêuticos/efeitos adversos , Dosagem Radioterapêutica
9.
Rev Stomatol Chir Maxillofac ; 98(1): 31-6, 1997 Jan.
Artigo em Francês | MEDLINE | ID: mdl-9273674

RESUMO

This is a case report of mandibular Histiocytosis X in its Eosinophilic Granuloma's form. A review of literature is realized in the two clinical forms of Histiocytosis X: localised forms, with insistance in the Eosinophilic Granuloma of jaws, and diffused forms represented by the Letterer-Siwe disease and the Hand-Schüller-Christian disease.


Assuntos
Granuloma Eosinófilo/diagnóstico , Doenças Mandibulares/diagnóstico , Adulto , Granuloma Eosinófilo/patologia , Fraturas Espontâneas/diagnóstico , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/patologia , Humanos , Masculino , Doenças Mandibulares/patologia , Nervo Mandibular , Neuralgia/diagnóstico
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