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1.
Clin Exp Rheumatol ; 37 Suppl 121(6): 3-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31856939

RESUMO

Several epidemiologic studies report on the prevalence of Behçet's syndrome (BS) and demographic and clinical findings in patients from different countries and ethnicities. Although these studies point out geographic differences in disease course, methodologic differences make it difficult to compare the results of these studies. Recent data suggest that neutrophil extracellular trap levels are elevated in patients with BS, and that it may be a potential therapeutic target for the reduction or prevention of BS-associated thrombotic risk. Details on the mode of functioning of ERAP have been delineated and further epigenetic data reported. Wall thickness of lower extremity veins is increased among BS patients without any apparent clinical involvement. Magnetic resonance (MR) venography and Doppler ultrasonography (USG) were comparable in the diagnosis of chronic deep vein thrombosis, while MR venography is more effective in detecting collateral formations. Results were also collected on some dietary and non-dietary factors in triggering oral ulcers, while smoking seems to have a protective role. With regards to the therapy, it has been demonstrated that endovascular interventions carry the risk of inducing pathergy phenomenon. Apremilast has been convincingly shown to be useful for oral ulcers of BS and classical immunosuppressives are effective as first line therapy in more than half of patients with uveitis. While infliximab and adalimumab seem to be equally effective in the treatment of refractory uveitis of BS, the combination of adalimumab and immunosuppressives appears to be superior to immunosuppressives alone for venous thrombosis of the extremities. In addition, tocilizumab might be an alternative to anti-TNF agents for patients with arterial involvement refractory to immunosuppressives. On the other hand, the place of IL-17 inhibition in the treatment of BS still remains questionable.


Assuntos
Síndrome de Behçet , Imunossupressores/uso terapêutico , Adalimumab , Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/tratamento farmacológico , Predisposição Genética para Doença , Humanos , Úlceras Orais/etiologia , Prevalência , Fator de Necrose Tumoral alfa/uso terapêutico , Uveíte/etiologia , Trombose Venosa/etiologia
2.
N Engl J Med ; 381(20): 1918-1928, 2019 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-31722152

RESUMO

BACKGROUND: The small-molecule phosphodiesterase 4 inhibitor apremilast modulates cytokines that are up-regulated in Behçet's syndrome. In a phase 2 trial involving patients with Behçet's syndrome, apremilast reduced the incidence and severity of oral ulcers. Data on the efficacy and safety of apremilast in patients with Behçet's syndrome who had active oral ulcers and had not previously received biologic agents are limited. METHODS: In a phase 3 trial, we randomly assigned, in a 1:1 ratio, patients who had Behçet's syndrome with active oral ulcers but no major organ involvement to receive either apremilast at a dose of 30 mg or placebo, administered orally, twice daily for 12 weeks, followed by a 52-week extension phase. The primary end point was the area under the curve (AUC) for the total number of oral ulcers during the 12-week placebo-controlled period (with lower values indicating fewer ulcers). There were 13 secondary end points, including complete response of oral ulcers, change from baseline in pain associated with oral ulcers, disease activity, and change from baseline in the Behçet's Disease Quality of Life score (range, 0 to 30, with higher scores indicating greater impairment in quality of life). Safety was also assessed. RESULTS: A total of 207 patients underwent randomization (104 patients to the apremilast group and 103 to the placebo group). The AUC for the number of oral ulcers was 129.5 for apremilast, as compared with 222.1 for placebo (least-squares mean difference, -92.6; 95% confidence interval [CI], -130.6 to -54.6; P<0.001). The change from baseline in the Behçet's Disease Quality of Life score was -4.3 points in the apremilast group, as compared with -1.2 points in the placebo group (least-squares mean difference, -3.1 points; 95% CI, -4.9 to -1.3). Adverse events with apremilast included diarrhea, nausea, and headache. CONCLUSIONS: In patients with oral ulcers associated with Behçet's syndrome, apremilast resulted in a greater reduction in the number of oral ulcers than placebo but was associated with adverse events, including diarrhea, nausea, and headache. (Funded by Celgene; ClinicalTrials.gov number, NCT02307513.).


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Síndrome de Behçet/tratamento farmacológico , Úlceras Orais/tratamento farmacológico , Inibidores da Fosfodiesterase 4/uso terapêutico , Talidomida/análogos & derivados , Administração Oral , Adulto , Anti-Inflamatórios não Esteroides/efeitos adversos , Área Sob a Curva , Síndrome de Behçet/complicações , Método Duplo-Cego , Feminino , Humanos , Masculino , Úlceras Orais/etiologia , Inibidores da Fosfodiesterase 4/efeitos adversos , Qualidade de Vida , Talidomida/efeitos adversos , Talidomida/uso terapêutico
4.
J Med Case Rep ; 13(1): 227, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31345262

RESUMO

BACKGROUND: Syphilis is a sexually transmitted bacterial infection of the spirochete, Treponema pallidum. While primary syphilis often involves genitalia, oral manifestations are observed in a subset of patients. These lesions are often associated with submandibular and cervical lymphadenopathy. This is a case report of a primary syphilitic lesion located on the hard palate of the oral cavity, with only a very few cases described previously. CASE PRESENTATION: We describe a rare case of syphilis in a 59-year-old African American man presenting with subjective fevers, chills, marked submental lymphadenopathy, a diffuse skin rash, and an ulcer of the hard palate. CONCLUSIONS: This case report demonstrates the importance of maintaining a high index of suspicion for syphilitic infection when a patient presents with nonspecific symptoms, a diffuse rash, and an oral lesion.


Assuntos
Úlceras Orais/etiologia , Sífilis/complicações , Idoso , Progressão da Doença , Exantema/etiologia , Humanos , Masculino , Palato Duro , Sífilis/diagnóstico , Sífilis/fisiopatologia , Treponema pallidum/isolamento & purificação
5.
Gen Dent ; 67(4): 63-66, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31355767

RESUMO

A 39-year-old woman sought specialized treatment complaining of a large, painful oral ulcer in the right buccal vestibule after receiving emergency endodontic treatment 3 days earlier. The patient reported that the tooth, the mandibular right first premolar, was not isolated with a rubber dam and that she felt the extrusion of a liquid in the buccal tissues. Clinically, a necrotic area with raised erythematous borders was observed in the mandibular right side. The clinical diagnosis was a chemically induced ulcer caused by a sodium hypochlorite accident. Dexamethasone and amoxicillin were prescribed to control pain and prevent secondary infection. The large size of the lesion was an indication for application of low-level laser therapy (LLLT), which was delivered at a wavelength of 685 nm (output power, 30 mW; power density, 0.5 mW/cm2 ; energy density, 6 J/cm2 ) every 2 days for a total of 6 sessions. The LLLT was applied to the necrotic area with a punctual mode (2 points) for 12 seconds per point. The patient reported a substantial reduction in pain after the second application, and the wound was completely healed after 6 sessions. The results observed in this patient suggest that LLLT could aid patients in recovering from NaOCl-related lesions.


Assuntos
Terapia com Luz de Baixa Intensidade , Úlceras Orais , Hipoclorito de Sódio/efeitos adversos , Acidentes , Adulto , Dente Pré-Molar , Feminino , Humanos , Úlceras Orais/etiologia , Úlceras Orais/terapia
6.
Chemotherapy ; 64(1): 42-47, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31163446

RESUMO

OBJECTIVES: We aimed to identify an optimal regimen for low-risk gestational trophoblastic neoplasia (LR-GTN) providing reduction in dosage and toxicity/side effects, enhancement of therapeutic efficacy, and a shorter treatment duration. METHODS: A total of 149 LR-GTN patients were enrolled in the affiliated Beijing Maternity Hospital of Capital Medical University from January 2014 to January 2017 and randomly divided into 3 groups with 50 cases in the methotrexate (MTX) group, 49 in actinomycin D (ACT-D) group, and 50 in ACT-D+MTX group. Follow-up recorded symptoms, physical and bimanual gynecological examinations, routine blood test, serum ß-HCG level, liver and renal functions, electrolytes, electrocardiogram before each treatment course, and pelvic and abdominal B-mode ultrasound or pelvic/abdominal/chest computed tomography. RESULTS: Serum complete remission (SCR) was 96.0, 87.8, and 83.7% for the ACT-D+MTX, ACT-D, and MTX groups, respectively, with SCR being highest in the ACT-D+MTX group, statistically higher than in the MTX group. Vomiting was the only side effect differing significantly by chemotherapy regimen, with a distinctly higher incidence in the ACT-D+MTX group compared with the MTX group (p = 0.028). The reduction rate of serum ß-HCG in the ACT-D+MTX group was significantly greater than in the other 2 groups. CONCLUSION: Combined ACT-D+MTX chemotherapy achieved overall better efficacy and showed less toxicity than ACT-D or MTX alone, and thus can be prioritized for the treatment of LR-GTN.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Dactinomicina/uso terapêutico , Doença Trofoblástica Gestacional/tratamento farmacológico , Metotrexato/uso terapêutico , Adulto , Antimetabólitos Antineoplásicos/efeitos adversos , Gonadotropina Coriônica/sangue , Dactinomicina/efeitos adversos , Quimioterapia Combinada , Feminino , Doença Trofoblástica Gestacional/patologia , Doenças Hematológicas/etiologia , Humanos , Modelos Logísticos , Metotrexato/efeitos adversos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Úlceras Orais/etiologia , Gravidez , Prognóstico , Resultado do Tratamento , Adulto Jovem
7.
BMJ Case Rep ; 12(4)2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31023740

RESUMO

Gingival pathology is a daily presentation, however a small number of systemic conditions can manifest similar to a common gingival condition and have fatal results. Dentist referred 56-year-old woman to Oral and Maxillofacial Surgery department with a 2-week medical history of gingival bleeding not responding to local measures. Biopsy showed eosinophilic infiltrate and vasculitis, and blood tests showed positive markers including cytoplasmic antineutrophil cytoplasmatic antibodies. Granulomatosis with polyangiitis is a rare disease affecting the respiratory tract, blood vessels and kidneys. Oral lesions are rarely the primary presenting feature. When left untreated, most cases are fatal within a year of diagnosis. The diagnosis can only be made when certain criteria are found, including granular oral lesions exhibiting an eosinophilic inflammatory infiltrate on biopsy. With 5% of cases showing intraoral lesions as the primary feature, it is essential that dentists have the knowledge of this rare disease to refer and not to treat as a common gingival condition.


Assuntos
Odontólogos/educação , Doenças da Gengiva/diagnóstico , Granulomatose com Poliangiite/patologia , Úlceras Orais/etiologia , Assistência ao Convalescente , Antibacterianos/uso terapêutico , Anticorpos Anticitoplasma de Neutrófilos/metabolismo , Biópsia , Diagnóstico Diferencial , Eosinófilos/patologia , Feminino , Células Gigantes de Corpo Estranho/patologia , Doenças da Gengiva/patologia , Glucocorticoides/uso terapêutico , Granulomatose com Poliangiite/sangue , Granulomatose com Poliangiite/tratamento farmacológico , Hemorragia/diagnóstico , Hemorragia/etiologia , Humanos , Pessoa de Meia-Idade , Úlceras Orais/diagnóstico , Úlceras Orais/tratamento farmacológico , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Doenças Raras , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
8.
Cient. dent. (Ed. impr.) ; 16(1): 73-76, ene.-abr. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-183386

RESUMO

Objetivo: Mostrar las manifestaciones orales cuya etiología está relacionada con la artritis reumatoide (AR), revisando la literatura más reciente, a propósito de un caso. Caso clínico: El tratamiento de la AR está basado principalmente en la terapia farmacológica, siendo esta responsable de manifestaciones a nivel de la cavidad oral. Se presenta el caso de una mujer de 65 años con AR en tratamiento bajo metotrexato y tocilizumab, que acude a consulta por presentar desde hace 40 días una úlcera en el borde lateral de la lengua. Conclusión: Las manifestaciones orales de la AR derivan principalmente de la terapia farmacológica, que se debe conocer para el correcto diagnóstico y tratamiento de la patología oral de estos pacientes


Objective: The aim of the present article was to describe the oral manifestations whose etiology is related to rheumatoid arthritis (RA), reviewing the most recent literature, in relation to a case. Clinical case: The treatment of RA is based mainly on pharmacological therapy, being responsible for the manifestations at the level of the oral cavity. We present the case of a 65-year-old woman with RA on treatment with methotrexate and tocilizumab, which occurs through 40 days on the lateral border of the tongue. Conclusion: The oral manifestations of RA are derived mainly from pharmacological therapy, which should know the correct diagnosis and treatment of the oral pathology of these patients


Assuntos
Humanos , Feminino , Idoso , Artrite Reumatoide/complicações , Doenças da Língua/etiologia , Úlceras Orais/etiologia , Artrite Reumatoide/tratamento farmacológico , Metotrexato/administração & dosagem
9.
Dermatol Ther ; 32(3): e12868, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30835915

RESUMO

Crohn's disease (CD) is a chronic, autoimmune inflammatory disease which may affect the entire gastrointestinal tract, from the oral cavity to the anus. Oral-pharyngeal ulcerations may be significant and persistent in patients with established CD, and the use of TNF-α inhibitor has demonstrated to be useful. We report a unique case of an unusual manifestation of oral CD characterized only by multiple, giant, long-lasting, relapsing ulcerations successfully treated with an escalating dose of Adalimumab at 40 mg weekly as a monotherapy.


Assuntos
Adalimumab/administração & dosagem , Doença de Crohn/complicações , Úlceras Orais/tratamento farmacológico , /administração & dosagem , Doença de Crohn/tratamento farmacológico , Relação Dose-Resposta a Droga , Humanos , Masculino , Úlceras Orais/etiologia , Doenças Faríngeas/tratamento farmacológico , Doenças Faríngeas/etiologia , Adulto Jovem
12.
BMJ Case Rep ; 12(2)2019 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-30739092

RESUMO

A multitude of disease processes ranging from periodontitis to malignancies can lead to formation of solitary ulcer on the palate. Hence solitary ulcers of palate can often be a challenging one to diagnose. We report an interesting case of a diffuse large B cell lymphoma of the maxillary sinus which perforated the palatal bone and presented clinically as a palatal ulcer. Initially the lesion manifested as a small ill-defined swelling in the posterior palatal slope in relation to 24and25 which were mobile and hence was erroneously diagnosed as chronic periodontal abscess. This paper is intended to stress the relevance of including non-Hodgkin's lymphoma in the differential diagnosis of solitary palatal ulcers as it may be often misdiagnosed as more common reactive or inflammatory lesions.


Assuntos
Linfoma Difuso de Grandes Células B/patologia , Neoplasias do Seio Maxilar/patologia , Úlceras Orais/patologia , Palato/patologia , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Neoplasias do Seio Maxilar/complicações , Neoplasias do Seio Maxilar/diagnóstico por imagem , Úlceras Orais/etiologia
13.
J Vet Intern Med ; 33(2): 862-867, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30663796

RESUMO

A 12-year-old, neutered female, domestic medium hair cat was evaluated for a nonhealing, oral mucosal ulceration. The cat had a history of idiopathic hypercalcemia that had been treated with a bisphosphonate for 41 months. Oral examination identified exposed maxillary bone adjacent to a previous extraction site. Histopathology of the exposed bone and associated mucosa was most consistent with medication-related osteonecrosis of the jaw. Treatment involved both medical and surgical interventions. Oral mucosal healing occurred after 6 months of treatment.


Assuntos
Alendronato/efeitos adversos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/veterinária , Doenças do Gato/induzido quimicamente , Difosfonatos/efeitos adversos , Alendronato/uso terapêutico , Animais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/patologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Doenças do Gato/tratamento farmacológico , Gatos , Difosfonatos/uso terapêutico , Feminino , Hipercalcemia/tratamento farmacológico , Hipercalcemia/veterinária , Úlceras Orais/etiologia , Úlceras Orais/veterinária
14.
Oral Dis ; 25(2): 515-522, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30383915

RESUMO

OBJECTIVE: Oral ulceration with bone sequestration (OUBS) describes a site-specific intraoral ulcer that covers exposed, non-vital bone in patients lacking any etiological factor known to induce osteonecrosis. We aimed to conduct a retrospective study of eight new cases of OUBS and review the literature. SUBJECTS AND METHODS: This is a retrospective study of OUBS cases, diagnosed and managed during 2007-2017. Inclusion criteria were the presence of oral ulcer with exposed non-vital bone at sites of bone prominence and the absence of any factor known to cause osteonecrosis. The English literature was reviewed on original OUBS cases. RESULTS: Eight patients (5 males and 3 females, aged 27-75 years) were diagnosed with OUBS during years 2007-2017. Four cases involved the mandibular mylohyoid ridge, one a mandibular anterior exostosis and three the maxillary buccal/palatal exostoses. Exposed bone was removed under local anesthesia, resulting in complete healing in all cases. The literature review yielded 32 OUBS cases in the mandible. CONCLUSION: Oral ulceration with bone sequestration is a distinct, probably under-reported rather than rare clinical entity that should be regarded the provisional diagnosis in case of an oral ulcer covering exposed, non-vital bone at sites of bone prominence in patients lacking any etiological factor known to induce osteonecrosis.


Assuntos
Úlceras Orais/complicações , Osteonecrose/complicações , Adulto , Idoso , Feminino , Humanos , Masculino , Doenças Mandibulares/cirurgia , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Úlceras Orais/etiologia , Úlceras Orais/cirurgia , Osteonecrose/etiologia , Osteonecrose/cirurgia , Estudos Retrospectivos
15.
J Clin Pediatr Dent ; 43(1): 46-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30289370

RESUMO

Autoimmune neutropenia is a self-limiting condition characterized by the presence of granulocyte-specific autoantibodies. This case report describes a 2-year-old female who presented to the Department of Pediatric Dentistry with a history of oral ulceration, complicated by high temperature, gingival hypertrophy and gingival hemorrhage. These symptoms had precipitated an admission to a district general hospital and diagnosis of viral tonsillitis. The severity of the presentation to the Pediatric Dental Department prompted a review of recent discharge blood investigations, which revealed a neutrophil count of 0.07×109/L(1.0-8.5 ×109/L) indicating severe neutropenia. Urgent referral to Pediatric Hematology resulted in same-day admission and a diagnosis of autoimmune neutropenia was established. The patient was managed with chlorhexidine mouthwash, prophylactic antimicrobial and antifungal medication and granulocyte colony stimulating factor (G-CSF). Neutropenia may present with features exclusive to the oral cavity. Recognition of atypical presentations such as oral ulceration with associated systemic illness may assist in early diagnosis.


Assuntos
Hemorragia Gengival , Hipertrofia Gengival , Neutropenia , Úlceras Orais/etiologia , Criança , Pré-Escolar , Feminino , Hemorragia Gengival/etiologia , Hipertrofia Gengival/etiologia , Fator Estimulador de Colônias de Granulócitos , Humanos , Neutropenia/complicações , Neutropenia/diagnóstico
16.
J Prosthet Dent ; 121(1): 76-82, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30093125

RESUMO

STATEMENT OF PROBLEM: Management of denture-related traumatic ulcers using ozone may improve tissue healing and reduce patient pain and discomfort. PURPOSE: The purpose of this clinical investigation was to assess the efficacy of ozone in the treatment of denture-related traumatic ulcers. MATERIAL AND METHODS: Seventy-five participants (study group) with denture-related traumatic ulcers were evaluated in this blinded, controlled cohort observational investigation. A control group (n=75) of participants with denture-related traumatic ulcers who matched the study group in sex and age were also recruited. Ulcers were treated with ozone gas for 60 seconds in the study group and with air for 60 seconds in the control group. Pain levels were evaluated by means of a visual analog scale (VAS), and ulcer sizes were measured in each participant at experiment baseline and each day for 15 days. Ulcer duration was established by calculating the period it took to completely heal and disappear. Major outcome measurements were ulcer duration, ulcer size, and levels of pain. RESULTS: Ulcer size decreased from day 2 in the study group (after ozone application) (P≤.01) and from day 4 in the controls (P≤.001). Recorded pain levels decreased from the first day soon after ozone application in the study group (P≤.001) and from day 3 in the controls (P<.001). Ulcer duration, ulcer size from day 3 to day 10, and reported pain levels from day 1 to day 10 decreased more in the study group (P≤.004). CONCLUSIONS: Exposure of denture-related traumatic ulcers to 60 seconds of ozone gas was associated with better ulcer healing and decreased pain levels, ulcer size, and ulcer duration.


Assuntos
Prótese Total/efeitos adversos , Úlceras Orais/tratamento farmacológico , Úlceras Orais/etiologia , Ozônio/uso terapêutico , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Úlceras Orais/patologia , Ozônio/administração & dosagem , Manejo da Dor/métodos , Resultado do Tratamento
17.
Pan Afr Med J ; 30: 230, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30574248

RESUMO

Behçet syndrome is a chronic, recurring, systemic disorder characterized by the histopathologic finding of nonspecific vasculitis in multiple organs. Behçet syndrome involves the gastrointestinal tract in 10-50% of patients; The main sites of involvement are the terminal ileum and cecum. In patients with Behçet syndrome, CT is advocated for early detection of complications as well as for exclusion of other abdominal pathologic conditions but there is no specific exam. The report of histology in conjunction with the clinical history and the presence of oral ulcers, uveitis and suspected cutaneous lesions suggests the diagnosis. The optimal medical treatment of Behçet syndrome has not yet been well established. In rare cases surgery must be required to control the disease. The authors report one case of Behcet Syndrome presenting with intestinal perforation.


Assuntos
Síndrome de Behçet/diagnóstico , Perfuração Intestinal/etiologia , Úlceras Orais/etiologia , Uveíte/etiologia , Adulto , Síndrome de Behçet/complicações , Síndrome de Behçet/cirurgia , Humanos , Perfuração Intestinal/cirurgia , Masculino , Tomografia Computadorizada por Raios X/métodos
18.
J Appl Oral Sci ; 27: e20180207, 2018 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-30427476

RESUMO

Ankylosing Spondylitis (AS) is an inflammatory rheumatic disease that affects the axial skeleton and the sacroiliac joints. Recent studies investigated the link between AS and oral diseases, particularly periodontitis. Others suggested that periodontitis may have a role in the pathogenesis of rheumatic diseases. OBJECTIVE: The aim of this study is to investigate the association between AS and oral conditions. MATERIAL AND METHODS: This research was conducted using the UK Biobank Resource under Application Number 26307. The UK Biobank recruited around 500000 participants throughout Great Britain. Clinical records were available for 2734 participants. Two case-control studies were conducted based on whether AS was self-reported or clinically diagnosed. Oral conditions were identified using self-reported reports of oral ulcers, painful gums, bleeding gums, loose teeth, toothache, and dentures. The association between AS and oral conditions was assessed using logistic regression adjusted for age, gender, educational level, smoking status, alcohol consumption, and body mass index. RESULTS: A total of 1307 cases and 491503 control participants were eligible for the self-reported AS study. The mean age was 58 years for the cases [7.5 standard deviation (SD)] and 57 years for the control groups (8.1 SD). Also, 37.1% of the cases and 54.2% of the control participants were females. Among the oral conditions, only oral ulcers were strongly associated with AS [1.57 adjusted odds ratio (OR); 95% confidence interval (CI) 1.31 to 1.88]. For the study of clinically diagnosed AS, 153 cases and 490351 control participants were identified. The mean age for both cases and control groups was 57 years; 7.6 SD for the cases and 8.1 for the control group. Females corresponded to 26.1% of the cases, and 54.2% of the control participants. Clinically diagnosed AS was associated with self-reported oral ulcers (2.17 adjusted OR; 95% CI 1.33 to 3.53). CONCLUSION: Self-reported and clinically diagnosed AS populations have increased risk of reporting oral ulcers. Further investigations are required to assess the link between a specific type of oral condition and AS.


Assuntos
Saúde Bucal/estatística & dados numéricos , Úlceras Orais/epidemiologia , Úlceras Orais/etiologia , Espondilite Anquilosante/complicações , Espondilite Anquilosante/epidemiologia , Adulto , Idoso , Bancos de Espécimes Biológicos , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Periodontite/etiologia , Prevalência , Fatores de Risco , Autorrelato , Reino Unido/epidemiologia
19.
J R Coll Physicians Edinb ; 48(4): 323-327, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30488887

RESUMO

Behçet's disease is a chronic, relapsing, systemic inflammatory disease affecting the orogenital mucosa, eyes, joints, blood vessels, nervous system and intestines. The prevalence of neurological involvement varies geographically and can include psychiatric manifestations. Current evidence for a causal association between Behçet's disease and bipolar disorder is limited to a small number of case reports. We report a case of a patient with a recent diagnosis of bipolar disorder who was subsequently diagnosed with Behçet's disease. The 38-year-old male presented with a 6-month history of right eye visual blurring, 5-month history of mouth ulcers and 3 months of genital ulceration. His inflammatory markers were raised. An MRI of the brain was conducted in the absence of any focal neurological signs or symptoms owing to his past psychiatric history. The MRI showed changes in the medial aspect of the right temporal lobe highly suspicious of neuro-Behçet's disease. His inpatient care was coordinated with neurology, rheumatology, ophthalmology and psychiatry teams, and he was later discharged with outpatient follow up owing to a clinical improvement on high-dose steroids. This case shows that, although widely unrecognised, neuro-Behçet's can occur in the absence of focal neurology. Additionally, neuro-Behçet's should be considered in patients with bipolar disorder presenting with symptoms suggestive of Behçet's disease. The case emphasises how patients presenting with ulceration, mood disorder and visual changes should not have these symptoms considered in isolation and multisystem disease should be considered. Furthermore, the coordinated multidisciplinary approach required for the care of patients with Behçet's disease is demonstrated.


Assuntos
Síndrome de Behçet/complicações , Síndrome de Behçet/diagnóstico por imagem , Transtorno Bipolar/complicações , Encéfalo/diagnóstico por imagem , Adulto , Doenças dos Genitais Masculinos/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Neuroimagem , Úlceras Orais/etiologia , Úlcera Cutânea/etiologia , Transtornos da Visão/etiologia
20.
Rev Med Brux ; 39(4): 330-336, 2018.
Artigo em Francês | MEDLINE | ID: mdl-30320997

RESUMO

Ulcerations and erosions of the oral mucosa are common and occur at any age. Their knowledge and recognition are essential to ensure optimal care at the earliest stage. Etiologies are numerous and the subject of different classifications. In this work, the authors address the most frequently encountered lesions, describing their main clinical presentations. A review of treatments is then proposed.


Assuntos
Úlceras Orais , Humanos , Mucosa Bucal , Úlceras Orais/diagnóstico , Úlceras Orais/etiologia , Úlceras Orais/terapia
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