Periodontitis and anti-neutrophil cytoplasmic antibodies in systemic lupus erythematosus and rheumatoid arthritis: a comparative study.

BACKGROUND: This investigation was designed to determine and compare the distribution pattern of anti-neutrophil cytoplasmic antibodies (ANCA) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in the presence or absence of periodontal disease. METHODS: Sera of 30 patients with SLE and 30 with RA were tested for ANCA utilizing an indirect enzyme immunosorbent assay (ELISA) directed to a neutrophil granular extract and 6 neutrophil granule proteins. A control group of 20 healthy individuals showing neither evidence of periodontal disease nor systemic compromise was also included in this study. RESULTS: For RA, the number of ANCA-positive sera was very low but was evenly distributed among patients with and without periodontitis. Conversely, a high number of ANCA-positive sera in SLE was found mostly in individuals presenting periodontal compromise. A statistically significant association between ANCA and periodontitis in SLE patients was found (P <0.005, chi square test). CONCLUSIONS: A marked difference in the number and distribution of ANCA with respect to periodontitis between RA and SLE was found. Hyperresponsiveness of B cells and polyclonal B activation to periodontopathic bacteria in SLE might be accountable for the high numbers of ANCA and the close association observed between those autoantibodies and periodontitis in SLE.

[Malignant turn of oral planus in three new cases]. / Transformación maligna del liquen plano oral en tres nuevos casos.

The possible malignant potential of oral lichen planus (OLP) is still controversial. We present three new oral lichen planus (OLP) patients who developed oral squamous-cell carcinoma (OSCC). In all cases, were analyzed variables like sex, age, clinical type, localization, extension, follow-up study and treatment, moreover were considered the patient's habits, localization, stage and treatment of cancer. The average age was 59 years and both of them were non smoker or with no alcohol habits. The follow-up period was greater than two years and the malignant lesion developed after mean of nine years, after the diagnosis of OLP had been established. Oral squamous-cell carcinoma (OSCC) arose on lesions previously diagnosed clinically and histologically as atrophic and erosive oral lichen planus in two of our patients and on a plaque lesion LP in a patient. All of them had been using topical corticoids before the cancer was diagnosed. The appearance of new cases of OLP malignization framed inside the established approaches, suggests the realization of new researches in order to determine the factors involved in this process.

Characteristics of the subject and interview influencing the test-retest reliability of the Diagnostic Interview for Children and Adolescents-Revised.

This paper reviews some of the characteristics of the informants as well as some of the attributes of the DICA-R interview that could influence the test-retest reliability in a sample of 109 psychiatric outpatients aged 7-17 years. Different regression models using reliability coefficients constructed from the kappa statistic were obtained. Of those characteristics evaluated in the children, a high level of psychological impairment proved to be significant when it came to predicting the lowest test-retest reliability of the answers; none of the subject-related characteristics were significant in the adolescent patient model. The attributes of the questions that proved to be significant when explaining the lower reliability obtained for the individual question in the children's model were the length of the questions (longest questions), the content (internalising), the presence of time concepts, comparison with the peer group, and the need to exercise judgement; in the adolescents' model, the significant attributes were found to be the internalising content, the presence of time concepts, evaluation concerning the impairment caused by the disorder, and the need to exercise judgement. In the group of children our results are in accordance with the original paper. Similar results were found with adolescents. These findings have implications for the development and revision of new interview schedules.

Oral-disease prevention in children with cancer: testing preventive protocol effectiveness.

UNLABELLED: Mucositis, gingivitis, herpetic stomatitis and candidiasis are a potential source of systemic infection in patients undergoing chemotherapy. Their severity and incidence may be reduced with procedures based on the prevention and elimination of sources causing oral infection and irritation. OBJECTIVE: The purpose of this investigation was to evaluate the effectiveness of an Oral Disease Preventive Protocol in children with cancer, subjected to chemotherapy and prior to application of dentobacterial infection control. MATERIAL AND METHODS: A controlled clinical test was run, with random assignations, on twelve 5-to-12-year-old patients diagnosed with Acute Lymphoblastic Leukemia (ALL) or Lymphoma, evaluated for twelve months, with a total of 154 evaluations. Five patients were boosted with oral physiotherapy, with non-alcoholic 0.05% fluoride mouthwashes, with topical application of myconazole oral gel; seven patients were given instructions on oral physiotherapy. RESULTS: There were no significant differences between the groups under evaluation (p>0.05). Of the oral complications evaluated, gingivitis registered the highest percentage (60%), followed by mucositis (18%) and candida albicans infection (7%). Most affected were the submandibular and cervical ganglions (59% and 41%, respectively). CONCLUSIONS: Prior control of sources causing oral infection and irritation effectively prevents complications during non-surgical cancer therapy.

Estado actual de la tuberculosis: servicio de salud metropolitano occidente / Current situation of tuberculosis in the west metropolitan health service

Se analiza el estado actual de la tuberculosis en el Servicio de Salud Metropolitano Occidente, así como del Programa de control de la afección en sus diversos aspectos de prevención (vacunación BCG); detección y localización de casos en la comunidad; notificación, tratamiento y control de ellos; capacitación del personal médico y paramédico involucrado en las acciones y supervisión técnica y evaluación periódica de las acciones programadas

Estado actual de la tuberculosis en el Servicio de Salud Metropolitano Occidente / Current status of tuberculosis in the Servicio de Salud Metropolitano Occidente

La tuberculosis persiste como un problema clínico, diagnóstico, terapéutico y epidemiológico pese a observarse una lenta pero mantenida tendencia a la disminución, tanto de la morbilidad como de la mortalidad atribuídas a ella en el curso de la última década. Lo anterior obliga a mantener una actitud de permanente alerta y a intensificar la pesquisa de los casos bacilíferos diseminados en la comunidad a través de la baciloscopía de expectoración de los casos sintomáticos y de los integrantes de los grupos de alto riesgo (inmunodeprimidos). Es necesario propender al diagnóstico y tratamiento lo mas precozmente posible de los casos detectados, aplicar cabalmente las normas establecidas y rescatar los pacientes que abandonan. Por último es de la mayor importancia el estudio de los contactos de los casos pesquisados y la educación sanitaria individual, familiar y colectiva