RESUMO
OBJECTIVE: The efficacy of a topical gel with triester glycerol oxide for treating ulcerations related to new complete dentures was studied and compared with a placebo gel. MATERIALS AND METHODS: Fifty edentulous patients were enrolled in this double-blind clinical study. All subjects received new maxillary and mandibular complete dentures and were recalled 1, 3 and 7 days after denture placement. Twenty-five subjects received topical gel with triester glycerol oxide (TGO), and 25 subjects received topical gel without TGO. At each visit, pain and discomfort with the new dentures was assessed, and at the last visit, healing of ulcerations was also graded by a clinician. Subjects also graded the gel's taste, smell and ease of use. RESULTS: Specifically, there was no statistically significant difference in ulcer healing (p > 0.05), ratings of smell, taste and ease of use (p > 0.05) or pain and discomfort scores (p > 0.05). However, within-group differences were observed in pain and discomfort scores between follow-up sessions (p = 0.01 for all comparisons). CONCLUSION: Clinically, TGO gel is not effective in the treatment of mucosal injuries occurring following placement of complete dentures.
Assuntos
Prótese Total/efeitos adversos , Emolientes/uso terapêutico , Glicerol/uso terapêutico , Úlceras Orais/tratamento farmacológico , Estomatite sob Prótese/tratamento farmacológico , Triglicerídeos/uso terapêutico , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Seguimentos , Géis , Humanos , Pessoa de Meia-Idade , Mucosa Bucal/efeitos dos fármacos , Mucosa Bucal/lesões , Boca Edêntula/reabilitação , Higiene Bucal , Úlceras Orais/etiologia , Dor/prevenção & controle , Satisfação do Paciente , Placebos , Olfato/efeitos dos fármacos , Fumar , Estomatite sob Prótese/etiologia , Paladar/efeitos dos fármacos , Condicionamento de Tecido Mole Oral , Resultado do TratamentoRESUMO
Cardiac valvular calcification (VC) is a frequent finding in chronic hemodialysis patients. In addition to demographic and metabolic factors, genetic susceptibility may also influence the occurrence and severity of these abnormalities and account for interindividual variability among patients. In this report, we studied the relation of calcium-sensing receptor (CaSR) gene polymorphisms to the development of VC in chronic hemodialysis patients. A total of 41 chronic hemodialysis patients (26 male, mean age 47.23 +/- 11.36 years vs. 15 females, mean age 48.13 +/- 14.66 years) undergoing treatment for more than 1 year were evaluated with transthoracic echocardiography. In patients with and without VC, CaSR gene polymorphisms (A990G, C1011G) were investigated by PCR, using allele-specific primers. In randomly chosen subjects, PCR analysis was verified by DNA sequencing. Cardiac valve calcification was detected in 21 patients (51.2%). Five of these patients (12.2%) had mitral valve calcification, 4 (9.75%) had aortic valve calcification, and 12 (29.27%) had both. In patients with VC, the frequency of the A/G genotype was slightly higher than those with no VC with a borderline P value (42.9% vs. 15%, chi(2)=3.840, P=0.050). The frequency of the C/C genotype was similar in patients with and without VC (90.5% vs. 85%, P>0.05). The results of this study are not enough to prove the role of CaSR gene polymorphisms in the development of VC. There is a need for large-scale studies on this topic.
Assuntos
Estenose da Valva Aórtica/genética , Calcinose/genética , Estenose da Valva Mitral/genética , Receptores de Detecção de Cálcio/genética , Insuficiência Renal Crônica/genética , Adulto , Estenose da Valva Aórtica/complicações , Calcinose/complicações , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/complicações , Projetos Piloto , Polimorfismo Genético , Diálise Renal , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/terapiaRESUMO
OBJECTIVES: The mammalian target of rapamycin inhibitors sirolimus and everolimus are immunosuppressive drugs for kidney transplant patients, but adverse events may include proteinuria. The purpose of this study was to compare the effects of sirolimus and everolimus on creatinine clearance and proteinuria after kidney transplant. MATERIALS AND METHODS: This study was a prospective evaluation period of 50 patients (age, 16-65 y) who had kidney transplant. There were 25 patients who used sirolimus and 25 patients who used everolimus. Evaluation at the beginning mTOR and end of the evaluation period included complete blood count, blood pressure, serum creatinine level, creatinine clearance, and proteinuria level in a 24-hour urine collection. RESULTS: Mean creatinine clearance at the beginning and end of the evaluation period was significantly less in the everolimus than sirolimus group. There was no significant change in creatinine clearance from the beginning to end of the evaluation period in either the sirolimus or everolimus group. Mean proteinuria at the beginning and end of the evaluation period was similar between the sirolimus and everolimus groups. Both groups had a significant increase in mean proteinuria from beginning to end of the evaluation period, but the increase in proteinuria was similar for the sirolimus and everolimus groups (difference not significant). CONCLUSIONS: In kidney transplant recipients, sirolimus and everolimus are associated with a similar level of increased mean proteinuria.
Assuntos
Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Proteinúria/induzido quimicamente , Sirolimo/análogos & derivados , Serina-Treonina Quinases TOR/antagonistas & inibidores , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Creatinina/sangue , Everolimo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/induzido quimicamente , Síndrome Nefrótica/diagnóstico , Estudos Prospectivos , Proteinúria/sangue , Proteinúria/diagnóstico , Fatores de Risco , Sirolimo/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
Ramsay Hunt syndrome is a rare complication of herpes zoster disease in which reactivation of latent varicella zoster virus infection occurs in the geniculate ganglion causing otalgia, unilateral vesicular eruption in a restricted dermatomal distribution, and peripheral facial paralysis. Dermal infections caused by human pathogenic herpes viruses are common in organ transplant recipients. For a transplant surgeon, it is imperative to remember that viral prophylaxis is essential in the follow-up of the transplant patients. Here, we presented a case of renal transplant and Ramsay Hunt syndrome with multiple cranial nerve involvement, with an atypical course. Management and differential diagnosis of this particular case are discussed with a review of the literature.
Assuntos
Herpes Zoster da Orelha Externa/virologia , Herpesvirus Humano 3/patogenicidade , Transplante de Rim/efeitos adversos , Adulto , Anticorpos Antivirais/sangue , Antivirais/uso terapêutico , Progressão da Doença , Dor de Orelha/virologia , Dor Facial/virologia , Paralisia Facial/virologia , Herpes Zoster da Orelha Externa/tratamento farmacológico , Herpes Zoster da Orelha Externa/patologia , Herpesvirus Humano 3/imunologia , Humanos , Imunossupressores/efeitos adversos , Masculino , Dermatopatias Infecciosas/virologia , Resultado do Tratamento , Vertigem/virologia , Ativação ViralRESUMO
OBJECTIVES/BACKGROUND: The aim of this study is to investigate the predictive value of intraoperative parathormone measurement addressing successful surgical resection in patients with secondary hyperparathyroidism. METHODS: The study included 42 consecutive patients operated on between May 2006 and July 2008. Patients were grouped according to successful surgery (Group 1, n = 36) and persistent postoperative hyperparathyroidism (Group 2, n = 6). Serum phosphorus (P), total calcium (tCa), ionized calcium (iCa), intact parathormone (iPTH), and alkaline phosphatase (ALP) were drawn preoperatively and intraoperatively upon 15 minutes after completion of resection (iPTH(15)). The rate of decrease of pith detected by iPTH(15) compared to preoperative values was calculated (iPTH(%)). RESULTS: Preoperative P, tCa, iCa, iPTH, and ALP were comparable. Subtotal parathyroidectomy (sPx) (n = 27) and total parathyroidectomy with autotransplantation (tPx) (n = 15) were performed. Mean iPTH(15) value, iPTH(%) rates were 145.9 +/- 12.3 pg/mL, % 91.6 +/- 0.7, and 522.5 +/- 85.4 pg/mL, % 75.1 +/- 2.0 (P = ,001) in Groups 1 and 2, respectively. Mean serum tCa and iCa at POD#1 in Group 1 were 7.6 +/- 0.1 mg/dL, 0.910 +/- 0.4 mmol/L, and Group 2 were 8.3 +/- 0.3 mg/dL, 1.050 +/- 0.4 mmol/L (P < .05), respectively. ALP levels were similar. CONCLUSION: iPTH(15) value and iPTH(%) rate accurately predicts the completeness of resection in secondary hyperparathyroidism. The rate of decrease in serum iPTH detected intraoperatively compared to preoperative baseline levels exceeding 90% in sPx, 95% in tPx, accurately predicts the success of surgery. Postoperative normocalcemia without calcium replacement would raise a suspicion about completeness of surgical resection.
Assuntos
Hiperparatireoidismo Secundário/cirurgia , Hormônio Paratireóideo/sangue , Paratireoidectomia , Adulto , Feminino , Humanos , Período Intraoperatório , Masculino , Valor Preditivo dos Testes , Resultado do TratamentoRESUMO
Cerebellar liponeurocytoma that has been recently identified as a distinct entity by the World Health Organization is characterized by areas of lipomatous differentiation and apparently by a favorable prognosis. In this paper, we described a case of 49-year-old female showing progressive clinical course inspite of a low labeling/mitotic index. We also review the relevant literature. Although, basically all reported cases share a similar histological pattern, i.e. focal accumulations of adiposities in an otherwise typical small cell tumor like central neurocytoma, some clinical properties such as (age, proliferative potential, therapy and survival) are not uniform. The exact biological behavior of this special variant tumor is established. Yet, this needs further confirmation on a large number of cases with longer follow-up periods.