ABSTRACT
RESUMEN: El queratoquiste odontogénico (QQO) es una quiste intraóseo poco frecuente que varía entre un 3 a 11% de todos los quistes odontogénicos, su ubicación en el maxilar es rara y la invasión al seno maxilar lo es aún más. El QQO es una patología benigna, localmente agresiva que tiene una alta tasa de recidiva. Se han descrito diversas técnicas quirúrgicas para su tratamiento, las cuales van desde lo más conservador como la enucleación a lo más radical como una resección. El uso de agentes coadyuvantes químicos o cauterizantes han logrado disminuir la tasa de recidiva en conjunto con tratamientos más conservadores, disminuyendo la morbilidad y secuelas asociada a una resección. El objetivo de este trabajo es presentar una serie de casos clínicos de QQO que invaden el seno maxilar, su tratamiento de manera conservadora y una revisión de la literatura comparando los diversos tratamientos y su tasa de recidiva.
ABSTRACT: Odontogenic keratocyst (OC) is a rare intraosseous pathology that varies between 3 % and 11 % of all odontogenic cysts, its location in the maxilla is rare, and invasion of the maxillary sinus is even more so. OC is a benign, locally aggressive pathology that has a high recurrence rate. Various surgical techniques have been described for its treatment, ranging from the most conservative, such as enucleation, to the most radical, such as resection. The use of chemical or cauterizing adjuvant agents has managed to reduce the recurrence rate in conjunction with more conservative treatments, reducing the morbidity and sequelae associated with a resection. The objective of this work is to present a series of clinical cases of OC that invade the maxillary sinus, their treatment being carried out in a conservatively manner, and a review of the literature comparing the various treatments and their recurrence rate.
ABSTRACT
Background: There is phenotypic and genetic variability among the species Borrelia burgdorferi that produces Lyme disease. Three gene species and seven serotypes have been defined. Aim: To study the efficacy of two gene species in the serological diagnosis of Borrelia burgdorferi infections in Granada, Spain. Material and methods: One thousand sixty nine sera coming from 1,251 subjects without Lyme borreliosis were analyzed. These subjects were studied for health or pregnancy controls, differential diagnosis of viral disease, diagnosis of syphilis, neurological or rheumatic diseases. In all samples, antibodies against Borrelia burgdorferi (B31 and Pko strains) and against Treponema pallidum were investigated. Screening tests (ELISA and hemagglutination) were followed by confirmations tests for positive samples (Western Blot IgG strain B31 and FTA-abs respectively). A clinical and laboratory follow up was done for subjects with positive serological tests. Results: The global rate of positive antibodies against Borrelia burgdorferi B31 was 8.31 per cent and against the strain Pko was 0.64 per cent. Western blot was negative in 36 per cent of subjects with positive ELISA B31. The distribution of antibodies against the strain B31 was acute herpes virus infection in 16 per cent, gestation in 3 per cent, HIV infection in 6.4 per cent, T pallidum infection in 36 per cent, rheumatic diseases in 25 per cent, neurological diseases in 17.5 per cent and health controls in 7.4 per cent. The percentage of positive Western Blot analyzes were 0.8, 2.1 and 0.4 per cent respectively. A reversion of positive ELISA tests was observed in 6 subjects. Conclusions: The disparity in rates of antibodies against Borrelia burgdorferi in different geographic regions may be due to differences in the serological tests used. The high rate of false positive ELISA tests underscores the need to use other serological tests
Subject(s)
Humans , Lyme Disease/diagnosis , Borrelia burgdorferi/pathogenicity , In Vitro Techniques , Serologic Tests/methods , Enzyme-Linked Immunosorbent Assay , Blotting, Western , Polymerase Chain ReactionABSTRACT
Some direct methods that can be used for the diagnosis of Lyme borreliosis are the culture, direct visualization or the detection of microbial DNA using polymerase chain reactions, in body tissues or fluids. Unfortunately, all these methods have a low sensitivity. There is a wide assortment of tests and antigens for indirect diagnosis, and the most recommended are ELISA tests and Western blot. The main inconvenient of these tests are the existence of shared serologic reactions, the variability of immune response and the difficult interpretation of results. Therefore, we propose the following guidelines for the diagnosis of Lyme borreliosis: For sero-epidemiological studies and to diagnose infection, antibodies should be determined in subjects with a compatible clinical picture, using an ELISA test that must be positive in at least two separate samples. All positive ELISA results should be confirmed with Western blot analysis, that must be interpreted using established criteria. Polymerase chain reactions should be used when they are available