Efficacy of current vaccines against recently isolated foot and mouth disease virus type A South America (Venezuela) in Egypt 2022

Foot and mouth disease is a highly contagious viral disease that poses a significant economic threat to cloven-hoofed animals, including cattle and sheep. The emergence of a novel foot and mouth disease virus-A isolate, FMDV-A-Egy-AHRI-RL385-Ven-2022, in Egypt in 2022 has raised concerns about its potential impact on existing vaccination programs. Given that vaccination is a key strategy for foot and mouth disease virus control, the present study was aimed to assess the cross-protective efficacy of both local and imported inactivated vaccines against this new threat. Through challenge experiments and serum neutralization tests, we observed limited effectiveness of both vaccine types. The calculated r1-values at 28 days post-vaccination indicated a minimal immune response to FMDV-A-Egy-AHRI-RL385-Ven-2022 (0.176 and 0.175 for local and imported vaccines, respectively). Challenge experiments further confirmed these findings, revealing 0percent protection from the local vaccine and only 20percent rotection from imported vaccines by day 7 post-challenge. These results underscore the urgent need to update existing foot and mouth disease virus vaccines in Egypt by incorporating the newly circulating FMDV-A-Egy-AHRI-RL385-Ven-2022 strain. This proactive measure is crucial to prevent future outbreaks and ensure effective disease control(AU)

La fiebre aftosa es una enfermedad vírica muy contagiosa que supone una importante amenaza económica para los animales biungulados, entre ellos el ganado vacuno y ovino. La aparición de un nuevo aislado del virus A de la fiebre aftosa, el FMDV-A-Egy-AHRI-RL385-Ven-2022, en Egipto en 2022 ha suscitado preocupación por su posible impacto en los programas de vacunación existentes. Dado que la vacunación es una estrategia clave para el control del virus de la fiebre aftosa, el objetivo del presente estudio fue evaluar la eficacia protectora cruzada de las vacunas inactivadas locales e importadas frente a esta nueva amenaza. Mediante experimentos de desafío y pruebas de seroneutralización, observamos una eficacia limitada de ambos tipos de vacuna. Los valores r1 calculados a los 28 días posvacunación indicaron una respuesta inmunitaria mínima frente a FMDV-A-Egy-AHRI-RL385-Ven-2022 (0,176 y 0,175 para las vacunas local e importada, respectivamente). Los experimentos de provocación confirmaron aún más estos resultados, revelando un 0 por ciento de protección de la vacuna local y sólo un 20 por ciento de protección de las vacunas importadas al séptimo día después de la provocación. Estos resultados subrayan la urgente necesidad de actualizar las vacunas existentes contra el virus de la fiebre aftosa en Egipto incorporando la nueva cepa circulante FMDV-A-Egy-AHRI-RL385-Ven-2022. Esta medida proactiva es crucial para prevenir futuros brotes y garantizar un control eficaz de la enfermedad(AU)

Láser de baja frecuencia para aftas mayores recurrentes. Caso Clínico / Low frequency laser for major recurrent aphthous stomatitis. Clinical case

La estomatitis aftosa recurrente (menor, mayor o herpética) es una de las enfermedades bucodentales más frecuentes, de etiología multifactorial y con predisposición genética. Para esta patología su diagnóstico es clínico, y tomando como base la historia clínica se puede discriminar con otras patologías ulcerativas. La terapia con láser de baja potencia (LLLT) se propone como un tratamiento no invasivo, actuando como un fotomodulador celular, por lo que reduce el dolor, la inflamación, y estimula la regeneración tisular, previniendo daños. En el presente artículo se reporta a un niño de 11 años con una herida dolorosa de 4 meses en el borde posterior de la lengua que apareció tras una mordedura, en el que a la exploración clínica se encontró una lesión amarillenta con zonas enrojecidas, rodeada de un halo blanquecino de bordes redondeados. Para el tratamiento se utilizó LLLT, luego de una semana disminuyó el dolor, el paciente comenzó a comer correctamente, a los 15 días se observó una reducción de los bordes rojizos de la lesión, pasado el mes la lesión había remitido casi por completo. La LLLT se describe como un tratamiento eficaz, no invasivo, reduciendo los síntomas, y mejorando la calidad de vida del paciente al promover la curación de las lesiones.

Recurrent aphthous stomatitis (minor, major or herpetic) is one of the most frequent bucodental diseases, of multifactorial etiology and with genetic predisposition. The diagnosis of this pathology is clinical, and based on the clinical history it can be discriminated with other ulcerative pathologies. Low power laser therapy (LLLT) is proposed as a non-invasive treatment, acting as a cellular photo modulator, which reduces pain, inflammation, and stimulating tissue regeneration, preventing damage. This article reports an 11-year-old boy with a 4-month-old painful wound on the posterior edge of the tongue that appeared after a bite, in which clinical examination revealed a yellowish lesion with reddened areas, surrounded by a whitish halo with rounded edges. LLLT was used for the treatment, after one week the pain decreased, the patient started to eat properly, after 15 days a reduction of the reddish edges of the lesion was observed, after one month the lesion had almost completely remitted. LLLT is described as an effective, non-invasive treatment, which reduces symptoms and improves the patient's quality of life promoting the healing of the lesions.

Eficacia del bórax en el tratamiento de la estomatitis aftosa

Fundamento: la estomatitis aftosa es una enfermedad crónica caracterizada por la ulceración de la mucosa bucal no queratinizada, que se presenta de forma aguda y dolorosa. Objetivo: evaluar la eficacia del bórax en el tratamiento de la estomatitis aftosa. Métodos: se realizó un estudio analítico, longitudinal prospectivo, en el Departamento de Estomatología del Policlínico Norte, Ángel del Castillo Agramonte, del municipio de Florida, en el período comprendido de diciembre del 2019 hasta abril del 2021. El universo estuvo constituido por 139 pacientes, y la muestra quedó conformada por 70 pacientes seleccionados por un método aleatorio simple. La misma quedó dividida en dos grupos: uno de estudio y otro de control a los que se le aplicó un tratamiento homeopático con bórax y un tratamiento convencional, respectivamente. Resultados: el rango de edad más afectado fue el de 21- 30 años, y el sexo femenino fue el más representado; los labios constituyeron el sitio de mayor afectación y prevaleció la estomatitis aftosa en su forma menor. En cada visita de control se observó una mejor evolución del dolor, el ardor y la cicatrización de las lesiones con el tratamiento homeopático, que con el convencional; se observó una efectividad de un 100 % en los pacientes tratados con bórax y la mayoría de los pacientes se mostró satisfecha con el tratamiento homeopático recibido. Conclusiones: el bórax resulta eficaz para el tratamiento de la estomatitis aftosa.

Background: aphthous stomatitis is a chronic disease characterized by the non-keratinized oral mucosa ulceration, which presents acutely and painfully. Objective: to evaluate the efficacy of borax in the aphthous stomatitis treatment. Methods: an analytical, longitudinal prospective study was carried out in the North Polyclinic Stomatology Department, Ángel del Castillo Agramonte, in the Florida municipality, from December 2019 to April 2021. 139 patients were studied and the sample was made up of 70 patients selected by a simple random method. It was divided into two groups: a study group and a control group to which a homeopathic treatment with borax and a conventional treatment were applied, respectively. Results: the most affected age range was 21-30 years old, and the female sex was the most represented; the lips were the most affected site and aphthous stomatitis prevailed in its minor form. At each control visit, a better evolution of pain, burning, and healing of the lesions was observed with the homeopathic treatment than with the conventional one; an effectiveness of 100% was observed in the patients treated with borax and the majority of the patients were satisfied with the homeopathic treatment received. Conclusions: borax is effective for the treatment of aphthous stomatitis.

Tratamiento con radiación láser de baja potencia en pacientes con estomatitis aftosa recurrente

Fundamento entre las urgencias periodontales que requieren atención inmediata está la estomatitis aftosa recurrente, debido a las molestias o complicaciones que ocasiona al paciente. El empleo de la radiación láser de baja potencia puede resultar efectivo en el tratamiento de esta entidad. Objetivo determinar el efecto terapéutico del tratamiento con radiación láser de baja potencia en pacientes con diagnóstico de estomatitis aftosa recurrente. Métodos estudio descriptivo, transversal, realizado en el periodo mayo/2019-mayo/2021, en el servicio estomatológico del policlínico Dr. Enrique Barnet, del municipio de Lajas, provincia de Cienfuegos, que incluyó a 46 pacientes con diagnóstico de estomatitis aftosa recurrente. Se empleó el análisis de documentos, la observación y el cuestionario; además del examen bucal como método diagnóstico. Los pacientes recibieron tratamiento con radiación láser de baja potencia. Se aplicó el programa EPIDAT 3.1 para el procesamiento estadístico de los datos. Resultados predominó el sexo femenino, la edad entre 19-34 años, así como las úlceras aftosas menores. Las lesiones se localizaron principalmente en labio. El 97,83 % de los pacientes refirió remisión de la lesión al quinto día de tratamiento. Todos los pacientes tratados evolucionaron favorablemente hacia la cicatrización. Solo un paciente presentó reacciones adversas. Conclusiones los resultados permitieron constatar los beneficios terapéuticos de la terapia con láser de baja potencia en el tratamiento de la estomatitis aftosa recurrente.

Background among the periodontal emergencies that require immediate attention is the RAS, due to the inconvenience or complications that it causes to the patient. The use of low power laser radiation can be effective in the treatment of this entity. Objective to determine the therapeutic effect of treatment with low-power laser radiation in patients diagnosed with recurrent aphthous stomatitis. Methods descriptive, cross-sectional study, carried out from May/2019 to May/2021, in the Dr. Enrique Barnet polyclinic's dental service, in Lajas municipality, Cienfuegos province, which included 46 patients diagnosed with recurrent aphthous stomatitis. Document analysis, observation and questionnaire were used; in addition to the oral examination as a diagnostic method. Patients received treatment with low-power laser radiation. The EPIDAT 3.1 program was applied for the statistical data processing. Results the female sex predominated, the age between 19-34 years, as well as minor aphthous ulcers. The lesions were located mainly on the lip. 97.83% of the patients reported remission of the lesion on the fifth day of treatment. All treated patients evolved favorably towards healing. Only one patient presented adverse reactions. Conclusions the results allowed us to verify the therapeutic benefits of low power laser therapy in the treatment of recurrent aphthous stomatitis.

Systemic immune inflammation index in patients with recurrent aphthous stomatitis / Índice de inflamação imune sistêmica em pacientes com estomatite aftosa recorrente

Abstract Objectives: Recurrent Aphthous Stomatitis (RAS) a chronic idiopathic oral mucosal disease. But yet the etiology and pathogenesis of RAS are not exactly known, it is thought that inflammation play an important role in the pathogenesis. The aim of this study is to demonstrate the role of systemic inflammation among the possible etiological factors of RAS and to find the possible diagnostic correlation between Systemic Immune Inflammation Index (SII). Methods: Patients who were consulted the otolaryngology outpatient clinic and diagnosed with RAS between 2019-2021 were retrospectively analyzed. Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR) and SII values were calculated based on the results of complete blood count. Demographic and hematological parameters between control and RAS groups were compared. The statistical significance level was considered as <0.05. Results: There was no statistically significant difference between the control and RAS groups in terms of sex and age distributions (p = 0.566 and p = 0.173, respectively). SII, NLR and PLR values were significantly higher in the RAS group compared to the controls (p < 0.001, p < 0.001 and p = 0.001, respectively). A very strong correlation between SII and NLR, moderately strong correlation between SII and PLR and moderate correlation between NLR and PLR values were detected (respectively ρ: 0.813, 0.719, 0.532; p-values <0.001). Conclusion: SII, NLR and PLR has significantly higher levels in the RAS group compared to the control group, that it supports the role of systemic inflammation in the etiopathogenesis of RAS. In addition, the results show that SII is a valuable marker for inflammation. Level of evidence: 4. HIGHLIGHTS RAS is a chronic, idiopathic, ulcerative oral mucosal disease. SII is a new and inexpensive biomarker that can easily be calculated using the platelet, neutrophil, and lymphocyte count. SII may be a valuable marker to demonstrate the role of systemic inflammation in RAS etiopathogenesis. Vascular, thrombotic, and inflammatory processes are thought to have a role in RAS activation.

Resumo Objetivo: A estomatite aftosa recorrente (EAR) é uma doença crônica idiopática da mucosa oral. Embora sua etiologia e patogênese não sejam totalmente conhecidas, acredita-se que a inflamação possa desempenhar um papel importante. O objetivo deste estudo é demonstrar o papel da inflamação sistêmica entre os possíveis fatores etiológicos da estomatite aftosa recorrente e encontrar uma possível correlação diagnóstica com o índice de inflamação imunológica sistêmica, SII. Método: Foram analisados retrospectivamente pacientes avaliados no ambulatório de otorrinolaringologia e diagnosticados com estomatite aftosa recorrente entre 2019-2021. A relação neutrófilos/linfócitos, a relação plaquetas/linfócitos e os valores de SII foram calculados com base nos resultados do hemograma completo. Parâmetros demográficos e hematológicos dos grupos controle e de pacientes foram comparados. O nível de significância estatística foi considerado como <0,05. Resultados: Não houve diferença estatisticamente significante entre os grupos controle e com estomatite aftosa recorrente quanto à distribuição por sexo e idade (p = 0,566 e p = 0,173, respectivamente). Os valores de SII, a relação neutrófilos/linfócitos e a relação plaquetas/linfócitos foram significantemente maiores no grupo de pacientes em relação aos controles (p <0,001, p <0,001 e p = 0,001, respectivamente). Foi detectada uma correlação muito forte entre SII e relação neutrófilos/linfócitos, uma correlação moderadamente forte entre SII e relação plaquetas/linfócitos e uma correlação moderada entre valores da relação neutrófilos/linfócitos e relação plaquetas /linfócitos (ρ: 0,813, 0,719, 0,532 respectivamente; p-valores <0,001). Conclusão: SII, relação neutrófilos/linfócitos e relação plaquetas/linfócitos apresentam níveis significantemente maiores no grupo com estomatite aftosa recorrente quando comparados ao grupo controle, o que corrobora o papel da inflamação sistêmica na sua etiopatogênese. Além disso, os resultados mostram que o SII é um marcador inflamatório valioso. Nível de evidência: 4. HIGHLIGHTS A estomatite aftosa recorrente é uma doença ulcerativa crônica idiopática da mucosa oral. O SII (do inglês Systemic Immune Inflammation Index) é um biomarcador novo e de baixo custo que pode ser facilmente calculado que usa a contagem de plaquetas, neutrófilos e linfócitos. O SII pode ser um marcador valioso para demonstrar o papel da inflamação sistêmica na etiopatogênese da estomatite aftosa recorrente. Acredita-se que processos vasculares, trombóticos e inflamatórios tenham um papel na ativação da estomatite aftosa recorrente.

Efectividad del Tysuacril en la estomatitis aftosa / Effectiveness of Tysuacril in aphthous stomatitis

RESUMEN Introducción: el Tisuacryl es un biomaterial empleado en la cirugía general y bucal, así como en el tratamiento de la estomatitis aftosa, considerada un proceso multifactorial y actualmente la enfermedad ulcerosa más común de la cavidad oral. Objetivo: determinar la efectividad del Tisuacryl con respecto a la terapia convencional en el tratamiento de la estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. Métodos: se realizó un estudio observacional analítico de casos y controles a 90 pacientes con estomatitis aftosa en Consolación del Sur, Pinar del Río, en el período comprendido entre septiembre 2018 y marzo 2020. La información se obtuvo de las historias clínicas individuales de Periodoncia al obtener el consentimiento oral y escrito de los pacientes o sus tutores. Los resultados se obtuvieron por análisis estadístico que incluyó el porciento y la prueba no paramétrica de Cochran Q. Resultados: predominó el sexo femenino y el grupo etario de 10 a 19 años para el 46,7 % en grupo estudio y el 42,2 % en grupo control; la disminución del dolor y la cicatrización iniciaron en el mayor número de pacientes a las 72 horas de tratamiento con Tisuacryl para el 91,1 % y el 55,6 % respectivamente; a los cinco días de aplicación del medicamento la totalidad de ellos estaban asintomáticos y casi todas las aftas bucales cicatrizadas. Conclusiones: las lesiones aftosas en la cavidad bucal evolucionaron satisfactoriamente con la aplicación del Tisuacryl al ser esta una alternativa efectiva de tratamiento en comparación con la terapia convencional.

ABSTRACT Introduction: Tisuacryl is a biomaterial used in general and oral surgery, as well as in the treatment of aphthous stomatitis, considered a multifactorial process and currently the most common ulcerative disease of the oral cavity. Objective: to determine the effectiveness of Tisuacryl with respect to conventional therapy in the treatment of aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Methods: an analytical observational case-control study was conducted on 90 patients with aphthous stomatitis in Consolación del Sur, Pinar del Río, in the period from September 2018 to March 2020. Information was obtained from individual Periodontics medical records by obtaining oral and written consent from patients or their guardians. Results were obtained by statistical analysis including percent and Cochran Q nonparametric test. Results: female sex and age group from 10 to 19 years old predominated for 46,7 % in the study group and 42,2 % in the control group; the decrease of pain and healing started in most patients 72 hours after treatment with Tisuacryl for 91,1 % and 55,6 % respectively; being five days after application of the drug all of them asymptomatic and almost all the oral aphthae healed. Conclusions: aphthous lesions in the oral cavity evolved satisfactorily with the application of Tisuacryl being an effective treatment alternative in comparison with conventional therapy.

Una mirada al tratamiento actual de la estomatitis aftosa recurrente. Revisión de la literatura / A look at the current management of recurrent aphthous stomatitis: scoping review

Resumen La estomatitis aftosa recurrente (EAR) es una patología ulcerativa crónica idiopática, que, aunque no llega a comprometer la vida de los pacientes, si puede desmejorar su calidad de vida. Presenta una alta incidencia en la población con un alto porcentaje de recurrencia. Atendiendo a su importancia, el objetivo de esta revisión es brindar una actualización respecto a las terapias farmacológicas y con láser para el manejo de la estomatitis aftosa recurrente. Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Science Direct, EBSCO HOST y LILACS desde enero de 2010 a octubre de 2020, identificando publicaciones en inglés y español. Los artículos que fueron incluidos debían estar relacionadas con la estomatitis aftosa y su tratamiento, enfocándose en el manejo farmacológico o con láser. La estrategia de búsqueda arrojó 4536 citas bibliográficas, de las cuales fueron incluidas 19 en esta presente revisión. La mayoría de los estudios fueron ensayos clínicos aleatorizados donde la población objeto fueron adultos que demostraron el uso de antiinflamatorios, inmunomoduladores, anticuerpos monoclonales, antisépticos, anestésicos, entre otros, para el manejo de la estomatitis aftosa recurrente. De los artículos analizados se pudo concluir que la terapia farmacológica debe ser instaurada de manera particular, de acuerdo a la clínica y antecedentes del paciente. Los fármacos de primera elección son de uso tópico, reservando los de uso sistémico para casos moderados o severos y para pacientes con tratamiento refractarios, asimismo, las recomendaciones coadyuvantes como alimentación e higiene pueden ayudar a la resolución de la enfermedad. La terapia láser surge como alternativa de tratamiento con bajo riesgo y buenos resultados para la EAR.

Abstract Recurrent Aphthous Stomatitis (RAS) is an idiopathic chronic ulcerative pathology. Although it does not compromise the life of the patients, it can impair their quality of life. It presents a high incidence in the population and a high percentage of recurrence. In view of its importance, the aim of this review is to provide an update on pharmacological and laser therapies that are being implemented for the management of RAS. A bibliographic search of literature that was published between January 2010 and October 2020 was performed in PubMed, Science Direct, EBSCOhost, and LILACS databases, identifying publications in English and Spanish languages. The articles that were included had to be related to aphthous stomatitis and its treatment, focusing on pharmacological or laser management. 4536 bibliographic citations were found and 19 of them were included in this review. Most of the studies were randomized clinical trials in which the target population were adults that reported the use of anti-inflammatory drugs, immunomodulators, monoclonal antibodies, antiseptics, anesthetics, among others for the treatment of recurrent aphthous stomatitis. From the articles analyzed, it was possible to conclude that pharmacological therapy should be established in a particular way according to the patient's symptoms and medical record. The first-choice drugs are of topical use, reserving those of systemic use for moderate or severe cases and for patients with refractory treatment. Likewise, adjuvant recommendations such as nutrition and hygiene can help in the resolution of the disease. Laser therapy emerges as an alternative treatment with low risk and positive results for recurrent aphthous stomatitis.

Tratamiento de la estomatitis aftosa recurrente en pacientes inmunocomprometidos. Revisión sistemática / Treatment of recurrent aphthous stomatitis in immunocompromised patients. Systematic review

RESUMEN Fundamento: Aunque la estomatitis aftosa recurrente no tiene una etiología bien definida porque es una enfermedad multicausal, se ha reconocido que las interacciones o el debilitamiento del sistema inmunitario, contribuyen principalmente a la magnitud del proceso patológico. Las propuestas de tratamiento en pacientes inmunocomprometidos son diversas y por lo general se centran en alteraciones inmunológicas específicas. Objetivo: Evaluar el efecto clínico de los tratamientos propuestos para la estomatitis aftosa recurrente en pacientes inmunocomprometidos. Metodología: La búsqueda se realizó en las bases de datos PubMed/Medline y Cochrane. Se incluyeron ensayos clínicos que tuviesen entre sus variables de respuesta principales: Cicatrización de la úlcera aftosa, tiempo de cicatrización, de recurrencia e intensidad del dolor y entre las variables secundarias: Los efectos adversos y los síntomas. La extracción de datos se realizó de manera independiente por los autores. Se aplicó la metodología por la colaboración Cochrane para evaluar el riesgo de sesgo en cada uno de los estudios. Resultados: Se incluyeron 11 ensayos clínicos (8 controlados) publicados entre 1995 y 2020 y que aportan resultados de la eficacia de varias intervenciones terapéuticas: talidomida (4), irsogladine (2), rebamipida (1), láser de diodo (1), cápsulas de Omega-3 (1), vitamina B 12 (1), Complejo B (1). Seis de estos estudios incluyeron pacientes con la forma menor de estomatitis aftosa recurrente. El periodo de seguimiento estuvo entre los 14 y 360 días. Conclusiones: La talidomida puede ser eficaz en el alivio de los síntomas, la cicatrización y remisión de las lesiones, el diodo de láser y vitamina B12 en la disminución de la intensidad del dolor.

ABSTRACT Background: Although recurrent aphthous stomatitis does not have a well-defined etiology due to it is a multicausal disease, it has been recognized that the interactions or the weakening of the immune system, contribute mainly to the magnitude of the process pathological. Treatment proposals in immune compromised patients are diverse and they usually focus on specific immunological alterations. Objective: To evaluate the clinical effect of the proposed treatments for recurrent aphthous stomatitis in immunocompromised patients. Methodology: The search was performed in the PubMed/Medline and Cochrane databases. Clinical trials were included that could have among their main response variables: Aphthous ulcer healing, healing time, recurrence and pain intensity and among the secondary variables: Adverse effects and symptoms. data extraction was done independently by the authors. The methodology was applied by Cochrane collaboration to assess the risk of bias in each of the studies. Results: 11 clinical trials (8 controlled) published between 1995 and 2020 and that provided the results of the efficacy of various therapeutic interventions: thalidomide (4), irsogladine (2), rebamipide (1), diode laser (1), Omega-3 capsules (1), vitamin B 12 (1), Complex B (1). Six of these studies included patients with the minor form of stomatitis recurrent aphthous. The follow-up period was between 14 and 360 days. Conclusions: Thalidomide may be effective in relieving symptoms, healing and remission of the lesions, the laser diode and vitamin B12 in the decrease of the intensity of the pain.

Evaluación de emergencia de una vacuna existente contra el virus de la fiebre aftosa tipo SAT2, aislado recientemente en Egipto en el 2018 / Emergency evaluation for existing vaccine against recently isolated Foot and mouth disease virus type SAT2 in Egypt 2018

El virus de la fiebre aftosa es un patógeno altamente infeccioso y contagioso. Recientemente, el topotipo VII, linaje Lib-12 del serotipo SAT2 se describió en brotes en Egipto durante 2018. La vacunación es una forma eficaz de controlar y combatir los brotes del virus de la fiebre aftosa, especialmente en áreas endémicas como Egipto. El presente estudio tuvo como objetivo evaluar la eficacia de la vacuna contra la fiebre aftosa que se produce actualmente, frente a la cepa de campo recientemente aislada del virus de la fiebre aftosa SAT2 topotipo VII, linaje Lib-12 (SAT2 Libia), mediante la aplicación de estudios in vitro e in vivo. Se inocularon en terneros, dos lotes de la vacuna actual contra el virus de la fiebre aftosa. A los 28 días posteriores a la vacunación, se recolectaron muestras de suero y se analizaron contra el virus de la fiebre aftosa SAT2 Libia adaptado a cultivo de tejidos y SAT2/EGY/2/2012 utilizando una prueba de neutralización viral para determinar la relación serológica (valor r1). El ensayo de reto en terneros vacunados se llevó a cabo empleando una cepa virulenta de la fiebre aftosa SAT2 Libia. Se encontró que los títulos de anticuerpos neutralizantes inducidos por los dos lotes de vacuna (1 y 2) y los de animales no vacunados, fueron 0,48, 0,39 y 0,15 log10 DICT50/mL, respectivamente, mientras que la prueba reveló valores de protección de 20 por ciento, 0 por ciento y 0 por ciento, respectivamente. Además, los valores de r1 fueron 0,195 y 0,186 para los lotes de vacuna (1 y 2), respectivamente. Se llegó a la conclusión de que los lotes de vacunas locales comerciales inactivadas disponibles actualmente (SAT2 SAT2/EGY/2/2012) no protegen a los terneros contra el virus circulante de la fiebre aftosa SAT2 topotipo VII, linaje Lib-12 que se aisló recientemente, por lo que es recomendable actualizar las vacunas existentes con la cepa aislada actualmente(AU)

Foot and mouth disease virus is a highly infectious and contagious pathogen. Recently the topotype VII, Lib‐12 lineage of serotype SAT2 was reported through outbreaks in Egypt during 2018. Vaccination is an effective way to control and combat the foot and mouth disease virus outbreaks especially in endemic areas like Egypt. The present study was aimed to evaluate the efficacy of the current produced foot and mouth disease vaccine, against the recently isolated field strain foot and mouth disease virus SAT2 topotype VII, Lib-12 lineage (SAT2 Libya), by applying in vitro and in vivo studies. Two batches of the current foot and mouth disease virus vaccine were inoculated in calves. At the 28th day post-vaccination serum samples were collected and tested against tissue culture adapted foot and mouth disease virus SAT2 Libya and SAT2/EGY/2/2012 using virus neutralization test to determine serological relationship (r1-value). The challenge test for vaccinated calves was carried out against the virulent foot and mouth disease virus SAT2 Libya. It was found that neutralizing antibody titers induced by the two vaccine batches (1 and 2) and those in unvaccinated animals were 0.48, 0.39 and 0.15 log10 TCID50/mL, respectively, while the challenge revealed protection values of 20 percent, 0 percent and 0 percent, respectively. Furthermore, the r1 values were 0.195 and 0.186 for vaccine batches (1 and 2), respectively. It was concluded that the available local commercial inactivated foot and mouth disease virus vaccine batches (SAT2 SAT2/EGY/2/2012) are unable to protect calves against the current circulating foot and mouth disease virus field isolate SAT2 topotype VII, Lib-12 lineage, thus it is highly recommended to update the existing vaccines with the present isolated strain(AU)

Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome in children: a brief literature review / Síndrome da febre periódica, estomatite aftosa, faringite e adenite em crianças: uma breve revisão de literatura

ABSTRACT Objective: To describe clinical, diagnostic and therapeutic characteristics of the periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. Data source: Literature review in the PubMed database by using specific descriptors to identify all articles published in the English language in the last three years; 38 articles were found. After performing selection of titles and abstract analysis, 13 out of the 38 articles were fully read. Relevant studies found in the references of the reviewed articles were also included. Data synthesis: The PFAPA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis and cervical Adenitis) is a medical condition grouped among the periodic fever syndromes. The etiology is uncertain, but possibly multifactorial, and its symptoms are accompanied by recurrent febrile episodes although weight and height development are preserved. It is a self-limiting disease of benign course with remission of two to three years without significant interference in the patient's overall development. Treatment consists of three pillars: interruption of febrile episodes, increase in the interval between episodes, and remission. Conclusions: Despite several attempts to establish more sensitive and specific criteria, the diagnosis of PFAPA syndrome is still clinical and reached by exclusion, based on the modified Marshall's criteria. The most common pharmacological options for treatment include prednisolone and betamethasone; colchicine may be used as prophylaxis, and surgical treatment with tonsillectomy can be considered in selected cases.

RESUMO Objetivo: Descrever as características clínicas, diagnósticas e de tratamento da síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA). Fontes de dados: Revisão de literatura na base de dados PubMed, feita por meio de descritores específicos para identificar todos os artigos publicados em língua inglesa nos últimos três anos. Dos 38 artigos encontrados, foram encaminhados para leitura integral 13 publicações após seleção de títulos e análise de abstract. Estudos relevantes encontrados nas referências dos artigos revisados também foram incluídos. Síntese dos dados: A PFAPA é traduzida do inglês periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis. Caracterizada por etiologia ainda incerta e possivelmente multifatorial, seus sintomas são acompanhados por episódios recorrentes de febre associados a um desenvolvimento pôndero-estatural preservado. É uma doença autolimitada de curso benigno, com remissão em dois a três anos, sem interferências significativas no desenvolvimento do paciente pediátrico. O tratamento consiste em três pilares: interrupção da crise febril, aumento do intervalo entre crises e remissão. Conclusões: Apesar de várias tentativas de estabelecer critérios atuais mais sensíveis e específicos, o diagnóstico da síndrome PFAPA ainda é clínico e de exclusão com base nos critérios de Marshall modificados. As opções farmacológicas mais utilizadas para o tratamento são a prednisolona e betametasona; colchicina pode ser utilizada como profilaxia e o tratamento cirúrgico com tonsilectomia pode ser considerado em casos selecionados.

Evaluación de la eficacia de la tintura de manzanilla al 20 % en la estomatitis aftosa / Evaluation of the efficacy of 20 % chamomile tincture in aphthous stomatitis

RESUMEN Fundamentación: En el tratamiento tradicional de la estomatitis aftosa no se incluye la tintura de manzanilla al 20 %, sin embargo, sus propiedades justifican su posible utilización. Objetivo: Evaluar la eficacia de la tintura de manzanilla al 20 % como alternativa de tratamiento en pacientes con estomatitis aftosa en la disminución de la intensidad del dolor. Metodología: Se realizó un estudio experimental abierto, controlado y aleatorizado en el municipio Sancti Spíritus entre septiembre de 2019 y marzo de 2021. Se seleccionaron 39 pacientes con estomatitis aftosa mayores de 12 años de edad; mediante asignación aleatoria, se conformaron 2 grupos al azar: 1 de estudio aplicando tintura de manzanilla al 20 % y otro de control utilizando triamcinolona al 0.1 %. La variable de resultado principal del estudio utilizada fue la eficacia. Resultados: Predominó el sexo femenino para ambos grupos. En el grupo estudio, la edad más representativa fue de 24 a 35 años (25 %) y en el grupo control predominaron las edades de 36 a 47 años (26.3 %). Al comparar la intensidad del dolor en los diferentes momentos de evolución no existieron diferencias significativas entre ambos grupos. Se observó un predominio de pacientes sin reacciones adversas, estas se presentaron en un número muy reducido, 1 paciente en cada grupo. Conclusiones: La tintura de manzanilla al 20 % como alternativa de tratamiento de los pacientes con estomatitis aftosa, resultó de eficacia similar a la triamcinolona al 0.1 %.

ABSTRACT Background: Traditional treatment of aphthous stomatitis does not include 20 % chamomile tincture, however its properties justify its possible use. Objective: To evaluate the efficacy of 20 % chamomile tincture as an alternative treatment in patients with aphthous stomatitis for the reduction of pain intensity. Methodology: An exposed, controlled and randomized experimental study was conducted in Sancti Spíritus municipality between September 2019 and March 2021. Thirty-nine patients with aphthous stomatitis older than 12 years of age were selected; by random assignment, 2 groups were randomly formed: 1 study group applying chamomile tincture at 20 % and another control group using triamcinolone at 0.1 %. Efficiency was the main outcome study variable. Results: Female sex predominated in both groups. In the study group, the most representative age was 24 to 35 years (25 %) in the control group the predominant age was 36 to 47 years (26.3 %). When comparing the pain intensity at different times of evolution there were no significant differences between the two groups. A patients' prevalence without adverse reactions was observed, these occurred in a very small number, 1 patient in each group. Conclusions: The efficacy of chamomile tincture at 20 %, as an alternative treatment for patients with aphthous stomatitis, was similar to that of triamcinolone at 0.1 %.

Eficacia clínica del extracto de Matico (Piper angustifolium) en la evolución de la cicatrización de heridas por estomatitis aftosa recidivante / Clinical efficacy of Matico extract (Piper angustifolium) in the evolution of wound healing due to recurrent aphthous stomatitis

La estomatitis aftosa recurrente (EAR) es un trastorno ulcerativo doloroso cíclico que comúnmente afecta la mucosa oral. Factores locales y sistémicos como trauma, sensibilidad alimentaria, deficiencias nutricionales, condiciones sistémicas y desórdenes inmunológicos están asociados con el desarrollo de la enfermedad. Debido a las similitudes en las características de las úlceras pépticas y las úlceras aftosas orales, parece razonable suponer que Helicobacter pylori podría desempeñar un papel en el desarrollo de la EAR. Las especies de Piper son plantas aromáticas que se utilizan como especias en la cocina, pero sus metabolitos secundarios también han mostrado efectos biológicos sobre la salud humana. El objetivo del presente estudio fue determinar la relación entre H. pylori y EAR y el efecto cicatrizante del extracto Matico sobre las ulceras bucales. Se reclutó a cuarenta sujetos con EAR. Los participantes fueron asignados al azar al grupo de prueba o al grupo de control. El tamaño y número de las úlceras se registraron el día 1 (valor inicial) y el día 30 (valor final). El tamaño de la ulceras, presencia de pseudomembranas y halos eritematosos fueron estadisticamente significativas en relación a la positividad de H. pylori (p <0,05). No hubo diferencias significativas entre la morfología, número y localización de las aftas (p> 0,05). El grupo que recibió el extracto tuvo un porcentaje de mejoría en la reducción del número de aftas del 65% el día final de evaluación en comparación de sólo un 25% del grupo que no recibió el extracto Matico(AU)

Recurrent aphthous stomatitis (RAS) is a cyclic painful ulcerative disorder that commonly affects the oral mucosa. Local and systemic factors such as trauma, food sensitivity, nutritional deficiencies, systemic conditions, immunological disorders and genetic polymorphisms are associated with the development of the disease. Because of similarities in the characteristics of peptic ulcers and oral aphthous ulcers, it seems reasonable to hypothesize that Helicobacter pylori could play a role in the development of RAS. Piper species are aromatic plants used as spices in the kitchen, but their secondary metabolites have also shown biological effects on human health. The aim of the present study was to determine the relationship between H. pylori and RAS and the healing effect of Matico extract on mouth ulcers. Fuorty subjects with RAS were recruited. The participants were randomly allocated to the test group or the control group. The size and number of ulcers were recorded on day 1 (initial value) and day 30 (final value). The size of the ulcers, the presence of pseudomembranes and erythematous halos were statistically significant in relation to the positivity of H. pylori (p <0.05). There were no significant differences between the morphology, number and location of the canker sores (p> 0.05). The group that received the extract had a percentage improvement in the reduction of the number of canker sores of 65% on the final day of evaluation compared to only 25% of the group that did not receive the Matico extract(AU)

La tintura de manzanilla al 20 % como alternativa de tratamiento para la estomatitis aftosa / Chamomile tincture at 20 % as an alternative treatment for aphthous stomatitis

RESUMEN Fundamento: Las aftas son causa de consultas frecuentes entre las urgencias estomatológicas. La tintura de manzanilla, resulta muy efectiva por su propiedad analgésica, antiinflamatoria, protectora, reparadora de membrana y reepitelizante. Objetivo: Ilustrar los resultados de la tintura de manzanilla al 20 % como alternativa de tratamiento en una paciente con estomatitis aftosa Presentación de caso: Paciente de 66 años de edad, femenina, con antecedentes de salud, fumadora, sometida a estrés, que acudió a consulta por lesiones aftosas dolorosas en el borde lateral izquierdo y dorso de la lengua. Conclusiones: La paciente con estomatitis aftosa, tratada con tintura de manzanilla al 20 %, mostró moderación del dolor a los 3 días, evolución general satisfactoria y cicatrización de las lesiones a los 5 días de la primera aplicación.

ABSTRACT Background: Aphthous ulcers are a frequent cause of assistance at the stomatology emergencies. Chamomile tincture (Matricaria Chamomilla) is very effective due to its analgesic, anti-inflammatory, protective, membrane-repairing and re-epithelialising properties. Objective: To illustrate the results of chamomile tincture at 20 % as an alternative treatment in a patient with aphthous stomatitis. Case report: A 66-year-old female patient, with healthy backgrounds, smoker, under stress, who consulted because of painful aphthous lesions on the left lateral border and tongue dorsum. Conclusions: The patient with aphthous stomatitis, treated with chamomile tincture at 20 %, showed pain moderation after 3 days, satisfactory general evolution and healing of the lesions 5 days after the first application.

Risk factors for recurrent aphthous stomatitis: a systematic review / Factores de riesgo para la estomatitis aftosa recurrente: revisión sistemática

SUMMARY: The cause and prevention of recurrent aphthous stomatitis (also called aphthous ulcers or canker sores) are still unknown. This may be due in part to ignorance of the risk factors present in susceptible people. In this systematic review (PROSPERO record #CRD42019122214), we show that most of the risk factors for the disease are single nucleotide genetic polymorphisms in genes related to the functioning of immune system (TLR4, MMP9, E-selectin, IL-1 beta and TNF-alpha). Single nucleotide genetic polymorphisms do not constitute a modifiable risk. This indicates that, at least in part, susceptibility to recurrent aphthous stomatitis is hereditary, and that these factors cannot be modified.

RESUMEN: Aún se desconoce la causa y cómo prevenir la estomatitis aftosa recurrente (más conocida como aftas). En esta revisión sistemática (registro PROSPERO #CRD42019122214) mostramos que la mayoría de los factores de riesgo para la enfermedad son polimorfismos genéticos de un solo nucleótido en genes relacionados con el funcionamiento del sistema inmune (TLR4, MMP9, E- selectin, IL-1 beta y TNF-alfa). Los polimorfismos genéticos de un solo nucleótido no constituyen un riesgo modificable.Ello indica que, al menos en parte, la susceptibilidad para las aftas es hereditaria y que esos factores no pueden ser modificados.

Efectividad terapéutica de la jalea de caléndula al 1 % en pacientes con estomatitis aftosa recurrente / Therapeutic effectiveness of calendula jelly at 1% in patients with aphthous recurrent stomatitis

Introducción: Para el tratamiento de pacientes con estomatitis aftosa recurrente suele emplearse el extracto fluido y la tintura de Caléndula officinalis L. como colutorio disuelto en agua. Teniendo en cuenta los inconvenientes que generan estas formulaciones se elaboró una jalea al 1 % contentiva de los principios activos de la referida planta. Objetivo: Evaluar la efectividad terapéutica de la jalea de caléndula al 1 % en pacientes con estomatitis aftosa recurrente. Métodos: Se realizó una intervención terapéutica en 30 pacientes con estomatitis aftosa recurrente, atendidos en el Policlínico Docente 30 de Noviembre de Santiago de Cuba, desde marzo hasta diciembre de 2019. La muestra se dividió en 2 grupos: control y de estudio, que recibieron tratamiento convencional y jalea de caléndula al 1 %, respectivamente. Se tuvieron en cuenta algunas variables de interés, a saber: edad, sexo, tiempo de remisión del dolor y de cicatrización, respuesta al tratamiento y efectividad terapéutica. Se empleó el porcentaje como medida de resumen y el estadígrafo de Ji al cuadrado con un nivel de significación de 0,05. Resultados: En la serie predominaron el grupo etario de 15- 24 años de edad (33,3 %) y el sexo femenino (60,0 %). En los tratados con la jalea de caléndula, la remisión del dolor y la cicatrización de las lesiones ulcerativas se evidenciaron en las primeras 24 y 48 horas, respectivamente, y la mayoría de estos habían mejorado a las 72 horas. Conclusiones: La jalea de caléndula al 1 % es efectiva como analgésico y cicatrizante en pacientes con estomatitis aftosa recurrente.

Introduction: The officinalis L Calendula fluid extract and tincture is usually used as mouthwash dissolved in water for the treatment of patients with aphthous recurrent stomatitis. Taking into account the inconveniences that generate these formulations a jelly at 1 % was elaborated with the active principles of the plant above mention. Objective: To evaluate the therapeutic effectiveness of the calendula jelly at 1% in patients with aphthous recurrent stomatitis. Methods: A therapeutic intervention in 30 patients with aphthous recurrent stomatitis, assisted in 30 de Noviembre Teaching Polyclinic was carried out in Santiago de Cuba, from March to December, 2019. The sample was divided in 2 groups: control and study that received conventional treatment and calendula jelly at 1%, respectively. Some variables of interest were taken into account, such as: age, sex, pain regression and scaring time, response to the treatment and therapeutic effectiveness. The percentage was used as summary measure and the chi-squared test with a significance level of 0.05. Results: In the series there was a prevalence of the 15 - 24 age group (33.3 %) and female sex (60.0 %). In the patients treated with the calendula jelly, pain regression and scaring of the ulcerative lesions were evidenced in the first 24 and 48 hours, respectively, and most of them had improved at 72 hours. Conclusions: The calendula jelly at 1% is effective as analgesic and healing in patients with aphthous recurrent stomatitis.

Síndrome de fiebre periódica, estomatitis aftosa, faringitis y adenitis / Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome

Introducción: El síndrome de fiebre periódica, estomatitis aftosa, faringitis y adenitis es un cuadro relativamente frecuente de curso autolimitado y buen pronóstico. Es la más común de las enfermedades autoinflamatorias que presentan fiebre recurrente y su etiología y fisiopatogenia permanecen inciertas. Objetivo: Describir el caso clínico de un niño que consultó por fiebre recurrente y faringitis y se arribó al diagnóstico de síndrome de fiebre periódica, estomatitis aftosa, faringitis y adenitis. Presentación del caso: Se trata de un paciente de 5 años que consultó por un episodio febril acompañado de faringitis y adenitis, con antecedente de múltiples episodios previos. Conclusiones: El síndrome fiebre periódica, estomatitis aftosa, faringitis y adenitis, es una entidad de curso benigno y autolimitado que constituye la causa más común de fiebre recurrente con un gran impacto en la vida de los pacientes. La fisiopatogenia permanece incierta. Es destacable la sospecha clínica para arribar al diagnóstico ya que no existen en la actualidad exámenes complementarios específicos(AU)

Introduction: Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome is a relatively common picture of self-limiting course and good prognosis. It is the most common of self-inflammatory diseases with recurrent fever and its etiology and physiopathology remain uncertain. Objective: Describe the clinical case of a boy who was checked due recurrent fever and pharyngitis and being diagnosed with Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome. Case presentation: This is a 5-year-old patient who was consulted due to a febrile episode accompanied by pharyngitis and adenitis, with a history of multiple previous episodes. Conclusions: Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome is a benign, self-limiting course entity that is the most common cause of recurrent fever with a large impact on patients' lives. Its physiopathology remains uncertain. Clinical suspicion for diagnosis is noteworthy as there are currently no specific complementary test for it(AU)

Alternative method for the evaluation of monovalent inactivated foot and mouth disease virus vaccine

Foot and mouth disease is a highly contagious viral disease of cloven-hoofed animals that has a significant economic impact on livestock. A recent outbreak was detected and recorded as exotic strain of foot and mouth disease virus SAT2 (Serotype SAT2, topotype VII, Lib-12 lineage). The emergency vaccine was produced and assessed in vivo and large number of vaccine batches were urgently needed. The present work was aimed to provide a rapid evaluation of inactivated foot and mouth disease SAT2 oily vaccine to exclude the unsatisfactory batches during emergency circumstances and to reduce time, effort and cost. The extraction of foot and mouth disease antigen content from oily adjuvanted vaccine was carried out using isopropyl myristate and benzyl alcohol methods. The extracted viral antigen was identified by foot and mouse disease serotyping ELISA and 146S content was quantified using sucrose density gradient analysis. Evaluations were carried out instantly and at 2h, 6h and 24h. The results indicated the efficiency of benzyl alcohol to breakdown the oil emulsion either MONTANIDE™ ISA 206 VG or MONTANIDE™ ISA 50 V2, while the isopropyl myristate was efficient for MONTANIDE™ ISA 50 V2 only. The identification and quantification of 146S for extracted antigen using benzyl alcohol indicated significant stable records at different time intervals for the vaccine batches, while the extraction using isopropyl myristate indicated unstable records at different time intervals. It was concluded that the evaluation of monovalent foot and mouse disease vaccine could be conducted in vitro, using serotyping ELISA and quantification of 146S for the extracted antigen, either using benzyl alcohol or isopropyl myristate (MONTANIDE™ ISA50 V2 only), with the consideration that 146S content should not less than 4 μg/mL(AU)

La fiebre aftosa es una enfermedad viral altamente contagiosa de los animales de pezuña hendida que tiene un impacto económico significativo en el ganado. Se detectó un brote reciente que se registró como causado por una cepa exótica del virus de la fiebre aftosa (serotipo SAT2, topotipo VII, linaje Lib-12). La vacuna de emergencia se elaboró y evaluó in vivo, existiendo una urgente necesidad de contar con un gran número de lotes de la misma. El presente trabajo tuvo como objetivo proporcionar una evaluación rápida de la vacuna oleosa inactivada (SAT2) contra la fiebre aftosa, para excluir los lotes insatisfactorios durante circunstancias de emergencia, reduciendo tiempo, esfuerzo y costo. La extracción del contenido de antígeno de fiebre aftosa, de la vacuna oleosa adyuvada, se llevó a cabo utilizando miristato de isopropilo y alcohol bencílico. El antígeno viral extraído se identificó utilizando un ELISA de serotipificación y se cuantificó el contenido de 146S mediante análisis de gradiente de densidad de sacarosa. Las evaluaciones se realizaron de forma instantánea y a las 2h, 6h y 24h. Los resultados indicaron la eficacia del alcohol bencílico para separar la emulsión de aceite para MONTANIDE ™ ISA 206 VG o MONTANIDE™ ISA 50 V2, mientras que el miristato de isopropilo fue eficaz para MONTANIDE™ ISA 50 V2 únicamente(AU)

Manifestaciones bucales de la enfermedad celíaca y alergia al trigo: Reporte de tres casos y revisión literatura / Oral Manifestations of Celiac Disease and Wheat Allergy: Report of Three Cases and Review of Literature

Resumen: La Enfermedad Celíaca (EC) es una enfermedad sistémica inmunomediada, provocada por el gluten y prolaminas relacionadas, en individuos genéticamente susceptibles. Se caracteriza por manifestaciones clínicas dependientes del gluten, anticuerpos específicos de EC, haplotipos HLA DQ2 o DQ8 y enteropatía. La mayoría de los pacientes son asintomáticos o con manifestaciones leves. Afecta principalmente el sistema gastrointestinal causando síntomas y signos como diarrea, dolor abdominal recurrente y distensión abdominal; además manifestaciones extradigestivas. Los pacientes con EC pueden tener manifestaciones bucales que incluyen estomatitis aftosa recurrente (EAR), hipoplasia del esmalte, glositis atrófica, entre otras. El diagnóstico de EC se basa en la historia clínica, serología, endoscopía e histología. Existen otras entidades que deben diferenciarse de la EC, como la sensibilidad al gluten no celíaca y la alergia al trigo. El objetivo de este trabajo es presentar tres pacientes con antecedentes de EAR y otras manifestaciones clínicas asociadas al diagnóstico precoz de EC y alergia alimentaria.

Abastract: Celiac Disease (CD) is an immune-mediated systemic disease, caused by gluten and related prolamins, in genetically susceptible individuals. It is characterized by gluten-dependent clinical manifestations, CD-specific antibodies, HLA DQ2 or DQ8 haplotypes, and enteropathy. Most patients are asymptomatic or with mild manifestations. It mainly affects the gastrointestinal system causing symptoms and signs such as diarrhea, recurrent abdominal pain and abdominal distension; also extradigestive manifestations. Patients with CD may have oral manifestations that include recurrent aphthous stomatitis (RAS), enamel hypoplasia, atrophic glossitis, among others. The diagnosis of CD is based on clinical history, serology, endoscopy and histology. There are other entities that should be differentiated from CD, such as non-celiac gluten sensitivity and wheat allergy. The aim of this study is to present three patients with a history of RAS and other clinical manifestations associated with the early diagnosis of CD and food allergy.

Impacto de enfermedades orales asociadas a estrés sobre la calidad de vida / Impact on Quality of Life of Oral Diseases Related to Stress

Resumen: Se ha sugerido que enfermedades de la mucosa oral asociadas a estrés impactan negativamente la calidad de vida. Sin embargo, la información no es concluyente. El objetivo fue comparar la calidad de vida asociada a salud bucal en dos grupos: Casos (21 pacientes de una clínica de enseñanza de medicina bucal con diagnóstico de liquen plano oral, estomatitis aftosa recurrente y síndrome de boca dolorosa; Control (42 sujetos sanos) pareados por edad y género. Se aplicó el cuestionario perfil de impacto de salud oral. Resultados: El análisis estadístico mostró que el grupo casos tiene peor calidad de vida (p 0.03) comparado con el de los controles, específicamente en las dimensiones incomodidad psicológica (p 0.027); inhabilidad física (p 0.004); e incapacidad (p 0.002; RM 5.63 IC 1.58-20.80). Se concluye que los sujetos que padecen enfermedades de la mucosa oral relacionada a estrés tienen mala calidad de vida.

Abstract: It has been suggested that oral mucosa diseases related to stress have a negative impact on the quality of life. However, the information regarding which aspects are the most affected is inconclusive. The objective was to compare the quality of life associated with oral health in two groups: Cases formed by 21 patients coming from a teaching clinic, suffering oral lichen planus, recurrent aphthous stomatitis, and burning mouth syndrome; Control formed by 42 healthy subjects matched for age and gender. Oral Health Impact Profile questionnaire was applied. Statistical analysis showed that group Cases has worse quality of life (p 0.03) than the one of controls, specifically on psychological discomfort (p 0.027), physical disability (p 0.004); and handicap dimensions (p 0.002; RM 5.63 IC1.58-20.80). It was concluded that patients suffering oral mucosa disease related to stress showed poor quality of life.

Adverse effects of foot-and-mouth disease vaccine in dairy cattle / Efeitos adversos da vacina contra febre aftosa em bovinos de leite

Foot-and-mouth disease represents an important barrier to the international commerce of animal products, potentially associated with significant economic losses. The systematic vaccination of bovines and buffaloes was fundamental for the eradication of this disease; however, the use of vaccines can lead to reactions at the application site. The objectives of this study were to evaluate the effects of the vaccination protocol to the production of dairy cows and to observe the occurrence of vaccinal reactions in the animals. At one property located in the municipality of Salvador do Sul, Rio Grande do Sul, 270 dairy cows were vaccinated against foot-and-mouth disease in May 2019. The vaccine was administered via a subcutaneous application using disposable syringes and needles for each animal. Inspection of the animals was performed before and 20 days after the vaccination to verify the presence of reactions to the vaccine. The study's sample was set by convenience, including 203 lactating animals with or without bovine somatotropin (BST) administration during the data collection period, which was limited to 20 days before and 20 days after the vaccination. Milk production data was obtained through SmartDairy® HerdMetrix™ software, tabulated in electronic spreadsheets using Microsoft Excel® and processed using the program SAS®, considering a 5% significance level for mixed model statistical analysis. A total of 160 animals (78.82%) presented local lesions at the application site, even when the recommended vaccination practices were followed, suggesting that the high reaction power was provoked by the vaccinal components. In regards to milk production, a statistically significant (p<0.05) decrease of 0.30kg of milk per animal/day was observed in the average daily production in the 20 days post-vaccination. These results demonstrate the local and systemic effects caused by the foot-and-mouth disease vaccine, evidenced by reduced levels of milk production and the occurrence of vaccine reactions, implying significant economic losses.(AU)

A febre aftosa representa uma importante barreira no comércio internacional de produtos de origem animal, podendo acarretar em significativas perdas econômicas. A vacinação sistemática de bovinos e bubalinos foi fundamental para a erradicação da doença. No entanto, a utilização de vacinas pode causar reações no local da aplicação. O objetivo deste trabalho foi avaliar os efeitos da vacina em bovinos leiteiros e observar a incidência de reações vacinais no local de aplicação. O estudo foi realizado numa propriedade leiteira do município de Salvador do Sul, Rio Grande do Sul, onde foram vacinados 270 bovinos contra febre aftosa no mês de maio de 2019. A vacina foi administrada por via subcutânea, com seringas e agulhas descartáveis para cada animal. Foi realizada inspeção dos animais antes da vacinação e 21 dias após a vacinação, para verificar a presença de reações vacinais. A amostra foi definida por conveniência, incluindo 203 vacas em lactação com ou sem administração de somatotropina bovina (BST) durante o período de coleta de dados, que l foi de 20 dias antes e 20 dias após a vacinação. Estes dados de produção de leite foram obtidos através do software SmartDairy® HerdMetrix™, tabulados em planilhas eletrônicas do Microsoft Excel® e processados usando o programa SAS®, considerando 5% de nível de significância para uma análise estatística modelo misto. Foi observado que 160 (78,82%) vacas apresentaram lesões no local de aplicação, mesmo quando a aplicação era realizada de acordo com as boas práticas de vacinação, o que indica o alto poder de reação provocada pelos componentes da vacina. Em relação à produção de leite, observou-se uma redução significativa (p<0,05) na produção média diária de 0,30kg de leite por animal/dia nos 21 dias após a vacinação. Esses resultados demonstram os efeitos locais e sistêmicos provocados pela vacina da febre aftosa, evidenciados pela redução na produção de leite e pela incidência de reações vacinais, o que implica em significativas perdas econômicas.(AU)