Complete enucleation surgical treatment and histological analysis of a mucocele in lower lip in a child: case report / Tratamiento quirúrgico de enucleación completa y análisis histológico de un mucocele en el labio inferior en un niño: reporte de caso

Objective: The aim of this case report is to describe the surgical removal of a mucocele and its histological analysis, in a child. Case Report: An 11-year-old female patient attended the Pediatric Dentistry clinic complaining of a lower lip lesion. During the anamnesis, the mother reported that the child had a habit of biting and sucking the spot frequently. Clinical examination showed the lesion was compatible with a mucocele. The proposed treatment was a complete enucleation of the lesion under local anesthesia. The incision and tissue divulsion were performed for maximum preservation of the mucosa, avoiding a possible recurrence. Total adjacent glands removal was also performed. The lesion was placed in 10% formaldehyde for histopathological analysis (H&E Staining), which showed dense connective tissue presenting chronic inflammatory infiltrate and extravasated mucin, presence of granulation tissue delimiting the area of extravasated mucin and presence of minor salivary glands. The patient was advised to quit the habit, and after seven days the sutures were removed. At the one-year follow-up there was no recurrence of the lesion. Conclusion: The proposed treatment proved to be effective without recurrence of the lesion.

Objetivo: El objetivo de este reporte de caso es describir la extirpación quirúrgica de un mucocele y su análisis histológico en un niño. Informe del caso: una paciente de 11 años de edad asistió a la clínica de Odontopediatria quejándose de una lesión en el labio inferior. Durante la anamnesis, la madre informó que el niño tenía la costumbre de morder y chupar el lugar con frecuencia. En el examen clínico, la lesión fue compatible con un mucocele. El tratamiento propuesto fue una enucleación completa de la lesión bajo anestesia local. La incisión y la divulgación del tejido se realizaron para la máxima preservación de la mucosa, evitando una posible recurrencia. También se realizó la extracción total de las glándulas adyacentes. La lesión se colocó en formaldehído al 10% para el análisis histopatológico (tinción H&E), que mostró tejido conectivo denso que presenta infiltrado inflamatorio crónico y mucina extravasada, presencia de tejido de granulación que delimita el área de mucina extravasada y presencia de glándulas salivales menores. Se aconsejó al paciente que abandonara el hábito, y después de siete días se retiraron las suturas. En el seguimiento de un año no hubo recurrencia de la lesión. Conclusión: El tratamiento propuesto demostró ser efectivo sin recurrencia de la lesión.

Stevens-Johnson syndrome and toxic epidermal necrolysis: a review

Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are considered a single entity with variability in the extent of the lesions, characterized by erythema multiforme that may involve mucosa. Severe cutaneous reactions secondary to medications are classified according to the area of epidermal detachment. The activation of cytotoxic T cells and macrophages is mediated mainly by IL-2 and interferon gamma secreted by Th1 lymphocytes, and the activation of eosinophils and B lymphocytes in IgE is mediated by secreted IL-4, IL-5, IL-10 and IL13 by B lymphocytes. The topography of SJS is predominantly central, affecting the trunk and sometimes a generalized dissemination is shown that affects a body surface area of less than 10%, characterized by irregular violaceous erythematous macules of target shooting, which can form confluent blisters. TEN is characterized by a skin detachment greater than 30% of the body surface, whose predominant lesion is diffuse erythema with individual macules, which give rise to detachment surfaces greater than 5 cm. The treatment is symptomatic, nonspecific, and aimed at avoiding complications, carried out in specialized intensive care units, due to ignorance of the pathogenesis. Integral management with different therapeutic alternatives can represent a crucial part in the multisystemic management of SJS and TEN.

Evaluation of strategic and selective anthelmintic treatments on Pelibuey ewes in Cuba / Evaluación de tratamientos antihelmínticos estratégicos y selectivos en ovejas Pelibuey en Cuba / Avaliação de tratamentos anti-helmínticos estratégicos e seletivos em ovelhas Pelibuey em Cuba

Background: gastrointestinal parasitism is an important limitation for sheep production in Cuba. This situation is worsened by the lack of an effective parasite control strategy. Objective: to assess whether selective and strategic treatments could help achieve a level of control of nematodes similar to systematic drenchings. Methods: an experimental group of 73 Pelibuey ewes was divided into four groups: 1) the Epizoo group (Epizootiological drenching schedule) was dewormed at lambing in the middle of the dry season and at weaning; 2) the FAMACHA© group was treated according to the color of ocular mucosa as indicative of anemia (Categories 4 and 5 of the FAMACHA© color chart); 3) the Chemical group was drenched every three months; and 4) the control group, in which animals remained untreated unless fecal egg count (FEC) was higher than 1500 eggs per gram of feces or the packed cell volume (PCV) was lower than 15%. FECs, body scorings (BCS), hematocrits and color of ocular mucosa (COM) were evaluated monthly. Results: the control group showed the highest FEC and the lowest PCV. We also observed similar levels of FEC and body condition (BCS) in the Epizoo, FAMACHA© and Chemical groups. The PCV in FAMACHA© group was the highest, while no differences were found between the other two groups. Hematocrit had a strong negative correlation (-0.41) with FEC. The FAMACHA© method allowed a dramatic decrease in anthelmintic use. Conclusions: the obtained results suggest that FAMACHA© method could be incorporated as part of an effective parasite control strategy in sheep.

Antecedentes: el parasitismo gastrointestinal constituye una de las principales limitantes para producción de ovejas en Cuba. Esta situación es mucho más grave porque no existe un programa adecuado de control parasitario. Objetivo: evaluar si el uso de un tratamiento antihelmíntico estratégico o selectivo logra reducir los niveles de infestación parasitaria comparado con un sistema de tratamientos químicos sistemáticos. Métodos: se utilizó un rebaño experimental de 73 reproductoras Pelibuey que se dividió aleatoriamente en cuatro grupos: 1) El grupo epizootiológico (Epizoo) se trató al parto, a mediados del periodo seco y al destete, 2) el grupo FAMACHA© se desparasitó en función de la coloración de la mucosa ocular indicativa de anemia (categorías 4 y 5 de la carta de colores FAMACHA©), 3) el grupo Químico: se desparasitó cada tres meses, y 4) grupo control: no recibió tratamiento mientras su hematocrito (PCV) fuera inferior a 15% o la carga parasitaria (FEC) no superara los 1500 huevos por gramo de heces. Con frecuencia mensual se determinó a cada animal el conteo fecal de huevos (FEC), la condición corporal (BCS), el hematocrito (PCV) y la coloración de la mucosa ocular (COM). Resultados: se observaron valores similares para la BCS y el FEC en los grupos Epizoo, FAMACHA© y Químico. El PCV presentó los valores más altos en el grupo FAMACHA© y el grupo Control presentó los más bajos; no se apreciaron diferencias significativas entre los grupos Químico y Epizoo. El grupo control presentó los mayores FEC y los más bajos PCV. El hematocrito tuvo una relación fuerte y negativa (-0,41) con el FEC. El método FAMACHA© propició una disminución en el uso de fármacos antihelmínticos. Conclusiones: los resultados obtenidos sugieren que el método FAMACHA© podría ser incorporado como parte de una estrategia efectiva de control parasitario en ovinos.

Antecedentes: o parasitismo gastrointestinal é uma limitação para a produção de ovinos em Cuba. Esta situação é agravada pela falta de uma estratégia eficaz de controle parasitário. Objetivo: avaliar se os tratamentos seletivos podem ajudar a alcançar um nível de controle de nematóides semelhante a dois tratamentos sistemáticos. Métodos: um rebanho experimental de 73 ovelhas foi dividido em quatro grupos: 1) o grupo Epizoo (Esquema de tratamento epizootiológico) foi tratado no parto, no meio da estação seca e ao desmame, 2) o grupo FAMACHA© foi tratado de acordo com a cor da mucosa ocular (categorias 4 e 5 na cartela de cores FAMACHA©), 3) o grupo químico são vermifugados a cada três meses, e 4) o grupo controle não recebeu tratamento, enquanto seu hematócrito (PCV) fosse inferior a 15% ou a carga parasitária (FEC) não ultrapassasse 1.500 ovos por grama de fezes. A contagem de ovos por grama (FEC) de fezes, o escore da condição corporal (BCS), hematócrito (PCV) e a coloração da mucosa ocular (COM) foram avaliados mensalmente. Resultados: um nível similar de FEC e BCS foram observados nos grupos Epizoo, FAMACHA© y Químico. O PCV apresentou-se maior no grupo FAMACHA© e o grupo Controle teve os valores mais baixos; enquanto nenhuma diferença foi estimada entre os outros dois grupos. O grupo controle apresentou o maior FEC e o menor PVC. O hematócrito teve uma forte correlação negativa (-0,41) com o FEC. O método FAMACHA© permitiu uma diminuição drástica do uso de anti-helmíntico. Conclusões: os resultados sugerem que o método FAMACHA© pode ser incorporado como parte de uma estratégia para o controle de parasitas gastrintestinais em ovelhas.

Old world leishmaniasis presenting as a nasal mass.

Mucosal leishmaniasis is a major problem in Latin America but has been rarely noticed in our region. Although there have been a few reports of mucosal involvement especially in the oral cavity from Southwest Iran, yet none have been presented from the Northeast where Leishmania tropica is the major concern. We report a patient with endonasal leishmaniasis due to L. tropica, an extremely rare entity in immunocompetent patients in our region. He presented with a mass in the left nasal vestibule causing a sense of obstruction on the same side, accompanied by occasional rhinorrhea and mild epistaxis. This case exemplifi es the need for considering leishmaniasis as a differential diagnosis for nasal obstruction in this endemic area.

Application of Z-form plasty with a nasal mucous membrane and alar cartilage flap to repair severe secondary nasal deformity after cleft lip operation / 中华医学美学美容杂志

Objective To investigate a repair method for unilateral complete cleft lip nasal deformities.Methods Based on the fullness of healthy nasal wing,Z-form plasty was designed with a nasal mucous membrane and alar cartilage flap,to prolong its curtate length of the deformed side through overlapping transposition,and then with suspension of the custom-crafted nasal wing to replace its abnormal structure,subsequently,to recover the normal anatomic structure of the nosewing,and to get the nasal deformity repaired.Results A total of 12 patients with the severe nasal deformity were treated by this method.and all had satisfactory results.Conclusion This technique is a good choice for repairing the severe secondary nasal deformity after single complete cleft lip operation.

Oral Lichen Planus

In this study twenty patients of clinically diagnosed oral lichen planus were analysed in respect to age. sex, patterns and associated disease. It was found more common in females in age group 01'3050 years. Mostly patients had classical bilateral lesions mostly on the buccal mucosa. Thyroiditis with generalized vitiligo was noted in one patient while diabetes was present in one patient.