ABSTRACT
SUMMARY: Despite attempts to develop the plastination technique in Bolivia, standardized results have not yet been achieved that could be communicated via scientific publications. There is a great deal of misunderstanding around the technique, confusing it with classic techniques of inclusion in different types of resin, such as polyester and epoxy, but these protocols are not plastination. The aim of this work was to communicate the first standardized room-temperature plastination protocol with silicone in Bolivia, with the unique feature of doing so at the altitude of the city of La Paz, thus constituting the first communication of a plastination technique at 4,150 m.a.s.l. sub sede La Paz, La Paz, Bolivia.
En Bolivia, a pesar de los intentos en el desarrollo de la técnica de Plastinación, aún no se han alcanzado resultados estandarizados que pudieran ser comunicados por medio de publicaciones científicas. Existe una gran confusión al momento de desarrollar la técnica, confundiéndola con técnicas clásicas de inclusión en distintos tipos de reina, como poliéster y epoxy, pero no correspondiendo estos protocolos desarrollados a la técnica de plastinación. En este sentido, el objetivo de esta trabajo consistió en comunicar el primer protocolo estandarizado de plastinación a temperatura ambiente con silicona de Bolivia, con la particularidad de desarrollarlo en la altura de la ciudad de La Paz, constituyéndose, de esta manera, en la primera comunicación de una técnica de plastinación a 4.150 metros sobre el nivel del mar.
Subject(s)
Humans , Altitude , Forearm/anatomy & histology , Plastination , Hand/anatomy & histology , Silicones , Temperature , BoliviaABSTRACT
A dermatite de contato pigmentada se destaca por sua raridade, sendo associada a inúmeros alérgenos cosméticos e têxteis. Acomete predominantemente mulheres de meia idade e fototipos altos. O teste de contato é imprescindível para a identificação do agente causal. O tratamento indicado consiste no afastamento do agente causal, no uso de fotoprotetores, clareadores tópicos e, por vezes, procedimentos dermatológicos abrasivos. Relatamos um caso de dermatite de contato pigmentada por cosmético motivado pela exuberância clínica e desfecho satisfatório, ressaltando a importância da suspeição diagnóstica e do manejo adequado impactando neste desfecho.
Pigmented contact dermatitis is a rare condition associated with numerous cosmetic and textile allergens. It predominantly affects middle-aged women with high phototypes. The patch test is essential to identify the causative agent. Treatment includes removal of the causative agent, sunscreen use, administration of topical bleaching agents, and occasionally abrasive dermatologic procedures. We report a case of pigmented cosmetic contact dermatitis motivated by its clinical exuberance and satisfactory outcome, emphasizing the importance of diagnostic suspicion and adequate management impacting this outcome.
Subject(s)
Humans , Female , Middle AgedABSTRACT
Abstract Background Capecitabine (Xeloda®) is a cytotoxic, antimetabolite chemotherapeutic agent. Its most common adverse events are diarrhea, hand-foot syndrome (HFS), hyperbilirubinemia, hyperpigmentation, fatigue, abdominal pain, and other gastrointestinal effects. HFS or palmar-plantar erythrodysesthesia (PPE) is an adverse reaction resulting from therapy with chemotherapeutic agents, classified into three degrees. Hyperpigmentation, as an adverse effect of capecitabine, can occur in different locations and with different patterns. The skin, nails and oral mucosal membrane can be affected. Objective The objective of this study was to report and discuss oral hyperpigmentation associated with HFS caused by the use of capecitabine, which is still poorly described in the literature. Methodology A literature review was carried out using the online databases PubMed, Scielo, BVS, Lilacs, Medline, BBO and Google Scholar, associating the descriptors "Capecitabine", "Pigmentation Disorders", "Oral mucosa", "Cancer" and "Hand-Foot Syndrome", which were related and used to exemplify, discuss and report the exposed clinical case. Results This case report corroborates the literature regarding the incidence in females and black skin persons like this patient who was affected by HFS when undergoing antineoplastic therapy with capecitabine and presented hyperpigmentation of the hands, feet and oral mucosa. On the oral mucosa, the hyperpigmented spots were diffuse, showing a blackish color and irregular edges. Their pathophysiology remains unknown. Study limitations Few articles citing capecitabine-associated pigmentation. Conclusions It is hoped that this study may contribute to the identification and correct diagnosis of hyperpigmentation in the oral cavity, as well as call attention to the adverse effects related to capecitabine.
ABSTRACT
Purpose: To evaluate presence of perilimbal pigmentation (PLP) in Indian patients with vernal keratoconjunctivitis (VKC). Methods: A cross sectional study was conducted from 2019 to 2020 at a tertiary eye care center in Western Maharashtra, India. In this study, 152 cases of VKC were identified. The presence, type, color, and extent of PLP were recorded. The incidence of presence of PLP was calculated. Its correlations with severity and duration of VKC were analyzed using Wilcoxon–Mann–Whitney U test and Chi square test. Results: Of 152 cases, 79.61% were males. Mean age at presentation was 11.4 ± 5.6 years. The characteristic PLP was present in 81 cases (53.29%; 95% confidence interval [CI]: 45.03%–61.42%; P < 0.001), of which 15 cases (18.5%) had this pigmentation in all the four quadrants. There was a significant difference between the groups with respect to quadrants involvement in terms of the extent of PLP in clock hours (?2 = 73.85, P < 0.001). However, the extent did not correlate with age (rho = 0.08, P = 0.487), sex (P = 0.115), time since onset in months (rho = 0.03, P = 0.77), duration of VKC and type or color of PLP (P = 0.12). Conclusion: Perilimbal pigmentation seems to be a consistent clinical finding seen in a significant number of VKC cases. It may benefit ophthalmologists in treating VKC cases when the palpebral/ limbal signs are elusive.
ABSTRACT
Este trabajo documenta el primer registro de anomalías cromáticas en el pecarí de collar (Pecari tajacu) y el tercero en el mapache (Procyon lotor) para México. Los hallazgos se realizaron durante el monitoreo realizado entre el 2009 y el 2021, utilizando cámaras-trampa, principalmente en la ecorregión de la Sierra Madre del Sur del estado de Guerrero, México. Procyon lotor fue registrado entre el 5 de noviembre y el 1 de diciembre de 2019, en vegetación riparia de bosque tropical caducifolio (17°47'35"N, 98°39'59"W, 1134 m de altitud). Mientras que Pecari tajacu se registró el 7 de junio y el 22 de julio del 2021 en una brecha saca cosecha abandonada (17°38'12"N, 100°40'50"W; 1532 m de altitud).
This paper documents the first record of chromatic anomalies in Collared Peccary (Pecari tajacu) and the third in the Raccoon (Procyon lotor) for Mexico. The findings were made during monitoring conducted between 2009 and 2021, using camera traps, primarily in the Sierra Madre del Sur ecoregion of the state of Guerrero, Mexico. Procyon lotor was recorded between November 5th and December 1st, 2019, in riparian vegetation of a deciduous tropical forest (17°47'35"N, 98°39'59"W, 1134 m altitude). Meanwhile, Pecari tajacu was recorded on June 7th and July 22nd, 2021, in an abandoned crop clearing (17°38'12"N, 100°40'50"W; 1532 m altitude).
ABSTRACT
El color de las restauraciones se considera una de las características más exigidas por los pacientes, cuyo éxito final dependerá de mantenerse en el tiempo, sin sufrir alteraciones. El objetivo de este estudio fue determinar la estabilidad de color que experimentan las resinas al ser sumergidas en una sustancia pigmentante en función al factor tiempo y al tipo de pulido final realizado. Estudio experimental in vitro de tres resinas de nanopartículas: Filtek Z-350 XT® (3M), Brillant NG® (Coltene), Tetric N-Ceram® (Vivadent) donde se comparó la estabilidad de color al ser sumergidas en café. Se confeccionaron 120 discos de resinas (color esmalte A3) divididos posteriormente en dos grupos: Grupo 1 protocolo habitual de pulido Grupo 2: protocolo habitual más sellador fotocurable Biscover® (Bisco). Las muestras fueron almacenadas en agua destilada en estufa a 37° durante 24 hs para su hidratación. Se registró el color utilizando el colorímetro Kónica Minolta®. Posteriormente se sumergieron las muestras en café, y se tomó nuevamente el color a las 24 hs y a los 7 días. Los datos fueron analizados estadísticamente mediante análisis de varianza y test de compación de Tukey. Se observó que la resina que más se pigmentó en el grupo 1 correspondió a la resina Filteck Z-350 con DE: 4,68 a las 24 hs y DE: 5,53 a los 7 días. Al analizar el grupo 2 las tres resinas se mantuvieron en valores bajos de DE: 0,96 a 1,42 en ambos períodos. Al sumergir las resinas en una sustancia pigmentante, la alteración del color se va produciendo en función del tiempo. Sin embargo, el uso complementario de un sellador fotocurable como pulido mejora significativamente la estabilidad de color en estos materiales, factores que el clínico debe tener en cuenta para lograr el éxito de sus restauraciones.
The color of the restorations is considered one of the characteristics most demanded by patients, whose final success will depend on being maintained over time, without undergoing alterations. The objective of this study was to determine the color variations experienced by reinforced resins when immersed in a pigmenting substance as a function of the time factor and the type of final polishing performed. In vitro experimental study of three nanoparticle resins: Filtek Z-350 XT® (3M), Brillant NG® (Coltene), Tetric N-Ceram® (Vivadent) where color stability was compared when immersed in coffee. 120 Discs of resins (enamel color A3) were made and subsequently divided into two groups: Group 1 usual polishing protocol Group 2: usual protocol plus Biscover® (Bisco) light-curing sealer. The samples were stored in distilled water in an oven at 37 ° for 24 hours for hydration. Color was recorded using the Konica Minolta® colorimeter. Subsequently, the samples were immersed in coffee, and the color was taken again at 24 hours and 7 days. Data were statistically analyzed using analysis of variance and Tukey's comparison test. It was observed that the most pigmented resin in group 1 corresponded to the Filteck Z-350 resin with DE: 4.68 at 24 hours and DE: 5.53 at 7 days. When analyzing group 2, the three resins maintained low DE values: 0.96 to 1.42 in both periods. By immersing the resins in a pigmenting substance, the change in color occurs over time. However, the complementary use of a light-curing sealer such as polishing significantly improves color stability in these materials, factors that the clinician must take into account to achieve the success of their restorations.
ABSTRACT
Background: Acquired dermal melanocytosis is a heterogenous group of hyperpigmented lesioins which predominantly involve the face. Aim: The aim of this study was to study the clinical presentation and histopathology of cases with extra-facial acquired dermal melanocytosis. Methods: Retrospective record analysis was performed between May 2016 to August 2019 to retrieve cases of extra-facial acquired dermal melanocytosis seen at the out-patient department of dermatology at the All India Institute of Medical Sciences, Jodhpur. Consecutive cases with histopathologically proven diagnosis of acquired dermal melanocytosis were included. Documentation of variation in clinical presentation and histopathologic findings was done in light of the existing literature. Results: Overall, four cases of extra-facial acquired dermal melanocyosis (female:male = 1:3) were seen during the study period. The lone case on head and neck involved the ear lobule and peri-auricular area. The other three cases had involvement of the hand. The histopathology confirmed the diagnosis of dermal melanocytosis but revealed peculiar findings of angiotropic melanocytes and dilated capillaries. Limitations: Small sample size and lack of comparison with perilesional normal skin were the limitations of this study. Conclusion: The findings of angiotropic melanocytes may be unique to extra-facial acquired dermal melanocytosis. This might indicate interaction between dermal melanocytes and capillary endothelial cells. This finding along with dermal capillary ectasia may indicate a possible role for vascular lasers in the management of these disorders
ABSTRACT
La enfermedad de Addison es un trastorno raro que afecta progresivamente a las glándulas suprarrenales. La etiología es variada siendo su principal causa autoinmune, el diagnóstico se obtiene mediante valores de laboratorio y exploración clínica. Se expone el caso de paciente femenino que en consulta presentó un evento sincopal, en la revisión clínica se observó pigmentación de mucosas orales y uñas de manos y pies; los valores de laboratorio mostraron: ACTH elevada, cortisol disminuido y alteraciones de electrolitos, confirmándose Enfermedad de Addison. Un diagnóstico oportuno evita complicaciones mortales en quien la padece.
Addison's disease is a rare disorder that progressively affects the adrenal glands. The etiology is varied, being its main autoimmune cause, the diagnosis is obtained through laboratory values and clinical examination. The case of a female patient who presented a syncopal event in the consultation is exposed. In the clinical review, pigmentation of the oral mucosa and fingernails and toenails was observed; Laboratory values showed: elevated ACTH, decreased cortisol and electrolyte disturbances, confirming Addison's disease. A timely diagnosis prevents fatal complications in those who suffer from it.
ABSTRACT
ABSTRACT Waardenburg syndrome is a rare congenital genetic disorder characterized by sensorineural hearing loss and pigmentary abnormalities of the hair, skin, and eyes. Based on the different clinical presentations, it is divided into four subtypes as in WS1 to WS4. This report describes a 15-year-old boy who presented with low vision and bilateral hearing loss. His visual acuity was 20/200 in both eyes. Slit-lamp examination revealed complete iris heterochromia, with one blue iris and one brown iris. Fundus examination showed symmetrical pigmentation of the retina and choroid, with atrophy of the pigment epithelium in the macular region, notably also in the eye with normal iris pigment illustrating the broad spectrum of the iris and fundus pigmentation as part of this syndrome. A carefully clinical and ophthalmological evaluation should be done to differentiate various types of Waardenburg syndrome and other associated auditory-pigmentary syndrome. Early diagnosis in some cases may be crucial for the adequate development of patients affected with this condition.
RESUMO A síndrome de Waardenburg é uma doença genética congênita rara caracterizada por perda auditiva neurossensorial e anormalidades pigmentares do cabelo, da pele e dos olhos. Com base nas diferentes apresentações clínicas, é dividida em quatro subtipos (WS1 a WS4). Este relato descreve o caso de um menino de 15 anos que apresentava baixa visão e perda auditiva bilateral. Sua acuidade visual era de 20/200 em ambos os olhos. O exame em lâmpada de fenda revelou heterocromia completa da íris, com uma íris azul e uma íris marrom. A fundoscopia mostrou pigmentação simétrica da retina e coroide, com atrofia do epitélio pigmentar na região macular, notadamente também no olho com pigmento de íris normal, ilustrando o amplo espectro de pigmentação de íris e fundo como parte dessa síndrome. Uma avaliação clínica e oftalmológica criteriosa deve ser feita para diferenciar os vários tipos de síndrome de Waardenburg e outras síndromes auditivo-pigmentares associadas. O diagnóstico precoce em alguns casos pode ser crucial para o desenvolvimento adequado dos pacientes acometidos por essa condição.
Subject(s)
Humans , Male , Adolescent , Pigmentation Disorders/diagnosis , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Waardenburg Syndrome/complications , Iris Diseases/diagnosis , Iris Diseases/etiology , Pigmentation Disorders/etiology , Waardenburg Syndrome/diagnosis , Visual Acuity , Slit Lamp Microscopy , Fundus Oculi , Hearing Loss, Sensorineural/etiologyABSTRACT
A 3-year-6-month-old boy presented with multiple asymptomatic banded white macules at birth, which expanded in proportion to his body, and deformity of his right thumb with slight dyskinesia. The patient showed difficulty in communication and concentration compared with children of the same age. The family history was unremarkable. The child had clear consciousness, passable spirits, and poor language ability. Physical examination revealed a special face and slight macrodactyly of the right thumb joints, and the heart, lung, and abdominal examination was otherwise normal. Skin examination showed multiple banded or confluent irregular white macules of varying sizes and slightly elevated plaques distributed along the Blaschko′s lines on the right chest, the flexor aspect of the right upper limb, the median line of the lower abdomen, and the right lower limbs, and banded brown macules on the palmar side of the right hand and radial aspect of the right thumb. Histopathological findings of the while macule on the lower limb were consistent with basaloid follicular hamartoma. Cranial magnetic resonance imaging revealed agenesis of the corpus callosum. Whole-exome sequencing of the lesional tissue showed a mutation c.1234C>T (p.L412F) in the SMO gene, which was not found in his parents. A diagnosis of Curry-Jones syndrome was made based on the skin lesions, and pathological and genetic findings. The mutation c.1234C>T (p.L412F) in the SMO gene may contribute to the disease. The patient continued functional exercises to improve the mobility of his right thumb, and underwent a close follow-up.
ABSTRACT
Objective:To report a Chinese pedigree with autosomal dominant Waardenburg syndrome, and to identify causative gene mutations.Methods:Clinical data and peripheral blood samples were collected from the proband and her parents. Genomic DNA was extracted, gene mutations were detected through a next-generation skin-targeted sequencing panel, and Sanger sequencing was performed to verify causative mutations.Results:The proband clinically presented with irregular white patches on the abdomen and lower limbs, moderate to severe sensorineural deafness in the right ear, and iris heterochromia in both eyes. The proband′s mother presented with iris heterochromia in both eyes, epicanthus, early canities and thick eyebrows. In the family, both the proband and her mother were diagnosed with Waardenburg syndrome. A causative frameshift mutation c.976-977delinsT (p.Thr327Profs*54) was identified in both the proband and her mother, which caused the AG to TT base substitution at positions 976 - 977 in the coding region of exon 7 of the PAX3 gene, resulted in a frameshift from the amino acid position 327 to 54 in the PAX3 protein (threonine was substituted by proline at amino acid position 327). The proband′s father showed a normal phenotype, and his genetic test results were negative.Conclusion:The novel frameshift mutation c.976-977delinsT (p.Thr327Profs*54) in the PAX3 gene may contribute to the clinical phenotype of the patients with Waardenburg syndrome in the family.
ABSTRACT
Objective:To observe whether hair follicle cells from mice of different species can integrate to generate new pigmented hair follicles, and to explore the role of different melanocyte populations in pigmented hair follicle reconstruction in mice.Methods:The epidermal cell population, hair follicle epithelial cell population and dermal cell population were isolated from the skin of fetal or neonatal C57BL/6J and BALB/C mice, and epidermal melanocytes were obtained by culture and purification of the epidermal cell population. The experiments were divided into 3 parts: (1) hair follicle reconstruction experiment in neonatal C57BL/6J mice, which included 2 groups: epidermal cells + hair follicle epithelial cells group and dermal cells group; (2) chimeric hair follicle reconstruction experiment, which included 4 groups: dermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice group, dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group, and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group; (3) pigmented hair follicle reconstruction experiment, which included 3 groups: dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group, dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group, and dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group. Different cells were implanted into dorsal skin fold chambers of the nude mice, and there were 4 mice in each group. At weeks 4 and 8 after inoculation, hair follicle reconstruction was assessed by gross observation, histological examination and immunofluorescence assay.Results:Among the 8 BALB/C nude mice in the 2 groups in the hair follicle reconstruction experiment, 7 survived and 1 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, no hair growth was observed in the epidermal cells + hair follicle epithelial cells group (3 mice) , while normal hair grew out in the dermal cells group (4 mice) mixed with epithelial components. Among the 16 BALB/C nude mice in the 4 groups in the chimeric hair follicle reconstruction experiment, 14 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + dermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of fetal BALB/C mice + dermal cells of fetal C57BL/6J mice group (3 mice) . Among the 12 BALB/C nude mice in the 3 groups in the pigmented hair follicle reconstruction experiment, 10 survived and 2 died of wound infections on week 4 after inoculation; at weeks 4 and 8 after inoculation, only white hair grew out in the dermal cells of neonatal BALB/C mice + cultured C57BL/6J epidermal melanocytes group (3 mice) , and no hair follicle melanocytes were observed by immunofluorescence assay, while brown-grey hair grew well in the dermal cells of neonatal BALB/C mice + epidermal cells of neonatal C57BL/6J mice group (4 mice) , and dermal cells of neonatal BALB/C mice + hair follicle epithelial cells of neonatal C57BL/6J mice group (3 mice) .Conclusions:The interaction between mesenchymal cells and hair follicle epithelial cells is a necessary condition for hair follicle reconstruction. The hair follicle cells from different species of mice can integrate to generate new pigmented hair follicles. Both hair follicle melanocytes and epidermal melanocytes can participate in the formation of pigmented hair follicles, but differentiated melanocytes have no such ability.
ABSTRACT
@#Gingival pigmentation is a nonplaque gum disease. Patients are often afraid to communicate with others because of gum color problems, which affect the social and mental health of patients. The commonly used treatment methods for gingival pigmentation include scalpel excision, gingival grinding, laser therapy, cryosurgery and electrosurgery. In this paper, the progress of gingival pigmentation treatment was reviewed in terms of bleeding, pain, tissue healing and recoloring. The results showed that the clinical effect of laser treatment was better. Among them, the semiconductor laser had more advantages in reducing bleeding, pain and the restaining rate, while the Er:Cr:YSSG/Er:YAG laser performed better for promoting tissue healing. Clinicians can choose the best kind of laser to use according to the actual situation. For patients with thin gingival biotypes, floating gingival transplantation or substitute materials can be selected to restore the gingival morphology. With the in-depth study of melanin regulation mechanisms, various drugs, such as ascorbic acid, natural peptides, synthetic peptides and derivatives, may be the main research direction for the treatment of gingival pigmentation in the future.
ABSTRACT
Abstract Background: In addition to melanocytic hyperfunction, changes are observed in the upper dermis of melasma, and fibroblasts play a central role in collagen synthesis and pigmentation induction. Objective: To explore the morphology, growth rate, and gene expression profile of fibroblasts from the skin with melasma in comparison to fibroblasts from the adjacent healthy skin. Methods: Ten women with facial melasma were biopsied (lesion and adjacent healthy skin), and the fragments were processed for fibroblast culture. Samples from five participants were seeded to evaluate growth (days 2, 5 and 8) and senescence (SA-β-gal) curves. The samples from the other participants were submitted to real-time PCR to comparatively evaluation of the expression of 39 genes. Results: Cultured fibroblasts from melasma skin were morphologically less fusiform in appearance and on average a 34% (95% CI 4%-63%) greater proportion of cells labeled with SA-β-gal than the fibroblasts from the adjacent skin. The cell growth rate was lower for the melasma samples after eight days (p < 0.01). The WNT3A, EDN3, ESR2, PTG2, MMP1, and SOD2 genes were up-regulated, whereas the COL4A1, CSF2, DKK3, COL7A1, TIMP4, CCL2, and CDH11 genes were down-regulated in melasma skin fibroblasts when compared to the ones from adjacent healthy skin. Study limitations: Small sample size; absence of functional tests. Conclusions: Fibroblasts from the skin with melasma showed a lower growth rate, less fusiform morphology and greater accumulation of SA-β-gal than those from adjacent photo exposed skin. Moreover, their gene expression profile comprised factors that may contribute to upper dermis damage and sustained melanogenesis.
ABSTRACT
Background: There is limited literature in children on efficacy of different routes of vitamin B12 administration for vitamin B12 deficiency macrocytic-megaloblastic anemia. Objective: To compare parenteral with oral vitamin B12 therapy in children with macrocytic-megaloblastic anemia. Study design: Single-center, open-label randomized controlled trial. Participant: 80 children aged 2 month-18 year with clinical and laboratory features of nutritional macrocytic anemia. Intervention: All children received an initial single parenteral dose of 1000 µg vitamin B12 followed by randomization to either parenteral or oral vitamin B12 for subsequent doses. Group A was given 1000 µg intramuscular (IM) vitamin B12 (3 doses on alternate days for those aged <10 year, five doses for age >10 year), followed by monthly 1000 µg IM for the subsequent two doses. Group B was given daily oral vitamin B12 1500 µg (500 µg in <2 years age) for three months. Folic acid and iron supplementation, and relevant dietary advice were given to both groups in a similar fashion. Outcome: Improvement in serum vitamin B12 levels and total hemoglobin was compared three months post-treatment. Result: The median(IQR) increase in serum vitamin B12 level was significantly higher in group A [600 (389,775) vs 399 (313, 606) pg/mL; P= 0.016]. The median (IQR) rise of hemoglobin was also more in group A [2.7 (0.4,4.6) vs 0.5 (-0.1,1.2) g/dL; P=0.001]. Conclusion: Increase in serum vitamin B12 levels and hemoglobin was better in children with nutritional macrocytic anemia receiving parenteral as compared to oral vitamin B12.
ABSTRACT
Abstract Vitiligo is a complex disease whose pathogenesis results from the interaction of genetic components, metabolic factors linked to cellular oxidative stress, melanocyte adhesion to the epithelium, and immunity (innate and adaptive), which culminate in aggression against melanocytes. In vitiligo, melanocytes are more sensitive to oxidative damage, leading to the increased expression of proinflammatory proteins such as HSP70. The lower expression of epithelial adhesion molecules, such as DDR1 and E-cadherin, facilitates damage to melanocytes and exposure of antigens that favor autoimmunity. Activation of the type 1-IFN pathway perpetuates the direct action of CD8+ cells against melanocytes, facilitated by regulatory T-cell dysfunction. The identification of several genes involved in these processes sets the stage for disease development and maintenance. However, the relationship of vitiligo with environmental factors, psychological stress, comorbidities, and the elements that define individual susceptibility to the disease are a challenge to the integration of theories related to its pathogenesis.
ABSTRACT
A valorização da estética tornou-se usual durante o tratamento odontológico, sendo o clareamento dental um dos procedimentos mais procurados para o tratamento de alterações na cor e diversos autores consideram que a dieta branca é importante para que o seu resultado estético não seja comprometido. Porém, outros autores afirmam que a ingestão de alimentos e de bebidas com corantes não interfere imediatamente e posteriormente no resultado do tratamento clareador. Este artigo verifica, por meio de revisão de literatura, se a dieta branca é realmente necessária durante ou após o clareamento dental. Foi realizado um levantamento bibliográfico nas bases LILACS e PUBMED, sendo encontrados 16 artigos que se enquadravam nos critérios de inclusão. Estudos in vitro, in situ e in vivo expostos nesse trabalho, relatam que não há interferência dos pigmentos durante o clareamento no resultado do procedimento. Há consenso também de que após o tratamento clareador, o vinho tinto interfere na manutenção da cor. Portanto, indicar a dieta branca ainda é uma recomendação que parcialmente não é baseada em evidências científicas, devido à falta de congruência nos resultados das pesquisas.
The appreciation of aesthetics has become usual during dental treatment, with tooth whitening being one of the most sought procedures for the treatment of color changes and several authors consider that the white diet is important so that its aesthetic result is not compromised. However, other authors state that the ingestion of food and drinks with dyes does not interfere immediately and later in the result of the bleaching treatment. This article verifies, through literature review, if the white diet is really necessary during or after tooth whitening. A bibliographic search was performed in LILACS and PUBMED, and 16 articles were found that met the inclusion criteria. In vitro, in situ and in vivo studies exposed in this work report that there is no interference of pigments during bleaching on the result of the procedure. There is also a consensus that after the bleaching treatment, red wine interferes with color maintenance. Therefore, indicating the white diet is still a recommendation that is partially not based on scientific evidence, due to the lack of congruence in research results.
ABSTRACT
Melasma is a skin condition characterized by dark spots and patches on the nose, cheeks, forehead and jaw line. Although it is completely harmless, it causes skin discoloration which is difficult to fade away with routine skin care. Melasma can lead to social isolation and stigmatization adversely affecting the quality of daily life which definitely has a major impact on individual’s psychological state and social relationship. The symptomatology of Vyanga given in various available Ayurvedic classics are Mandala (circular patches), Shyava (brown), Tanu (thin), Niruja (painless), etc. The clinical features of melasma can be correlated with Vyanga and condition can be treated based on the Vyanga Chikitsa. Objectives: To evaluate the efficacy of Haritakyadi Lepa in the management of Vyanga and to review the etiopathology and the clinical aspect of the Vyanga. Result: Based on the collected data, efforts were made to evaluate the efficacy of Haritakyadi Lepa followed by Sadyo Virechana with Manibhadra Guda in the subjects of melasma vis-à-vis Vyanga. Conclusion: In contemporary science, topical steroids have been described in the management of melasma. Alternative to that Haritakyadi Lepa along with Madhu selected for treatment, has shown very effective result in Vyanga.
ABSTRACT
Introduction: Dermal manifestations in chronic kidney disease (CKD) patients may range from mild ones, like xerosis, skin pallor, pruritus, coated tongue, superficial infections and hair and nail changes, to severe life-threatening ones, like nephrogenic systemic fibrosis, which is a rare entity in current times. The present study was done to evaluate the spectrum of mucocutaneous manifestations in patients with CKD and to look for an association between them and various biochemical parameters and inflammatory markers. Material and methods: This study was a 1 year prospective, observational study conducted on adult patients with CKD who presented to the Nephrology clinic in Pt. BD Sharma PGIMS, Rohtak. Patients between the ages of 17 and 75 years with CKD stages II or more with dermatological conditions were included in this study. Each participant was subjected to detailed clinical, biochemical, radiological and dermatological examination by same consultants in order to avoid interpersonal variations. Various skin, mucosal, nail and hair manifestations along with cutaneous infections were analyzed across the spectrum of CKD. Results: Among cutaneous infections, fungal infections predominated, amongst which, onychomycosis was the most common. Xerosis was the most common dermatological disease and the prevalence of xerosis, skin pallor and pruritus was found to increase significantly from Stage II to Stage V and VD of CKD in a statistically significant manner. An association was found between xerosis and decreasing levels of hemoglobin and while ferritin was not different between patients with and without xerosis, high-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients with xerosis. Similarly, hs-CRP levels were significantly elevated in patients with xerostomia and nail pallor as compared with those who did not have these conditions. Lastly, patients with nail pallor had significantly lower albumin. Conclusion: It was observed in our study that in CKD patients on hemodialysis and on conservative management, xerosis, pruritus, pigmentation, nail changes, oral mucosa changes and cutaneous infections were the predominant cutaneous manifestations. In patients with CKD, mucocutaneous manifestations progressively worsened as renal function deteriorated.
ABSTRACT
Não se aplica, trata-se de uma carta
Not applicable, this is a letter.