Tratamiento de las repercusiones sinérgicas en presencia de enfermedad periodontal en el paciente con diabetes: revisión de la literatura / Treatment of the synergistic effects of periodontaldisease in patients with diabetes. literature review

Introducción: La interacción de las enfermedades periodontales serelacionan con el medio ambiente, huésped, factores microbianos ysusceptibilidad genética. En esta patología la interacción de las bacteriasy el sistema inmunológico dan como resultado una producción elevada de mediadores infl amatorios como las interleucinas IL-1, IL-6 y el TNF-α que destruirán el tejido conectivo y óseo. La diabetes por sí misma ya sea tipo 1 o 2 va a tener repercusiones a nivel de los diferentes órganos de la economía como los riñones, sistema nervioso,ojos, sistema circulatorio y de ahí al periodonto. Cuando el paciente nose encuentra en control sistémico, los efectos adversos van aumentandoy se provoca una sinergia entre la alteración glucémica y la afectaciónperiodontal. Se ha descrito la relación del efecto benéfi co del tratamientoperiodontal en el control glucémico en pacientes diabéticos y no diabéticos. Conclusión: El tratamiento periodontal no quirúrgico demostró reducir los valores de los parámetros periodontales así como los valores séricos de glucosa en ayuno y hemoglobina glucosilada y coadyuvar en el control glucémico.

Introduction: The interaction of periodontal disease is related to theenvironment, host, microbial factors and genetic susceptibility. In thiscondition, the interaction of bacteria and the immune system result inincreased production of infl ammatory mediators such as IL-1, IL-6interleukins, and TNF-α that will destroy connective tissue and bone.Diabetes itself either type 1 or 2 will have repercussions at the levelof the diff erent organs of the economy as it is kidneys, nervous system,eyes, circulatory system and hence the periodontium. When the patientis not in controlling systemic adverse eff ects are increased and synergybetween periodontal health and glycemic involvement provoked. It hasbeen reported regarding the benefi cial eff ect of periodontal treatmenton glycemic control in diabetic and non-diabetic patients. Conclusion:The non-surgical periodontal treatment was shown to reduce the valuesof periodontal parameters and serum fasting glucose and glycatedhemoglobin and assist in glycemic control.

Coronectomía en terceros molares mandibulares como alternativa de tratamiento seguro en la prevención del daño al nervio alveolar inferior: revisión bibliográfica y reporte de 30 casos / Coronectomy in third mandibular molars as an alternative treatment to prevent damage to the inferior alveolar nerve: bibliographic review and 30 cases report

La lesión del nervio alveolar inferior (NAI) al extraer los terceros molares mandibulares esa menudo causada por la íntima relación entre el nervio y las raíces dentarias. La técnica de coronectomía ola retención intencionada de raíz, podría mitigar este problema. Treinta pacientes fueron sometidos a coronectomia en 30 terceros molares mandibulares con seguimiento de al menos 6 meses. Todos los pacientes fueron radiografiados antes de la intervención, inmediatamente después de la operación, y después de 6meses. La técnica se realizó con protección del nervio lingual como parte del procedimiento quirúrgico. Todas las raíces quedaron al menos 3 mm por debajo de las tablas óseas bucal y lingual. No hubo ningún caso de daño del NAI. Hubo un caso de afectación transitoria del nervio lingual, probablemente por el uso del retractor lingual. Un paciente requirió la retirada posterior de las raíces de los terceros molares, debido a la falta cicatrización, y otro paciente requirió la retirada posterior de una raíz a causa de migración posterior ala superficie. La migración de las raíces se observó en aproximadamente el 30 % de los pacientes durante un período de 6 meses. La coronectomia parece ser una técnica viable en aquellos casos en que la extracción completa del diente podría poner al NAI en un riesgo considerable de daño. La técnica parece estar asociada con una baja incidencia de complicaciones, pero la migración posterior de las raíces puede ser un problema en el largo plazo.

The inferior alveolar nerve (IAN) injury to remove the third molars is often caused by the intimate relationship between the nerve and the roots of the teeth. Coronectomy technique or intentional root retention, may minimize this problem. Thirty patients underwent coronectomy in 30 third molars with follow up of at least 6 months. Coronectomy technique deliberately protected the lingual nerve as part of the surgical procedure. All roots were at least 3 mm below the buccal and lingual bony walls. All patients were radiographed preoperatively, immediately postoperatively, and after 6 months. There were no cases of IAN damage involved in this study of 30 patients who underwent 30 coronectomies. There was one case of transient lingual nerve involvement, probably by the use of lingual retractor. One patient required subsequent removal of the roots of both lower third molars, due to lack of healing, and one patient required subsequent removal of a root cause of migration back to the surface. migration of the roots was observed in approximately 30 percent of patients during a period of six months. Coronectomy seems to be a viable technique in those cases where the removal of all tooth could put the IAN at considerable risk of damage. The technique appears to be associated with a low incidence of complications, but the subsequent migration of the roots can be a problem in the long term.

The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis in the golden hamster model

New therapeutic alternatives against leishmaniasis remain a priority. The activity of azithromycin against Leishmania (Leishmania) major has been previously demonstrated. Different responses among species of Leishmania make species-specific drug screening necessary. The activity of azithromycin against Leishmania (Viannia) braziliensis and Leishmania (Leishmania) amazonensis was evaluated in golden hamsters infected through footpad injections of metacyclic promastigotes, and compared with untreated controls and animals treated with meglumine antimoniate. Footpad thickness, lesion cultures and dissemination sites were analyzed. Treatment of golden hamsters with oral azithromycin at 450mg/kg had no activity against infections with Leishmania (Leishmania) amazonensis. For infections due to Leishmania (Viannia) braziliensis, azithromycin demonstrated significant activity relative to untreated controls, but inferior to meglumine antimoniate, for controlling lesion size. Neither drug was able to totally eliminate parasites from the lesions. It was concluded that azithromycin has activity against Leishmania (Viannia) braziliensis but not against Leishmania (Leishmania) amazonensis in this model.

Novas alternativas terapêuticas contra a leishmaniose são ainda uma prioridade. A atividade da azitromicina contra a Leishmania (Leishmania) major foi anteriormente demonstrada. Diferentes respostas entre as espécies de Leishmania fazem com que um screening de drogas específicas para espécies seja necessário. A atividade da azitromicina contra a Leishmania (Viannia) braziliensis e a Leishmania (Leishmania) amazonensis foi avaliada em Golden hamsters infectados a través de injeções de promastigotas metacíclicas e comparando com controles sem tratamento e animais tratados com antimoniato de N-metil-glucamina. Foram analisadas a espessura da pata, a cultura das lesões e disseminação para órgãos internos. A azitromicina oral em dose de 450mg/kg não teve atividade contra a infecção por Leishmania ( Leishmania) amazonensis. Para infecções devidas à Leishmania (Viannia) braziliensis, a azitromicina teve uma atividade significativa em relação aos controles sem tratamento, mas foi inferior ao antimoniato de N-metil-glucamina quanto ao controle do tamanho das lesões. Nenhuma das drogas conseguiu eliminar totalmente os parasitos das lesões. Foi concluído que a azitromicina tem atividade contra Leishmania (Viannia) braziliensis, mas não tem atividade contra Leishmania (Leishmania) amazonensis neste modelo.

Alpha-blockade therapy in alternating day dose in the management of benign prostatic hyperplasia

This study was conducted to compare the efficacy of Terazosin given in alternate day doses with that of the same drug given in daily doses in the medical management of benign prostatic hyperplasia (BPH) using the following parameters: International Prostate Symptom Score (IPSS), urine flow rate, residual urine volume and quality of life. Ninety patients were randomly assigned to Daily Dose, Alternate Day Dose and Placebo groups. Symptom scores using the IPSS were measured at pre-treatment, and at 1st, 3rd and 6th week treatment periods. Pre- and post-treatment measurements of urine flow rate, residual urine volume and quality of life were done. Two-way ANOVA and Wilcoxon Matched Pair Signed Ranked Test was used to determine the level of significance. The study showed that there was significant improvement in the symptom score in both Daily Dose (15.80 +/- 1.74 to 5.93 +/- 1.03) (p 0.001) and Alternate Day Dose group (16.06 +/- 1.87 to 6.13 +/- 1.45) (p 0.001) compared to the placenta group. Likewise there was significant improvement in the urine flow rate in both groups, (4.82 +/- 0.75 to 5.76 +/- 0.67) (p (65.66 +/- 17.54 to 46.46 +/- 12.77) (p = 0.001) in the Alternate Day Dose group. The quality of life improved (3.26 +/- 0.88 to 1.66 +/- 0.72) (p = 0.002) in the Daily Dose group and (3.66 +/- 0.81 to 1.80 +/- 0.77) (p = 0.001) in the Alternate Day Dose group. (Author)

The outcome of renal ultrasound in the assessment of 159 consecutive patients with benign prostatic hyperplasia

We determined the value of renal ultrasonography in the assessment of patients with benign prostatic hyperplasiaRenal ultrasound was performed in 159 patients with benign prostatic hyperplasia and results were correlated with other clinical parameters of the patients, 11 (7%) had dilatation of the renal patients, 13 (8%) had renal cysts and 2 (1%) had nephrolithiasis. Serum creatinine level as one of the clinical parameters appeared to correlate well with hydronephrosis. Together with the results of post-void residual measurements, this study showed that renal ultrasound is suggested only in patients with a specific serum creatinine level and/or significant post-void residual volume. (Author)