Desmoplastic Fibroma Recurrence Associated with Tuberous Sclerosis in a Young Patient.

Case Report. A nine-year-old patient with a diagnosis of tuberous sclerosis (with no pathological record) that showed calcifications at the brain level. Besides, the case showed the Vogt triad (epilepsy, mental retardation, and sebaceous adenoma). The patient clinically showed a volume increase of hard consistency, without suppuration and no sessile that included the following teeth 73, 74, and 75. Cone beam computed tomography (CBCT) was obtained, and it displayed a delimited unilocular lesion. After surgical excision, the histopathological report was desmoplastic fibroma (DF). It was observed that the patient had an aggressive recurrence of DF at four months after surgery treatment. Due to these clinical findings, resective osseous surgery and curettage were carried out. It is uncommon to find these two pathologies together (DF and tuberous sclerosis). Since DF is a benign pathology but very invasive and destructive, it is necessary a constant follow-up examination due to a high recurrence frequency.

Frequency of dental caries in active and inactive systemic lupus erythematous patients: salivary and bacterial factors.

OBJECTIVE: The objective of this study was to determine dental caries frequency and to analyze salivary and bacterial factors associated with active and inactive systemic lupus erythematous (SLE) patients. Also, a proposal to identify dental caries by a surface, teeth, and the patient was developed. MATERIAL AND METHODS: A cross-sectional, blinded study that included 60 SLE patients divided into two groups of 30 subjects each, according to the Activity Index for Diagnosis of Systemic Lupus Erythematous (SLEDAI). The decayed, missing, and filled teeth (DMFT) index and Integrative Dental Caries Index (IDCI) were used for analyzing dental caries. The saliva variables recorded were: flow, pH, and buffer capacity. The DNA copies of Streptococcus mutans and Streptococcus sobrinus were estimated by real-time PCR. RESULTS: The caries frequency was 85% for SLE subjects (73.3% for inactive systemic lupus erythematous (ISLE) and 100% for active systemic lupus erythematous (ASLE)); DMFT for the SLE group was 12.6 ± 5.7 and the IDCI was (9.8 ± 5.9). The ASLE group showed a salivary flow of 0.65 compared with 0.97 ml/1 min from the ISLE group; all variables mentioned above showed a statistical difference (p < 0.05). The salivary pH was 4.6 (6.06 for ISLE and 3.9 for ASLE). The DNA copies of S. mutans and S. sobrinus were high; all variables mentioned above show a significant statistical difference (p < 0.05) between groups. CONCLUSION: SLE patients had high DMFT and IDCI scores that were associated with a decrease in salivary flow, pH, and buffer capacity. There were high counts of S. sobrinus and S. mutans species, and IDCI is a useful tool to provide more detail about dental caries in epidemiological studies.

Molecular identification and antibiotic resistant bacteria isolated from primary dentition infections.

BACKGROUND: Bacterial resistance to antibiotics is a health problem in many parts of the world. The aim of this study was to identify bacteria from dental infections and determine bacterial resistance to antibiotics used in dental care in the primary dentition. METHODS: This cross-sectional study comprised 60 children who presented for dental treatment for active dental infections in the primary dentition. Samples from dental infections were collected and bacteria were identified by polymerase chain reaction (PCR) assay. Bacterial resistance to antibiotics was determined by colony forming units on agar plates containing amoxicillin, clindamycin and amoxillicin-clavulanic acid (A-CA) tested at 8 µg/ml or 16 µg/ml. RESULTS: Clindamycin in both concentrations tested (8 µg/ml and 16 µg/ml) showed the highest bacterial resistance (85.9%), followed by amoxicillin (43.7%) and A-CA (12.0%). All comparisons among the three antibiotics used in the study exhibited statistical significance (p = <0.05) in both concentrations tested (8 µg/ml and 16 µg/ml), and under aerobic and anaerobic conditions. The most prevalent resistant species identified by PCR in primary dentition infections were: Streptococcus oralis and Prevotella intermedia (75.0%); Treponema denticola and Porphyromonas gingivalis (48.3%); Streptococcus mutans (45.0%); Campylobacter rectus; and Streptococcus salivarius (40%). CONCLUSIONS: This study demonstrated that A-CA exhibited the lowest bacterial resistance for clinical isolates in primary dentition infections.

Hemorragias y hematomas intracraneales en el embarazo / No disponible

La hemorragia intracraneal durante el embarazo es una complicación poco frecuente pero con una alta morbilidad y mortalidad. Aunque las causas de hemorragia son similares a las de la población general, la embarazada presenta unos cambios fisiológicos así como una patología propia que pueden predisponer a las mismas. La causa más frecuente identificada es la hipertensión arterial. La preeclampsia es específica de las gestantes, siendo la hemorragia cerebral la primera causa de muerte materna en la hipertensión inducida por el embarazo. La hemorragia secundaria a una rotura de aneurisma o una malformación arteriovenosa es una complicación grave pero afortunadamente rara. Cambios fisiológicos asociados al embarazo predisponen a la formación, crecimiento y rotura del aneurisma. Los hematomas secundarios a anestesia subaracnoidea o tras una punción accidental del saco dural durante una anestesia epidural no es muy frecuente pero pueden provocar graves alteraciones con déficit neurológicos significativos. La cefalea prolongada representa un signo de alarma de hematoma subdural. En este trabajo, revisamos distintos aspectos relacionados con la etiología, fisiopatología, diagnóstico y las medidas terapéuticas de la hemorragia intracraneal en la mujer embarazada

Intracranial hemorrhage during pregnancy is a rare complication, but with high morbidity and mortality. Although the causes are similar to those in the general population, pregnancy presents some physiological changes as well as its own pathology predisposes it to hemorrhage. The most frequently identified cause is arterial hypertension. Pre-eclampsia is specific to pregnancy, cerebral hemorrhage being the first cause of maternal death in the hypertension induced by pregnancy. Secondary hemorrhage to a ruptured aneurysm or arteriovenous malformation is a very serious, although fortunately rare, complication. Physiological changes in pregnancy may predispose to the formation, growth and rupture of an aneurysm On the other hand, secondary hematomas from spinal subdural anesthesia or accidental puncture of the dural sack during an epidural anesthesia is not very frequent, but can potentially cause very serious alterations with significant neurological deficits. Prolonged headache should be regarded as a warming sign of subdural hematoma. This update reviews different aspects related to the etiology, physiopathology, diagnosis and therapeutic measures of cerebral hemorrhage in the pregnant patient

[Factor VII, a therapeutic alternative in the treatment of severe haemoghage disorders]. / Factor VII, alternativa terapéutica en el tratamiento de trastornos hemorrágicos graves.

Plasmatic coagulation has like purpose the formation of a stable clot of fibrina, this process is possible thanks to the intervention of the factors of the coagulation that are plasmatic proteins. Some of these factors are vitamin K dependent (factors II, VII, IX and X) and all except for the factors VIII, XII and XIII which are synthesized in the liver. Three clinical cases of patients are described who present serious hemorrhagic disorders, associated to different hepatic alterations, which do not respond to conventional treatments. As a measure of urgency and therapeutic alternative, the administration of recombinant factor VII is used with the aim of activating the extrinsic pathway of the coagulation and of obtaining a positive answer in the control of the hemorrhage.

Embarazada a término y disección deaorta ascendente / Dissection of the ascending aorta at full-term pregnancy

No disponible

Factor VII, alternativa terapeútica en el tratamiento de trastornos hemorrágicos graves / Factor VII, a therapeutic alternative in the treatment of severe haemoghage

La coagulación plasmática tiene como finalidad la formación de un coágulo estable de fibrina. Este proceso es posible gracias a la intervención de los factores de la coagulación que son proteínas plasmáticas. Algunos de estos factores son dependientes de vitamina K (factores II, VII, IX y X) y todos a excepción de los factores VIII, XII y XIII se sintetizan en el hígado. Se describen tres casos clínicos de pacientes que presentan trastornos hemorrágicos graves, asociados a distintas alteraciones hepáticas, que no responden a tratamientos convencionales. Como medida de urgencia y alternativa terapéutica se recurre a la administración de factor VII recombinante, con el objetivo de activar la vía extrínseca de la coagulación y obtener una respuesta positiva en el control de la hemorragia La coagulación plasmática tiene como finalidad la formación de un coágulo estable de fibrina. Este proceso es posible gracias a la intervención de los factores de la coagulación que son proteínas plasmáticas. Algunos de estos factores son dependientes de vitamina K (factores II, VII, IX y X) y todos a excepción de los factores VIII, XII y XIII se sintetizan en el hígado. Se describen tres casos clínicos de pacientes que presentan trastornos hemorrágicos graves, asociados a distintas alteraciones hepáticas, que no responden a tratamientos convencionales. Como medida de urgencia y alternativa terapéutica se recurre a la administración de factor VII recombinante, con el objetivo de activar la vía extrínseca de la coagulación y obtener una respuesta positiva en el control de la hemorragia (AU)