ABSTRACT
IgM multiple myeloma (MM) is a rare subtype of myeloma that shares clinical and pathological features with Waldenström's macroglobulinaemia. These are two separate entities that differ both in therapy and prognosis. We report a 57-year-old male, who presented with anaemia, hypercalcaemia, acute renal failure and several vertebral fractures that clinically suggested a multiple myeloma. Further investigations revealed a serum monoclonal component of IgM lambda type and a bone marrow infiltrated by small, lymphoplasmocytic cells. IgM MM was finally diagnosed by means of both inmunophenotypic and immunohistochemistry techniques, stressing the importance of inmunophenotypic evaluation when clinical and morphological features are discordant. Fluorescence in situ hybridization (FISH) studies disclosed a particular combination of deletion 13q14, t(11;14) and monoallelic deletion C-MAF without t(14;16). The clinical evolution after a Bortezomib-containing polychemotherapy and autologous stem cell transplantation (ASCT) conditioned with busulphan and melphalan is also presented. This very uncommon case highlights the impact of immunophenotyping on the differential diagnosis between IgM MM and WM, to choose the best treatment and establish an appropriate outcome.
Subject(s)
Gene Deletion , Immunoglobulin M/blood , Multiple Myeloma/blood , Multiple Myeloma/genetics , Proto-Oncogene Proteins c-maf/genetics , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biopsy , Bone Marrow/pathology , Diagnosis, Differential , Humans , Immunophenotyping , Male , Middle Aged , Multiple Myeloma/diagnosis , Multiple Myeloma/drug therapy , Treatment Outcome , Waldenstrom MacroglobulinemiaABSTRACT
OBJECTIVES: To characterise the black-pigmented bacterial species found in the subgingival samples of cats with periodontal disease using molecular-based microbiological techniques. METHODS: Sixty-five subgingival samples obtained from 50 cats with periodontal disease were analysed by polymerase chain reaction amplified ribosomal DNA restriction analysis and cloning and sequencing of the 16S rRNA genes. RESULTS: Among the 65 subgingival samples, eight phylogenetic profiles were obtained, of which the most prevalent species were: Porphyromonas gulae (40%), P. gingivalis/P. gulae (36 · 9%), P. gulae/Porphyromonas sp. UQD 406 (9 · 2%), Odoribacter denticanis (6 · 2%), P. gulae/Porphyromonas sp. UQD 348 (1 · 5%) and P. circumdentaria (1 · 5%). When compared with the species resulting from biochemical diagnosis, the identification of P. gulae was congruent in 70% of the cases, while colonies identified as P. intermedia-like corresponded in 80% of cases to P. gulae. CLINICAL SIGNIFICANCE: The use of molecular-based microbiological diagnostic techniques resulted in a predominance of Porphyromonas spp. in the subgingival plaque of cats suffering from periodontal disease. Further characterisation of these bacteria identified P. gulae, O. denticanis and P. circumdentaria. The more frequently detected phylogenetic profiles corresponded to P. gingivalis and P. gulae.
Subject(s)
Bacteroidaceae Infections/veterinary , Cat Diseases/microbiology , Periodontitis/veterinary , Porphyromonas/isolation & purification , Animals , Bacterial Load , Bacteroidaceae/classification , Bacteroidaceae/genetics , Bacteroidaceae/isolation & purification , Bacteroidaceae Infections/microbiology , Cats , Female , Male , Periodontitis/microbiology , Polymerase Chain Reaction/veterinary , Porphyromonas/classification , Porphyromonas/genetics , RNA, Ribosomal, 16S/analysisABSTRACT
BACKGROUND: Ventral hernia repair (VHR) with mesh performed concurrently with colorectal surgery is presumably associated with significant risks of infection and recurrence. The purpose of this study is to evaluate the outcomes of patients undergoing VHR with non-absorbable mesh (NAM) or biological mesh (BM) at the same time as open colorectal surgery. METHODS: A retrospective review of short- and long-term outcomes for 25 patients undergoing repair of VHR with NAM or BM at the same time as an open colorectal procedure from 1991 to 2007 was performed. RESULTS: The mean age of the patients was 50.8 ± 12.7 years. Fifteen patients (60 %) underwent VHR with NAM versus 10 (40 %) with BM at the time of colorectal surgery. Mean follow-up after surgery was 32.9 ± 38.2 months. Overall wound infection, mesh infection and hernia recurrence rates were 44, 36 and 36 %, respectively. There was no difference between the NAM and BM mesh repair groups in terms of operative indications (p = 0.23) and operations performed (p = 0.47). Both groups had similar gender, ASA score, age, BMI, operating time, hernia recurrence rate, wound infection and follow-up. CONCLUSIONS: Although a proportion of patients who undergo concomitant use of mesh for VHR during colorectal resection has reasonable outcomes, there is a high associated risk of wound and mesh infection. Thus, a judicious decision regarding the use of mesh for hernia repair needs to be made on a case-by-case basis for patients undergoing open bowel surgery at the same time.
Subject(s)
Hernia, Ventral/surgery , Surgical Mesh , Surgical Wound Infection/epidemiology , Adult , Digestive System Surgical Procedures , Equipment Design , Female , Humans , Male , Middle Aged , Quality of Life , Recurrence , Retrospective StudiesABSTRACT
The purpose of this study was to evaluate the subgingival microbiota and determine the most prevalent periodontal pathogens implicated in feline periodontal disease and to correlate these findings with the clinical periodontal status. Subgingival microbiological samples were taken under sedation from 50 cats with clinical signs of periodontal disease. Pooled paper point samples from 4 selected subgingival sites were cultured on blood agar and on Dentaid-1 medium. Suspected pathogens were identified, subcultured, and preserved. The association between the microbiological findings and the clinical status was studied using correlation coefficients (CC). In addition, cats were stratified in subgroups according to presence of putative pathogens, and comparisons were carried out using unpaired t-test. Three bacterial species were frequently detected including Porphyromonas gulae (86%), Porphyromonas circumdentaria (70%) and Fusobacterium nucleatum (90%). The mean proportion of total flora was high for P. gulae (32.54%), moderate for P. circundentaria (8.82%), and low for F. nucleatum (3.96%). Among the clinical variables, tooth mobility was correlated (CC > 0.50, p < 0.001) with recession, pocket depth, attachment level, gingival index, and calculus index (CC = 0.29, p = 0.04) as well as with total bacterial counts (CC = 0.38, p = 0.006). Cats with more than 10% of P. gulae showed significantly more mobility (p = 0.014) and recession (p = 0.038), and a tendency for deeper probing pocket depths (p = 0.084) and attachment loss (p = 0.087). The results from this cross-sectional study confirmed that P. gulae is the most relevant pathogen in periodontal disease in cats.
Subject(s)
Cat Diseases/microbiology , Periodontal Diseases/veterinary , Porphyromonas/isolation & purification , Age Factors , Animals , Bacterial Load , Cats , Dental Calculus/microbiology , Dental Calculus/veterinary , Dental Plaque Index , Female , Fusobacterium nucleatum/isolation & purification , Gingiva/microbiology , Gingival Recession/microbiology , Gingival Recession/veterinary , Gingivitis/microbiology , Gingivitis/veterinary , Male , Periodontal Attachment Loss/microbiology , Periodontal Attachment Loss/veterinary , Periodontal Diseases/microbiology , Periodontal Index , Periodontal Pocket/microbiology , Periodontal Pocket/veterinary , Porphyromonas/classification , Sex Factors , Tooth Mobility/microbiology , Tooth Mobility/veterinaryABSTRACT
The Polyakov loop has been used repeatedly as an order parameter in the deconfinement phase transition in QCD. We argue that, in the confined phase, its expectation value can be represented in terms of hadronic states, similarly to the hadron resonance gas model for the pressure. Specifically, L(T)≈1/2[∑(α)g(α)e(-Δ(α)/T), where g(α) are the degeneracies and Δ(α) are the masses of hadrons with exactly one heavy quark (the mass of the heavy quark itself being subtracted). We show that this approximate sum rule gives a fair description of available lattice data with N(f)=2+1 for temperatures in the range 150 MeV
ABSTRACT
Se describe la técnica del colgajo de reposición apical desde el primer autor, Nabers en 1954, así como las modificaciones realizadas por Ariaudo y Tyrrel en 1957 y Friedman en 1962. También se presenta un caso clínico donde se describen los diferentes pasos de la cirugía de reposición apical. Por último, se hace una revisión evaluando la eficacia del colgajo de reposición apical en el tratamiento de la periodontitis (AU)
This paper describes the technique apically positioned flap since the first author Nabers in 1954 and also the modifications performed by Ariaudo and Tyrrell in 1957 and Friedman in 1962. Also a clinical case is presented where it can be observed the different steps of the apically positioned flap in clinical pictures. Afterwards some papers in which the efficacy of the apically positioned flap in the treatment of periodontitis are evaluated and described (AU)
Subject(s)
Humans , Surgical Flaps , Periapical Periodontitis/surgery , Tooth Apex/transplantation , Root Canal Preparation/methodsABSTRACT
BACKGROUND: Periodontal disease in cats is highly prevalent, and its aetiology is associated to bacteria located in the subgingival microbiota, being Porphyromonas sp. the most prevalent genus. The conventional technique to sample the subgingival microbiota is the use of cotton swabs over the mucosa and teeth; however the use of subgingival paper points could improve the bacterial recovery. AIM: The objective was to compare two microbial sampling approaches for the evaluation of the periodontal disease-associated microflora in cats. METHODS: The study was designed as a pilot study. Ten cats were clinically evaluated and sampled under sedation. Subgingival pooled samples were collected from four sites. In parallel, samples were obtained with a cotton swab, by striking over the gingival margin and surface of the upper right canine. Samples were cultured on blood agar (aerobic and anaerobic incubation), Dentaid-1 (for Aggregatibacter actinomycetemcomitans and enterics), and a specific medium for Bartonella henselae. RESULTS: For total anaerobic counts, paper point samples (6.59 ± 0.5) demonstrated significantly higher counts (p=0.03) than cotton swab samples (5.54 ± 1.1). Moreover, the use of paper points increased the frequency detection of most pathogens thus reducing false negatives for Porphyromonas gulae (100% with paper points samples and 80% with cotton swab samples). CONCLUSIONS: Significant higher recoveries of anaerobic bacteria and more frequent detection of putative periodontal pathogens was observed when microbiological sampling was performed with paper points, in cats with periodontal disease.
Subject(s)
Bacterial Load/methods , Bacterial Load/veterinary , Cat Diseases/microbiology , Periodontal Diseases/veterinary , Aggregatibacter actinomycetemcomitans/isolation & purification , Animals , Bartonella henselae/isolation & purification , Cats , Female , Male , Periodontal Diseases/microbiology , Pilot Projects , Porphyromonas/isolation & purificationABSTRACT
La mayoría de los tumores de los tejidos blandos pueden presentarse en varios sitios del organismo, así como en la mucosa bucal. En este artículo se van a describir los diferentes tipos de tumores benignos de la mucosa oral, se clasificarán según el tejido de procedencia. El diagnóstico definitivo será histológico y permitirá tomar una decisión terapéutica (AU)
The majority of soft tissues tumors can be present in various sites of the organism, as well as in the oral cavity. In this paper, we will describe all the different types of benign tumors in the oral cavity, the classification will be according to the tissue of origin. The definitive diagnosis would be histological and this would provide the correct treatment (AU)
Subject(s)
Humans , Mouth Mucosa/pathology , Mouth Neoplasms/pathology , Warts/pathology , Diagnosis, Differential , Keratoacanthoma/diagnosis , Papilloma/diagnosis , Condylomata Acuminata/diagnosis , Warts/diagnosis , Molluscum Contagiosum/diagnosis , Connective Tissue/pathology , Vascular Neoplasms/diagnosis , Melanoma/diagnosis , Neurilemmoma/diagnosisABSTRACT
La clasificación de las Enfermedades Periodontales ha cambiado en las últimas décadas. En la clasificación la AAP de 1989 la periodontitis necrotizante ocupaba el cuarto lugar. En el Workshop Europeo de 1993 la periodontitis necrotizante aparece en el grupo de los descriptores primarios. Según el Internacional Workshop for a Classification of Periodontal Diseases and Conditions 1999 en el que se revisó y se modificó la clasificación de las patologías periodontales, las enfermedades periodontales necrotizantes ocupan el punto cinco, diferenciándose entre Gingivitis Necrotizante y Periodontitis Necrotizante. Y se añade en la clasificación el grupo de abscesos periodontales. En este artículo de revisión vamos a profundizar cerca de las formas agudas de periodontitis (AU)
The Periodontal Diseases classification had changed in the last decades. In AAP classification of 1989 the necrotize was in the 4th position. In the European Workshop was in the group of primary descriptors. According to the International Workshop for a Classification of Periodontal Diseases and Conditions 1999, review and modificated the classification of periodontal pathologies, the periodontal necrotize diseases are in the 5thposition, distinguishing between Necrotize Gingivitis and Necrotize Periodontitis. And Peridontal Abscesses was add to the classification. In this paper we are going to review about the acute forms of Periodontal Diseases (AU)
Subject(s)
Humans , Male , Female , Periodontitis/epidemiology , Periodontitis/etiology , Periodontitis/microbiology , Gingivitis, Necrotizing Ulcerative/complications , Periodontal Abscess/complications , Periodontal Abscess/epidemiology , Stress, Physiological/complications , Malnutrition/complications , Metronidazole/therapeutic use , Periodontitis/diagnosis , Penicillins/therapeutic use , Tetracyclines/therapeutic use , Nicotiana/adverse effects , Ethanol/adverse effects , Periodontitis/pathology , Periodontitis/therapy , Stomatitis, Herpetic/complications , Diagnosis, DifferentialABSTRACT
El tratamiento conservador de embarazo cervical es poible en centros de tercer nivl de complejidad donde se cuente con servicios de Obstetricia, Imágenes, Hemodinamia y UTI. Presenta una tasa de fracasos del 8 al 20 porciento determinada fundamentalmente por la edad gestacional al momento del diagnóstico
Subject(s)
Pregnancy , Pregnancy, EctopicABSTRACT
El tratamiento conservador de embarazo cervical es poible en centros de tercer nivl de complejidad donde se cuente con servicios de Obstetricia, Imágenes, Hemodinamia y UTI. Presenta una tasa de fracasos del 8 al 20 porciento determinada fundamentalmente por la edad gestacional al momento del diagnóstico
Subject(s)
Pregnancy , Pregnancy, EctopicABSTRACT
Se presentan dos casos de baja prevalencia pero que en algunas ocasiones adquieren gran complejidad en su tratamiento, dado que necesitan el empleo de transfusión de plaquetas sanguíneas como terapia sistémica, un procedimiento que comprende grandes inconvenientes. Las plaquetas deben ser transfundidas dentro de un período no superior a 6 horas, dado que poseen una gran labilidad y pierden el 80 por ciento de su actividad. Estas son afecciones genéticas y hemorrágicas debidas a la ausencia de glucoproteínas de la membrana plaquetaria
Subject(s)
Humans , Male , Adolescent , Child , Dental Care for Chronically Ill/methods , Blood Platelet Disorders/classification , Blood Platelet Disorders/diagnosis , Blood Platelet Disorders/drug therapy , Tranexamic Acid/therapeutic use , Antifibrinolytic Agents/therapeutic use , Blood Chemical Analysis/methods , Blood Coagulation/physiology , Epistaxis , Hemostasis , Platelet Transfusion , Bernard-Soulier Syndrome/diagnosis , Sulfonium Compounds , Thrombasthenia , Vasoconstriction/physiology , von Willebrand Diseases , von Willebrand FactorSubject(s)
Humans , Female , Adult , Adrenal Cortex Hormones/therapeutic use , Enzyme-Linked Immunosorbent Assay , Tooth Extraction , Lupus Coagulation Inhibitor/therapeutic use , Antiphospholipid Syndrome/diagnosis , Antiphospholipid Syndrome/therapy , Abortion, Habitual , Syphilis/diagnosis , ThrombosisABSTRACT
Las manifestaciones bucales en la infección por VIH en niños son diversas y frecuentes. La vía de contagio más importante es la transmisión vertical del virus, es decir, de madre a hijo. La lesión más frecuente en estos niños fue la cadidiasis bucal y la parotidomegalia. La tumoración de la glándula parótida uni o bilateral, parece ser una lesión común en niños, lo que es muy poco frecuente en adultos VIH+. Es necesario reconocer las manifestaciones bucalaes en niños infectados por VIH, tratarlos y evitar complicaciones
