Effect of potassium citrate supplement on stone recurrence before or after lithotripsy: systematic review and meta-analysis.

This meta-analysis summarizes the available evidence on the effectiveness of citrate supplement for preventing the recurrence of nephrolithiasis in patients undergoing extracorporeal shock wave lithotripsy (SWL). Electronic searches were conducted using Medline-PubMed, Web of Science, Embase, BVS (Scielo, Lilacs), and Google Scholar literature databases. The authors worked in pairs to select studies that met the following criteria: randomized controlled trials that were conducted in adults and assessed the effect of potassium citrate supplement before or after SWL therapy for urolithiasis. Our primary aim was to asses the stone-free rate among the groups included in the studies. Fixed effect was used in the meta-analysis with 95% confidence interval (95% CI). Heterogeneity was analyzed by the I 2 value. A total of 2505 references were initially selected. Of those, four were subjected to meta-analysis contributing five samples. These four studies included 374 participants who were followed for a period of 12 months after SWL. Mean potassium citrate dosage was approximately 55 mEq/day (18 mmol). The results showed that citrate supplement significantly protected against the recurrence of nephrolithiasis during 1 year after SWL [RR; 95% CI 0.21 (0.13, 0.31)]. The heterogeneity was not significant across the analyzed studies (p = 0.224). The quality of the analyzed studies was generally low. The available evidence shows that citrate supplement effectively reduces the recurrence of nephrolithiasis in patients undergoing SWL. However, statistical analysis of a larger trial conducted with methodological rigor is warranted.

Osteoma compacto central de mandíbula: relato de caso clínico / An central compact osteoma of the mandible: report of clinical case

O osteoma é considerado um tumor ósseo benigno de crescimento lento, contínuo, indolor e de etiologia controversa. Geralmente é diagnosticado em pacientes jovens no período da puberdade,VG nos exames radiográficos de rotina ou quando assume um grande tamanho levando à assimetria facial. Os osteomas são classificados quanto à localização radiográfica em três grupos: central, periféricoe extraósseo. No exame histológico, são classificados em dois tipos: compacto e medular. Noprimeiro, predomina osso lamelar denso e escasso tecido medular. No segundo, predomina osso dotipo trabecular com abundante medula fibro gordurosa. Neste caso clínico apresentado de Osteoma Compacto Central de Mandíbula, o tratamento proposto foi O DO controle clínico-radiográfico periódico, por ser de pequeno tamanho, assintomático, e, ainda, não comprometer o nervo alveolar inferior e não haver relatos de malignização.

Osteoma has been considerated a benign bone tumor. It presents slow, continuous and painless growth. It has a controversial etiology. Usually it is diagnosed on young patients at puberty periodduring routine radiographic exams or when it assumes a huge size causing facial asymmetry. Osteoma is classificated in three groups according radiographic localization: central, peripheral and extraskeletal. And it is classificated in two groups according histologic exam: compact and medullar. Thefirst type predominate dense lamella bone and scarce medullar tissue. And the second one predominate bone with spaces and abundant medulla with fibrofatty. The aim of this article is to describea clinical case of Central Compact Osteoma of the Mandible that was decided just to follow up with periodic radiographic control because it was no commited to inferior alveolar nerve and there is not reports of the malignity.

Adenoma Pleomórfico de glândula salivar menor do palato / Palate Pleomorphic Adenoma of mirror salivary gland

O objetivo deste estudo histológico da lesão exofítica de forma ovóide, bem delimitada e de consistência dura localizada no palato duro foi comparar os achados histológicos da lesão com os citados na literatura pesquisada. A lesão foi excisionada e incluída em parafina histológica e os cortes histológicos foram corados pela hematoxilina e eosina (H.E.) e, analisados em microscopia de luz comum. Os cortes histológicos analisados apresentavam um parênquima tumoral ricamente celularizado por células epiteliais dispostas em lençol, cordões e ilhotas isoladas e áreas com múltiplos ductos de células mioepiteliais. O estroma é formado por uma quantidade variável de material condróide que muitas vezes está entremeado por células epiteliais. A lesão é circunscrita por uma cápsula de tecido conjuntivo fibroso. Analisando estes aspectos histológicos com os da literatura estudada concluímos que a lesão do palato se trata de um tumor denominado de adenoma pleomórfico de glândula salivar menor