Oral pathology and oral medicine in Latin American countries: current stage.

BACKGROUND: Oral Pathology (OP) and Oral Medicine (OM) are specialties in dentistry whose main objective is the diagnosis and treatment of oral and maxillofacial diseases, and aspects related to the academic training of professionals and fields of practice are distinct and heterogeneous around the world. This study aimed to evaluate professional training and areas of activity in OP and OM in Latin American countries. MATERIAL AND METHODS: A questionnaire was sent to 11 countries, with a professional in each country responsible for answering it. The questionnaire had 21 questions related to the process of professional training, areas of practice, the existence of scientific events in each country, and also collected demographic and population information. RESULTS: OP and OM are practiced in all the countries studied, but the specialty is not recognized in all of them. Brazil was the first to recognize both as a specialty. Postgraduate programs designed to train specialists are available in various countries. Two countries offer residency programs, 6 countries provide specialization courses, 6 offer master's programs, and 3 have doctoral programs. Brazil boasts the highest number of undergraduate courses (n=412), while Uruguay has the lowest (n=2). Professional societies representing the specialty exist in ten countries. Brazil has the highest number of OP and OM specialists (n=422 and 1,072), while Paraguay has the smallest number (n=1 and 3). CONCLUSIONS: Although both specialties are widely practiced around the globe, professional training, the number of dentists trained and the fields of professional practice are very different between the countries studied.

Viral kinetics during the first month of treatment in patients with genotype 1 chronic hepatitis C.

OBJECTIVE: to identify predictive factors of response to pegylated interferon alpha-2b and ribavirin in patients with genotype 1 chronic hepatitis C. Viral kinetics were studied in weeks 2 and 4. METHODS: a prospective and consecutive study of patients with genotype 1 chronic hepatitis C referred to our Hepatology Clinic between January 2004 and October 2006 for antiviral treatment. Baseline data were recorded and viremia levels were determined hours before the weekly dose of pegylated interferon by qualitative and quantitative PCR. RESULTS: 57 patients were included in the study, although 3 of these were excluded during follow up; 65% were male (n = 35), with a mean age of 42 (26-65) years. Baseline viremia levels were > 800,000 IU/mL in 67% (n = 36). Liver biopsy was performed in 86% (n = 46), 22% (n = 12) had advanced fibrosis. Forty were naïve, 4 relapsing and 10 non-responders. Ribavirin dose was modified in one patient alone due to adverse effects. End treatment response and sustained virological response (SVR) were 59 and 41%, respectively. A univariate analysis revealed a statistically significant association of SVR with baseline viremia (p = 0.006), baseline GGT (p = 0.025), and a reduction in viremia > or =2 logs at 2, 4 and 12 weeks (p = 0.001). The extent of viremia reduction at week 2 was associated with 100% SVR, and at 4 weeks the positive predictive values was 84% and the negative predictive values was 96.5%. A subanalysis of the naïve group yielded analogous results. CONCLUSIONS: in our study, a reduction in viremia > or = 2 logs 2 weeks after treatment could ensure SVR. At 4 weeks, most non-responders could be identified.

Cinética viral durante el primer mes de tratamiento en pacientes con hepatitis crónica C genotipo 1 / Viral kinetics during the first month of treatment in patients with genotype 1 chronic hepatitis C

Objective: to identify predictive factors of response to pegylatedinterferon alpha-2b and ribavirin in patients with genotype 1chronic hepatitis C. Viral kinetics were studied in weeks 2 and 4.Methods: a prospective and consecutive study of patients withgenotype 1 chronic hepatitis C referred to our Hepatology Clinicbetween January 2004 and October 2006 for antiviral treatment.Baseline data were recorded and viremia levels were determinedhours before the weekly dose of pegylated interferon by qualitativeand quantitative PCR.Results: 57 patients were included in the study, although 3 ofthese were excluded during follow up; 65% were male (n = 35),with a mean age of 42 (26-65) years. Baseline viremia levels were> 800,000 IU/mL in 67% (n = 36). Liver biopsy was performedin 86% (n = 46), 22% (n = 12) had advanced fibrosis. Forty werenaïve, 4 relapsing and 10 non-responders. Ribavirin dose wasmodified in one patient alone due to adverse effects. End treatmentresponse and sustained virological response (SVR) were 59and 41%, respectively. A univariate analysis revealed a statisticallysignificant association of SVR with baseline viremia (p = 0.006),baseline GGT (p = 0.025), and a reduction in viremia >= 2 logs at2, 4 and 12 weeks (p = 0.001). The extent of viremia reduction atweek 2 was associated with 100% SVR, and at 4 weeks the positivepredictive values was 84% and the negative predictive valueswas 96.5%. A subanalysis of the naïve group yielded analogousresults.Conclusions: in our study, a reduction in viremia >= 2 logs2 weeks after treatment could ensure SVR. At 4 weeks, mostnon-responders could be identified(AU)

Objetivo: identificar qué factores predicen la respuesta al interferónpegilado alfa-2b y ribavirina en pacientes con hepatitiscrónica C genotipo 1. Se estudió la cinética viral en la semana 2 y4.Métodos: se evaluaron de forma prospectiva y consecutiva alos pacientes con hepatitis crónica C genotipo 1 remitidos a nuestraconsulta de hepatología entre enero de 2004 y octubre de2006, para tratamiento antiviral. Se recogieron datos basales y laviremia se determinó horas antes de la dosis semanal de interferónpegilado por PCR cualitativa y cuantitativa.Resultados: cincuenta y siete pacientes fueron incluidos aunque3 fueron excluidos durante el seguimiento. Un 65% fueronvarones (n = 35) con edad media de 42 (26-65) años. La viremiabasal fue > 800.000 UI/ml en 67% (n = 36). Se realizó biopsiahepática en 86% (n = 46), 22% (n = 12) tenían fibrosis avanzada.40 fueron naïves, 4 recidivantes y 10 no respondedores. La dosisde ribavirina se modificó por efecto secundario sólo en un paciente.La RFT y la RVS fueron de 59 y 41%, respectivamente. Elanálisis univariante mostró asociación estadísticamente significativacon RVS de la viremia basal (p = 0,006), GGT basal (p =0,025) y el descenso en la viremia >= 2 logaritmos a las 2, 4 y 12semanas (p = 0,001). El descenso de la viremia en la semana 2 seasoció con 100% de RVS y a las 4 semanas el VPP fue 84% y elVPN 96,5%. Se realizó un subanálisis en el grupo de pacientesnaïves con resultados superponibles.Conclusiones: en nuestro estudio el descenso de la viremia >= 2 logaritmos a las 2 semanas de tratamiento aseguró la RVS. Alas 4 semanas, identificamos a la gran mayoría de los pacientes norespondedores(AU)

Antibody-mediated phagocytosis of the amyloid beta-peptide in microglia is differentially modulated by C1q.

Microglial ingestion of the amyloid beta-peptide (Abeta) has been viewed as a therapeutic target in Alzheimer's disease, in that approaches that enhance clearance of Abeta relative to its production are predicted to result in decreased senile plaque formation, a proposed contributor to neuropathology. In vitro, scavenger receptors mediate ingestion of fibrillar Abeta (fAbeta) by microglia. However, the finding that cerebral amyloid deposition in a transgenic mouse model of Alzheimer's disease was diminished by inoculation with synthetic Abeta has suggested a possible therapeutic role for anti-Abeta Ab-mediated phagocytosis. Microglia also express C1qR(P), a receptor for complement protein C1q, ligation of which in vitro enhances phagocytosis of immune complexes formed with IgG levels below that required for optimal FcR-mediated phagocytosis. The data presented here demonstrate FcR-dependent ingestion of Abeta-anti-Abeta complexes (IgG-fAbeta) by microglia that is a function of the amount of Ab used to form immune complexes. In addition, C1q incorporated into IgG-fAbeta enhanced microglial uptake of these complexes when they contained suboptimal levels of anti-Abeta Ab. Mannose binding lectin and lung surfactant protein A, other ligands of C1qR(P), also enhanced ingestion of suboptimally opsonized IgG-fAbeta, whereas control proteins did not. Our data suggest that C1qR(P)-mediated events may promote efficient ingestion of Abeta at low Ab titers, and this may be beneficial in paradigms that seek to clear amyloid via FcR-mediated mechanisms by minimizing the potential for destructive Ab-induced complement-mediated processes.