Medication related to pigmentation of oral mucosa.

BACKGROUND: The diagnosis of oral melanotic lesions is, more often than not, challenging in the clinical practice due to the fact that there are several reasons which may cause an increase in pigmentation on localized or generalized areas. Among these, medication stands out. MATERIAL AND METHODS: In this work, we have carried out a review in the reference pharma database: Micromedex® followed by a review of the scientific published literature to analyse coincidences and possible discrepancies. RESULTS: Our findings show that there are several prescription drugs that can cause pigmented lesions in the oral mucosa. This must be known by clinicians in order to properly diagnose pigmented lesions. We have identified a set of 21 medicaments which cause these lesions, some of which are used frequently in the clinic, such as Metronidazole, Amitriptyline, conjugated oestrogens and Chlorhexidine gluconate. We also found discrepancies with the data published in specialized literature, some of which wasn't reflected in the Summary of Product Characteristics. CONCLUSIONS: Our work highlights the importance of the proper communication of adverse drug reactions (ADR) by health professionals in order to provide thorough and accurate information and diagnosis.

Auto-paracrine regulation of the proliferation of pituitary ACTH-producing cells demonstrated by immunoblockade of IL-1Beta

Pituitary gland and is involved in the stimulationof ACTH secretion. However, to date ithas not been determined whether IL-1Beta is ableto regulate the proliferation of pituitaryACTH-producing cells, like other regulatoryfactors involved in the regulation of ACTHsuch as vasopressin or CRH. The aim of thepresent study was to address whether IL-1Beta isinvolved in regulating the proliferation andapoptosis of pituitary ACTH-secreting cells.Thus, we performed an in vitro study onmonolayer cultures of rat pituitary cells, neutralisingthe possible paracrine effect of IL-1Beta by immunoblockade of the interleukin andlater determining the degree of proliferationor apoptosis of ACTH-secreting cells. Theeffects of immunoblockade were validated bydetermining the modifications in the patternsof the immunohistochemical reaction toACTH-positive cells. Immunoblockade of IL-1Beta decreased the percentage and proliferationof ACTH-positive cells at all time-pointsanalysed, mainly between 6 and 12 h(p<0.01). Moreover, immunoblockade decreasedthe sizes of the cellular and nuclear areas atall time-points studied, with significantdecreases (p<0.01) after 3, 6 and 12 hours.The results obtained suggest that -in the sameway as it regulates the secretion of the hormone-IL-1Beta could be involved in regulating theproliferation of ACTH cells (AU)

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Effects of Arg-vasopressin and corticosterone on IL-1b-induced modifications of pituitary ACTH-producing cells

Interleukin 1b (IL-1b) stimulates the hypothalamic-pituitary-adrenal axis, however the autoparacrineeffects of IL-1b‚ on pituitary ACTHproducingcells and the relations among IL-1band Arg-vasopressin or corticosterone have notyet been analyzed. To address these effects,pituitary monolayer cultures were treated withIL-1b, Arg-vasopressin and corticosterone, eitheralone or in combined treatment, and animmunocytochemical, morphometric and densitometricstudy of ACTH-positive cells was carriedout. IL-1b significantly increased the percentageand cellular and nuclear size ofACTH-positive cells, and similar effects werefound following treatment with Arg-vasopressin.Combined treatment with IL-1b andArg-vasopressin increased these parametersmore than in separate treatments. Corticosteronedecreased these parameters and blockedthe effects of IL-1b and Arg-vasopressin in thecombined treatments. In sum, our results suggestthat IL-1b is an auto-paracrine regulator ofpituitary ACTH-producing cells, that it reinforcesthe stimulatory effects of Arg-vasopressinand that corticosterone is an inhibitory regulatorof the auto-paracrine effects of IL-1b and Argvasopressin (AU)

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Un análisis de la adherencia al tratamiento en fisioterapia / Analysis of adherence with treatment in physiotherapy

Uno de los mayores problemas que afectan a las intervenciones en salud es la falta de adherencia al tratamiento. En Fisioterapia esto se agudiza por el costo y el esfuerzo que le supone al paciente cumplir con las prescripciones. El presente trabajo define el concepto de adherencia al tratamiento como la coincidencia entre el comportamiento de una persona y las prescripciones que ha recibido. También se analizan diez variables que influyen en esta adherencia. Además, se describen algunos estudios empíricos que han mejorado la adherencia en Fisioterapia. Finalmente, a modo de conclusión, se propone el uso de estas variables en la intervención fisioterapéutica para mejorar la adherencia a la misma (AU)