RESUMO
A 42 year old patient was referred to the Department of Oral and Maxillofacial Surgery of the Federal University of Uberlândia, for treatment of mandibular fractures (condyles and symphysis), a victim of a run over. The symphysis was surgically approached, using as surgical access the pre-existing laceration in the submental region. Five days after discharge, the patient returned with dehiscence of the wound and physical examination showed infestation by larvae in the symphysis. Mechanical removal and debridement were performed under local anesthesia, where plate exposure was noted. The patient underwent oral ivermectin therapy, intravenous antibiotic therapy and a thorough debridement was performed under general anesthesia due to the invasion of deep spaces in the supra-hyoid region. After 2 weeks, it presented with purulent drainage at the site. The miniplates were replaced by a 2.4 mm reconstruction plate and antibiotic therapy was maintained. Due to the social risk, the patient remained hospitalized for 45 days, when he was discharged with outpatient return, but did not attend the returns.
RESUMO
O ameloblastoma é um tumor odontogênico benigno e raro, de comportamento biológico variado, crescimento lento e agressivo. Clinicamente, pode ser classificado em três grupos: multicístico ou sólido, unicístico, periférico ou extraósseo. A variante unicística plexiforme possui um padrão menos agressivo e responde melhor ao tratamento conservador, o qual consiste na marsupialização e posterior curetagem e enucleação. O presente caso relata um ameloblastoma unicístico que ocorreu no ramo mandibular direito de uma criança de 11 anos, submetida ao tratamento conservador, com resultado satisfatório.
Ameloblastoma is a benign and rare odontogenic tumor of varied biological behavior, slow and aggressive growth. Clinically, it can be divided into three groups: multicystic or solid, unicystic, peripheral or extraosseous. The plexiform unicystic form has a less aggressive pattern and responds better to the conservative treatment. This treatment consists of marsupialization and subsequent curettage and enucleation. The present case reports a unicystic ameloblastoma that occurred on the mandible of an 11 year old child, who was submitted to conservative treatment.
RESUMO
The development of clinical immunity to Plasmodium falciparum malaria is thought to require years of parasite exposure, a delay often attributed to difficulties in developing protective antibody levels. In this study, we evaluated several P. falciparum vaccine candidate antigens, including apical membrane antigen 1 (AMA-1), circumsporozoite protein (CSP), erythrocyte binding antigen 175 (EBA-175), and the 19-kDa region of merozoite surface protein 1 (MSP1(19)). After observing a more robust antibody response to MSP1(19), we evaluated the magnitude and longevity of IgG responses specific to this antigen in Peruvian adults and children before, during, and after P. falciparum infection. In this low-transmission region, even one reported prior infection was sufficient to produce a positive anti-MSP1(19) IgG response for >5 months in the absence of reinfection. We also observed an expansion of the total plasmablast (CD19(+) CD27(+) CD38(high)) population in the majority of individuals shortly after infection and detected MSP1-specific memory B cells in a subset of individuals at various postinfection time points. This evidence supports our hypothesis that effective antimalaria humoral immunity can develop in low-transmission regions.
