Best impression materials in oral rehabilitation-study protolocol

Short Communication selected from the Oral Presentations of the 56th Congress of the Groupèment International pour la Recherche Scientifique en Stomatologie et Odontologie, Peñafiel (Portugal) May 2012.

El deterioro del Baluarte de San Pedro, un estudio de caso

RESUMENEl centro histórico de la ciudad de San Francisco de Campeche, México, cuenta con edificios civiles y militares de la época colonial, los cuales se encuentran sometidos a la acción de agentes ambientales como humedad, radiación solar, temperatura, erosión eólica, acción biológica y productos de origen antropogénico que inducen su deterioro. El objetivo del presente estudio fue diagnosticar el daño y posible origen de costras negras en el Baluarte de San Pedro, edificio representativo del sistema defensivo de la ciudad. Las patologías de deterioro y el análisis mediante difracción de Rayos X realizado en muestras representativas del edificio indican la presencia de yeso en los muros sur y suroeste del Baluarte. Lo anterior es indicio de la acción de emisiones de vehículos automotores que circulan diariamente sobre las avenidas circundantes. Por otra parte, existe abundante colonización microbiana cuya actividad se relaciona con la presencia de oxalatos de calcio, compuestos característicos de procesos de biodeterioro.Palabras Clave: Deterioro; edificios históricos; San Francisco de Campeche; Baluarte de San Pedro; biodeterioro.ABSTRACTThe downtown of San Francisco de Campeche, México, has several civilian and militarian ancient buildings dating from the Hispanic colonization. These buildings are exposed to environmental agents such as high relative humidity and temperature, sun radiation, wind erosion, biologic action and anthropogenic products, which produce their deterioration. The objective of this paper is to present and discuss the diagnosis of deterioration of the San Pedro bastion as well as the possible origin of black crusts observed over the walls. Visual inspection and X Ray Diffraction analysis detected gypsum at south and southwest walls, which is indicative of the action of combustion products of vehicles circulation over neighboring avenues. Moreover, it was observed abundant microbial colonization, which activity is related to the presence of calcium oxalates that are evidence of a bio-deterioration process.Keywords: Deterioration; historic buildings; San Francisco de Campeche; Bastion of San Pedro; biodeterioration.

Childhood hypophosphatasia with myopathy: clinical report with recent update

Hypophosphatasia is a rare genetic disease with low tissue nonspeficic alkaline phosphatase activity (TNSALP), due to ALPL gene mutation. There are 6 clinical forms. Childhood form is caractherized by short stature, premature loss of decidous teeth and diffuse bone pain associated with a pathological bone fracture in the past. Laboratory findings present low serum level of alkaline phosphatase and high levels of serum and urinary extracelular metabolytes. It is described a case report of a 34 years old woman with previous diagnosis of childhood hypophosphatasia, caryotype 46,XX, and molecular screening for the gene ALPL with a c.1426>A p.E476K mutation, who complained of proximal muscular weakness intensified with the cold weather, exercise, and a waddling gait. The electromyography was compatible with myopathy but the muscle biopsy was normal. The serum creatine kinase levels were normal, as well as the others muscle enzymes. Clinical and laboratory/ /imaging dissociation is frequent in other metabolic bone diseases as osteomalacia. The rarity of this case of childhood hypophosphatasia with "de novo" non-progressive myopathy of the lower limbs, justified a case report with literature revision.

Rank/Rankl/opg: literature review

The discovery of the receptor activator of nuclear factor-kB (RANK)/RANK Ligand (RANKL)/osteoprotegerin (OPG) pathway contributed to the understanding of how bone formation and resorption were processed and regulated. RANKL and OPG are members of the tumor necrosis factor (TNF) and TNF receptor (TNFr) superfamilies, respectively, and binding to receptor activator of NF-kB (RANK) not only regulate osteoclast formation, activation and survival in normal bone modeling and remode-ling, but also in several other pathologic conditions characterized by increased bone turnover. There is accumulating evidence of the potential role of OPG and RANKL in other tissues. Looking beyond the RANK/RANKL/OPG axis, Wingless (Wnt) pathway emerged as the osteoblast differentiation way, and also as a bone mass regulator. Researchers have been discovering new molecules and cytokines interactions. Altogether, data suggest that RANK/RANKL/OPG system could be targeted as a new treatment strategy in bone conditions. FREEDOM is the more recently published clinical trial about a RANKL-specific recombinant fully human monoclonal antibody (denosumab). OPG is also a potential innovative therapeutic option to be investigated.

Wine phenolic compounds influence the production of volatile phenols by wine-related lactic acid bacteria

AIMS

To evaluate the effect of wine phenolic compounds on the production of volatile phenols (4-vinylphenol [4VP] and 4-ethylphenol [4EP]) from the metabolism of p-coumaric acid by lactic acid bacteria (LAB).

METHODS AND RESULTS

Lactobacillus plantarum, Lactobacillus collinoides and Pediococcus pentosaceus were grown in MRS medium supplemented with p-coumaric acid, in the presence of different phenolic compounds: nonflavonoids (hydroxycinnamic and benzoic acids) and flavonoids (flavonols and flavanols). The inducibility of the enzymes involved in the p-coumaric acid metabolism was studied in resting cells. The hydroxycinnamic acids tested stimulated the capacity of LAB to synthesize volatile phenols. Growth in the presence of hydroxycinnamic acids, especially caffeic acid, induced the production of 4VP by resting cells. The hydroxybenzoic acids did not significantly affect the behaviour of the studied strains. Some of the flavonoids showed an effect on the production of volatile phenols, although strongly dependent on the bacterial species. Relatively high concentrations (1 g l(-1) ) of tannins inhibited the synthesis of 4VP by Lact. plantarum.

CONCLUSIONS

Hydroxycinnamic acids were the main compounds stimulating the production of volatile phenols by LAB. The results suggest that caffeic and ferulic acids induce the synthesis of the cinnamate decarboxylase involved in the metabolism of p-coumaric acid. On the other hand, tannins exert an inhibitory effect.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study highlights the capacity of LAB to produce volatile phenols and that this activity is markedly influenced by the phenolic composition of the medium.

Drug provocation tests to betalactam antibiotics: experience in a paediatric setting

BACKGROUND

Few studies have been performed in children with suspected betalactam allergy. We aimed to assess the role of the drug provocation test (DPT) with betalactams in a paediatric setting and to study the association between allergy to betalactam antibiotics and other allergic diseases.

METHODS

We included all the patients under 15 years old who were consecutively referred to the Immunoallergy Department, Dona Estefânia Hospital, Portugal (January 2002 to April 2008) for a compatible history of allergic reaction to betalactam. All were submitted to a DPT. Children were proposed to perform skin tests (ST) to betalactam antibiotics followed by DPT. If they decline ST, a DPT with the culprit drug was performed.

RESULTS

We studied 161 children, 60% were boys, with a median age of 5 years old at the time of the DPT. Thirty-three patients (20.5%) had an immediate reaction and 33 (20.5%) a non-immediate reaction. The severity of the reported reactions was low in most cases. Skin tests to betalactams were performed in 47 children and were positive in 8. DPT was positive in only one (3.4%) of the patients skin tested and in 11 (13.4%) of those not skin tested. The severity of the DPT reaction was low. Asthma and food allergy were associated with a positive DPT in the later group.

CONCLUSIONS

DPT seems a safe procedure even in the absence of ST in non-severe cases. This could be a practical option in infants and pre-school children, where ST are painful and difficult to perform. Additional caution should be taken in children with asthma and food allergy.

[Assessment of erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP) on rheumatoid arthritis activity prediction]

OBJECTIVE

Rheumatoid Arthritis (RA) disease activity plays an important role in patients disability. A standardized approach to measure it was achieved by using disease activity score (DAS) based on erythrocyte sedimentation rate (ESR) and more recently C-reactive protein (CRP). In this study we will assess the role and influence of ESR and CRP in evaluating and assessing the disease activity.

METHODS

This is a retrospective, longitudinal study, whose data was obtained from the national RA patient clinical database BioreportAR (following ACR criteria) under biological disease modifying anti-rheumatic drugs (BDMARDs), involving 71 patients from CHLO-Hospital Egas Moniz. The ESR and CRP of each patient were recorded from 2 separated visits. The swollen joint counts (SJC), tender joint counts (TJC), visual analog scale (VAS) for pain, patient global assessment and physician global assessment were also recorded. DAS 28-ESR, DAS 28-CRP, simplified disease activity index (SDAI) and clinical disease activity index (CDAI) were calculated. The relevant Pearson correlations were established between variables.

RESULTS

A sample of 71 patients with an average age of 55 years old and an average RA duration of 9,8 years, was analysed. ESR and CRP correlated poorly between themselves (r=0,31, p<0,001) and they were shown not to be significant predictors of SJC (ESR r=0,29 p< 0,001 and CRP r=0,089 p<0,001) or TJC (ESR r=0,28 p<0,001 and CRP r=0,072 p<0,001). However DAS-ESR and DAS-CRP were highly correlated (r=0,88, p<0,001) as also as, DAS ESR-CDAI (r=0,89, p<0,001), DAS RCP-CDAI (r= 0,88 p< 0,001) and SDAI-CDAI (r=0,89 p<0,001). DAS-CRP values were lower than those in DAS-ESR, but in 84,7% of the visits disease activity status were.

CONCLUSIONS

The significant correlation between DAS-ESR and DAS-CRP, indicated that it will not be necessary to perform both evaluations. DAS-CRP yielded a better activity score more often than DAS-ESR, but with 84,7% of concordance in the disease activity status, indicating that both measures are useful for assessing disease activity in RA. Furthermore the correlation between DAS scores and CDAI, and also between SDAI-CDAI may enable physicians to easily assess the disease activity without ESR or CRP values.

[Fibrous dysplasia and McCune-Albright syndrome: case-report and differential diagnose with Paget bone disease]

Fibrous dysplasia of bone or Jaffe Lischtenstein's disease is a genetic, non-inheritable disease of bone development, characterized by bone pain, deformities and fracture, mainly observed in yo ung adults. The frequency is equal between sexes. Mutations in the gene coding the Gsα, GNAS complex, results in osteoblastic differentiation defects, and bone resorption. The disease can have a monostotic or polyostotic form, or be associated with café-au-lait skin spots and precocious puberty (McCune-Al bright syndrome). The normal bone and bone marrow is replaced with abnormal benign intramedullary fibro-osseous tissue, and can involve any bone in the body. The vertebral involvement is rare. Radiological and pathological findings can be diagnostic. Biphosphonates and calcium, vitamin D and phosphorus supplements have been used in fibrous dysplasia treatment. Osteosarcoma is a rare, but serious malignant complication. We report the case of a 68 year old woman with a history of hypofisectomy, with a progressive low back pain, without systemic or neurological symptoms. The bone scan, the ra di o graphs and the computed tomography findings revealed polyostotic fibrous dysplasia, with vertebral and mandibular involvement. In this paper we compared fibrous dysplasia of bone with Paget bone disease.

Prevalence evolution and impact of cardiovascular risk factors on allograft and renal transplant patient survival

OBJECTIVE

The prevalence of traditional cardiovascular risk factors in renal transplantation is high. Studying the evolution of cardiovascular risk factors over time may help us to design better strategies to control them. The relative impact of traditional cardiovascular risk factors on allograft survival and mortality in transplant recipients is not clear. This study was performed to determine the incidence and risk factors for allograft survival and mortality among renal transplant patients.

PATIENTS AND METHODS

We enrolled 250 patients who had undergone transplantation between 1980 and 2004. They were followed for various periods, and we analyzed the impact of traditional and nontraditional risk factors on renal allograft survival.

RESULTS

The prevalence of hypertension was >80% during all the follow-up periods. Blood pressure diminished, antihypertensive drug prescription increased, and 15% of patients had adequate blood pressure control during follow-up. The prevalence of pretransplant diabetes mellitus was 6.8%; the incidence of posttransplant diabetes mellitus (PTDM) was 14.2%. The prevalence of PTDM increased over the course of patient evolution. The prevalence of dyslipidemia was in all cases >70%; total cholesterol and low-density lipoprotein (LDL)-cholesterol decreased; prescription of statins increased; and the percentage of patients with good lipid control also increased. The 25% prevalence of active smoking at the time of transplantation decreased to 13.6% at 10 years posttransplantation. The mean patient follow-up was 8 +/- 4.6 years. Sixty-five patients (26%) lost their grafts and 40 (16%) died during follow-up. Donor age, exercise, diastolic blood pressure, renal function, and albumin levels were independent risk factors for graft loss. Charlson comorbidity index at transplantation, recipient and donor ages, exercise, diastolic blood pressure, and LDL-cholesterol posttransplantation were independent risk factors for mortality among renal transplant recipients.

CONCLUSION

Blood pressure and lipid control improved during follow-up, however, insufficiently among renal transplant patients. The prevalence of diabetes gradually increased, and the incidence of smoking cessation was low. Diastolic blood pressure, exercise, and albuminemia were the most significant modifiable cardiovascular risk factors for renal allograft survival. Diastolic blood pressure, LDL-cholesterol level, and exercise were the most relevant modifiable cardiovascular risk factors for the survival of renal transplant patients.