Treatment of central giant cell lesions using bisphosphonates with intralesional corticosteroid injections

ABSTRACT: Central giant cell lesions are benign intraosseous proliferative lesions that have considerable local aggressiveness. Nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. Recently, bisphosphonates have been used to treat central giant cell lesions. A case of a 36-year-old male with a central giant cell lesion crossing the mandibular midline was treated with intralesional corticosteroids combined with alendronate sodium for the control of systemic bone resorption. The steroid injections and the use of bisphosphonates were stopped after seven months when further needle penetration into the lesion was not possible due to new bone formation. After two years, the bony architecture was near normal, and only minimal radiolucency was present around the root apices of the involved teeth. The patient was followed up for four years, and panoramic radiography showed areas of new bone formation. Thus far, neither recurrence nor side effects of the medication have been detected.     

Association between underweight and overweight/obesity with oral health among independently living Brazilian elderly

ObjectivePoor oral status, represented by partial/complete tooth loss, may lead to changes in food choice, which may ultimately lead to underweight, overweight, or obesity. The aim of this study is to evaluate whether poor oral status is associated with underweight or overweight/obesity, regardless of physical activity.MethodsThis cross-sectional study is part of a major project, The Frailty in Brazilian Elderly Study, carried out in Campinas, Brazil (2008–2009). The sample was composed of 900 independent-living older adults. Complete data were available for 875 individuals including sociodemographic, self-reported amount of medications used and eating difficulty questionnaire, smoking habit, depressive symptoms, physical activity, oral examination, and anthropometric assessments according to the WHO criteria. Body mass index was used as an outcome. Multinomial logistic regression was adjusted for confounding variables.ResultsThe mean age of the sample was 72.7 y (±5.81) and the prevalence of edentulism was 47.7%. Edentate individuals not wearing dentures were more likely to be underweight [odds ratio (OR) = 3.94, 95% confidence interval (CI) 1.14–13.64] and overweight/obese (OR = 2.88, 95%CI 1.12–7.40). Males (OR = 0.56, 95%CI 0.36–0.85) and those not using medications (OR = 0.41 95%CI 0.24–0.70) were less likely to be overweight/obese. Individuals who smoke (OR = 2.62, 95%CI 1.26–5.44) were more likely to be underweight. Older individuals with family income between 3.1 and 5 minimum wage (OR = 1.69, 95%CI 1.00–2.87) were more likely to be overweight/obese.ConclusionTo our knowledge, this is one of the first studies associating poor oral health, represented by edentulism not rehabilitated with dentures, with unfavorable body mass, regardless of the two major confounders, physical activity and depression symptoms.     

Effect of Ventilation Systems on Prevalence of Symptoms Associated with “Sick Buildings” in Brazilian Commercial Establishments

In this questionnaire study, the authors compared the prevalence of certain symptoms and signs associated with Sick Building Syndrome and perceptions relative to environmental discomfort of employees in a central-air-conditioned shopping center and in natural-ventilation commercial shops located on the streets of Niteröi, Rio de Janeiro, Brazil. There was a statistically significant higher prevalence of symptoms (e.g., water and itching of eyes, sore throat, nose irritation, difficulty breathing, skin irritation, sneezing) that were characteristic of Sick Building Syndrome in the air-conditioned building than in the naturally ventilated stores. The results indicated that there exists a continuing need for further research in Brazilian work environments.     

Pain intensity is associated with self-reported disability for several domains of life in a sample of patients with musculoskeletal pain aged 50 or more

BackgroundMost studies that investigate the impact of pain on function have focused on a particular pain site and use unidimensional measures of disability, making it difficult to know how pain impacts on different areas of functioning and whether different pain characteristics impact differently on function.AimTo investigate the relationship between pain characteristics and self-reported disability in patients with musculoskeletal pain aged ≥50 years.MethodsTwo hundred and four consecutive patients with musculoskeletal pain aged ≥50 years had their pain assessed (frequency, global pain intensity, pain intensity for the most painful site, location and number of pain sites) and were asked to fill in the World Health Organization Disability Assessment Schedule (WHODAS 2.0) that assesses disability in 6 domains of daily life.ResultsMost patients reported chronic (77.5%), multisite or widespread (55.4%) pain that was always present (90.2%) and of moderate to severe intensity (mean score for global pain intensity = 5.91; SD = 2.02). Mean WHODAS 2.0 total score was 28.06 and SD was 19.86, corresponding to moderate disability. When entering age, sex, level of education, depression, number of comorbid chronic conditions and pain characteristics in a stepwise regression analysis, global pain intensity was the most important predictor for the domains of getting around (adjusted R² = 0.21, p < 0.001), self-care (adjusted R² = 0.14, p < 0.001), household activities (adjusted R² = 0.20, p < 0.001) and work (adjusted R² = 0.34, p < 0.001) and total score (adjusted R² = 0.19, p < 0.001).ConclusionsPain intensity seems to be an important predictor of disability for several domains of life, suggesting that pain-related disability should be assessed for these domains.     

Induction of cancer cell death by apoptosis and slow release of 5-fluoracil from metal-organic frameworks Cu-BTC

This study aimed to evaluate the mechanism associated with cytotoxic activity displayed by the drug 5-fluorouracil incorporated in Cu-BTC MOF and its slow delivery from the Cu-BTC MOF. Structural characterization encompasses elemental analysis (CHNS), differential scanning calorimetry (DSC), thermogravimetric analysis (TG/DTG), Fournier transform infrared (FIT-IR) and X-ray diffraction (XRD) was performed to verify the process of association between the drug 5-FU and Cu-BTC MOF. Flow cytometry was done to indicate that apoptosis is the mechanism responsible for the cell death. The release profile of the drug 5-FU from Cu-BTC MOF for 48 hours was obeisant. Also, the anti-inflammatory activity was evaluated by the peritonitis testing and the production of nitric oxide and pro-inflammatory cytokines were measured. The chemical characterization of the material indicated the presence of drug associated with the coordination network in a proportion of 0.82 g 5-FU per 1.0 g of Cu-BTC MOF. The cytotoxic tests were carried out against four cell lines: NCI-H292, MCF-7, HT29 and HL60. The Cu-BTC MOF associated drug was extremely cytotoxic against the human breast cancer adenocarcinoma (MCF-7) cell line and against human acute promyelocytic leukemia cells (HL60), cancer cells were killed by apoptosis mechanisms. The drug demonstrated a slow release profile where 82% of the drug was released in 48 hours. The results indicated that the drug incorporated in Cu-BTC MOF decreased significantly the number of leukocytes in the peritoneal cavity of rodents as well as reduced levels of cytokines and nitric oxide production.