Drug-induced gingival overgrowth: a case report

A variety of systemic drugs can lead to adverse effects in the oral environment. This article reports the case of a 61-year-old man who had a severe drug-induced gingival overgrowth (DIGO) caused by nifedipine. DIGO is relevant due to severe gingival enlargement, which causes disfigurement and blocks physiological and social functions such as mastication and speaking. Management of DIGO is always a challenge due to the patient's systemic condition. This article shows, step-by-step, how the treatment was executed and how the DIGO was reversed.     

Seroprevalence of hepatitis B and C viruses in moderate and severe COVID-19 inpatients: A cross-sectional study at a referral center in Mexico

Introduction and ObjectivesThe emergence of SARS-CoV-2, which causes the coronavirus disease (COVID-19) has caused a great impact on healthcare systems worldwide, including hepatitis B and C viruses screening and elimination programs. The high number of COVID-19 hospitalizations represent a great opportunity to screen patients for hepatitis B virus (HBV) and hepatitis C virus (HCV), which was the aim of this study.Material and MethodsCross-sectional, retrospective study performed between April 2020 and 20201 at a referral center in Mexico dedicated to the care of adults with severe/critical COVID-19. We retrieved clinical, demographic, and laboratory results from each patient´s medical records, including antibodies against HCV (anti-HCV), HBV surface antigen (HBsAg), antibodies against the HBV core antigen (anti-HBcAg), and antibodies against HBsAg (anti-HBsAg).ResultsOut of 3620 patients that were admitted to the hospital, 24 (0.66%), 4 (0.11%), and 72 (1.99%) tested positive for anti-HCV, HBsAg, and anti-HBcAg, respectively. Of all seronegative patients, 954 (27%) had undetectable anti-HBsAg and 401 (12%) had anti-HBsAg at protective levels. Blood transfusion was the most relevant risk factor. Only 9.7% of the anti-HBc positive, 25% of the HBsAg positive, and 52% of the anti-HCV positive were aware of their serological status.ConclusionsIn this study we found a prevalence of anti-HCV of 0.66%, HBsAg in 0.11%, and isolated anti-HBcAg in 1.99%. We also found that HBV vaccination coverage has been suboptimal and needs to be reinforced. This study gave us a trustworthy insight of the actual seroprevalence in Mexico, which can help provide feedback to the Hepatitis National Elimination Plan.     

Detection of the gubernacular canal and its attachment to the dental follicle may indicate an abnormal eruption status

Objectives:To evaluate and compare the detection of gubernacular canals (GC) and their characteristics in normal and abnormal tooth eruption.Materials and Methods:Patients with unerupted teeth were classified according to sex and age. Each tooth was classified according to dental group, eruption status, formation status, angulation, and GC detection. The opening of the GC in the alveolar crest and the attachment sites in relation to the dental follicle were assessed. Data were analyzed by the chi-square and Kruskal-Wallis tests, with a significance level of 5%.Results:Cone-beam computed tomography scans of 159 patients were evaluated. The final sample (N = 598) consisted of 423 teeth with normal eruption, 140 impacted teeth, and 35 teeth with delayed eruption. The overall detection rate of GC was 90.6%. These rates were 94.1%, 87.1%, and 62.9% for normal eruption, impacted teeth, and delayed eruption, respectively. GC detection rates were higher in the early stages of tooth formation in normal tooth eruption and in impacted teeth. The rate of GC detection was even lower in delayed teeth when they were angulated. Unusual attachment sites of the GC to the dental follicle were associated with abnormal eruption status.Conclusions:The results of the present study suggest that GC characteristics may indicate an abnormal eruption status.     

国产雷帕霉素洗脱支架治疗急性冠状动脉综合征：安全性和临床有效性

目的:分析国产雷帕霉素洗脱支架治疗急性冠状动脉综合征的安全性和有效性。方法:选择2004-11/2006-02在河北大学附属医院接受冠状动脉介入治疗的急性冠状动脉综合征患者102例,其中ST段抬高型心肌梗死54例,非ST段抬高型心肌梗死28例,不稳定型心绞痛20例。根据血管情况置入国产雷帕霉素药物洗脱支架(Firebird支架),支架选择原则为:支架长度应覆盖病变两端;血管直径:支架直径=1∶1.1。所有患者术前3d均口服阿司匹林100mg,氯吡格雷75mg,术中推注肝素8000￣10000U,手术每延迟1h,补充肝素1000u,术后皮下注射低分子肝素5￣7d;服用氯吡格雷75mg,1次/d,共服用9￣12个月,并长期服用阿司匹林100mg,1次/d。随访情况:术后6个月时随访64例;7个月时随访26例;8个月时随访12例;平均随访6.8个月,患者出院后定期进行门诊随访,记录一般情况及严重心脏不良事件(包括急性、亚急性、迟发支架内血栓形成;再发心肌梗死;急诊冠状动脉旁路移植术;死亡),术后6￣8个月行冠状动脉造影评价支架内再狭窄情况。并观察材料及宿主反应。结果:102例患者经皮冠状动脉介入治疗治疗均获得成功,共治疗靶血管102支,置入Firebird支架116枚,术中3例ST段抬高型心肌梗死患者出现无复流现象,2例发生室颤,电转复恢复窦性心律,3例因分支受压,出现心绞痛症状。术后4例出现穿刺部位血肿,经重新加压压迫后好转。随访6￣8个月所有患者未发生严重心血管事件;42例(41.2%)患者术后6￣8个月行冠状动脉造影复查,无一例发生支架内再狭窄。随访期间所有患者无全身毒性及超敏反应发生,生物相容性好。结论:国产药物洗脱支架治疗急性冠状动脉综合征安全,有效。     

Evidence for the mechanisms underlying the effects of pimaradienoic acid isolated from the roots of Viguiera arenaria on rat aorta

The present study examines the effects of the diterpene ENT-pimara-8(14),15-dien-19-oic acid (PA) on rat thoracic aorta. PA (10(-5), 3 x 10(-5) and 10(-4) mol/l) caused concentration-dependent inhibition of phenylephrine (Phe)-induced contraction in either endothelium-intact or endothelium-denuded aortic rings. PA attenuated the contraction induced by CaCl(2) in Ca(2+)-free solution containing Phe (10(-7) mol/l) or KCl (30 mmol/l). This diterpene did not interfere with Ca(2+) release from intracellular stores mediated by either Phe (10(-6) mol/l) or caffeine (30 mmol/l). PA (10(-6) to 3 x 10(-4) mol/l) concentration dependently relaxed Phe-pre-contracted rings with intact (92.64 +/- 7.60%) or denuded endothelium (98.82 +/- 1.56%). Pre-incubation of denuded aortic rings with N(G)-nitro-L-arginine methyl ester (10(-4) mol/l), 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (10(-6) mol/l) or indomethacin (10(-5) mol/l) reduced PA-induced relaxation (percentage of relaxation: 77.50 +/- 3.95, 78.56 +/- 2.81, 77.11 +/- 6.22, respectively). However, the relaxant responses induced by PA on Phe-pre-contracted rings were unaffected by tetraethylammonium (1 and 5 mmol/l). PA also relaxed KCl-pre-contracted rings with intact (97.44 +/- 3.66%) or denuded endothelium (95.95 +/- 3.72%). Collectively, these results support the notion that the effects elicited by PA on vascular smooth muscle are endothelium-independent and involve extracellular Ca(2+) influx blocked. In addition, PA effects are partly dependent on the release of nitric oxide from the vascular smooth muscle through an activation of guanylyl cyclase-dependent mechanism and are related to the release of metabolites derived from the arachidonic acid pathway. Finally, our results demonstrated that the PA relaxant action is not related with the opening of potassium (K(+)) channels.     

Chronic ethanol consumption reduces adrenomedullin-induced relaxation in the isolated rat aorta

Adrenomedullin (AM) is a peptide that displays cardiovascular protective activity. We investigated the effects of chronic ethanol consumption on vascular reactivity to AM and the expression of AM system components in the rat aorta. Male Wistar rats were treated with ethanol (20% vol/vol) for 6 weeks. Vascular reactivity experiments were performed in the isolated rat aorta. Metalloproteinase-2 (MMP-2) levels were determined by gelatin zymography. Nitrite and nitrate generation was measured by chemiluminescence. Protein and mRNA levels of pre-pro-AM, calcitonin receptor-like receptor (CRLR) and RAMP1, 2, and 3 (receptor-activity-modifying proteins) were assessed by western blot and quantitative real-time polymerase chain reaction, respectively. Ethanol intake reduced AM-induced relaxation in endothelium-intact rat aortas, whereas calcitonin gene-related peptide-, acetylcholine-, and sodium nitroprusside-induced relaxation were not affected by ethanol intake. N^G-nitro-l-arginine-methyl-ester (l-NAME), 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one, and tetraethylammonium reduced AM-induced relaxation in aortic rings from both control and ethanol-treated rats. Ethanol consumption did not alter basal levels of nitrate and nitrite, nor did it affect the expression of MMP-2 in the rat aorta. Ethanol consumption increased mRNA levels of pre-pro-AM and RAMP1. Protein levels of AM, CRLR, and RAMP1, 2, and 3 were not affected by ethanol consumption. The major findings of the present study are that ethanol consumption reduces the vascular relaxation induced by AM and changes the mRNA expression of the components of the AM system in the vasculature. This response could be one of the mechanisms by which ethanol predisposes individuals to vascular dysfunction and hypertension.     

MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery

The authors evaluated magnetic resonance (MR) images obtained with intravenously administered gadolinium in ten patients who had facial paralysis and no facial nerve tumor. In patients with either Bell palsy (four patients) or facial paralysis after temporal bone surgery (six patients), intratemporal facial nerve enhancement was seen. Facial nerve enhancement on MR images proved to be a nonspecific finding.