RESUMEN

BACKGROUND: Liposuction is one of the most commonly performed cosmetic procedures worldwide. Complications associated with submental liposuction are rare. However, when they occur they are significant and can cause disfiguring consequences. The objective of this study was evaluated complications from submentual liposuction in literature and description of clinical experience of complication after submentual liposuction. MATERIAL AND METHODS: At first, a scoping review was carried out online search with no time restrictions for complications after submental liposuction was performed in the databases Medline / PubMed, Embase, and Web of Science. The variables analyzed were: age, sex, type of esthetic procedure, anesthesia, complications, time after Procedure, treatment, follow-up care, and sequelae. Then, a case of a patient with submental hematoma after an aesthetic procedure for submental liposuction was described. RESULTS: Firstly, 539 articles were selected, after application of the inclusion criteria, 4 studies were included. Most cases were female (8:1), with a mean age of 55.77 years. Postoperative complications were found, such as submental depression, submental edema, hypertrophic scar formation, scar contracture, cervical necrotizing fasciitis, Cervico-facial dystonia and transient facial nerve paralysis. The follow-up period for cases ranged from 3 to 12 months. The clinical case presented there was no sequelae. CONCLUSIONS: Submental liposuction requires the surgeon's attention. Anatomical knowledge, correct clinical and surgical management, diagnosis, and immediate approach to adverse situations are points that must be respected in this type of esthetic procedure to avoid more serious complications.

Asunto(s)

Lipectomía , Estética Dental , Femenino , Humanos , Lipectomía/efectos adversos , Lipectomía/métodos , Masculino , Persona de Mediana Edad , Cuello/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía

RESUMEN

The aim of this systematic review was to evaluate published evidence on the association between the use of antidepressants and complications involving dental implants. Two reviewers independently performed electronic searches of the MEDLINE/PubMed, Cochrane Library, and Scopus databases for relevant articles published up to May 30, 2019. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle-Ottawa Scale was used for the appraisal of the methodological quality of the studies included. A meta-analysis was performed to determine the risk of dental implant failure in individuals taking antidepressants. Five comparative observational studies were selected for this review; these included a total of 2056 participants with 5302 implants. The results suggest a risk ratio of 3.73 (95% confidence interval 1.85-7.52, P=0.0002) for implant failure in antidepressant users submitted to oral rehabilitation when compared to non-users. However, these studies did not present methodological rigour or standardize the drugs used. Thus, there is insufficient evidence for an association between antidepressant use and dental implant complications.

Asunto(s)

Implantes Dentales , Antidepresivos/efectos adversos , Implantación Dental Endoósea/efectos adversos , Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental , Humanos

RESUMEN

INTRODUCTION: The correlation between oral lesions and atopy is not new, but few studies have investigated the prevalence of mucosal changes in diseases within the atopic spectrum, leading to conflicting data. Some studies found a possible relationship between geographic tongue, transient lingual papillitis and atopic diseases. AIM: To investigate the frequency of geographic tongue and fungiform papillary glossitis in patients with atopic diseases, and its correlation with serum IgE levels and skin test results. MATERIAL AND METHODS: The sample was comprised of participants with atopic diseases paired with participants who received negative puncture skin tests. All were submitted to stomatological and medical evaluations, prick test and oral cytopathological. RESULTS: The female sex was more numerous in both groups. Mean age was 21 years. A total of 60 diagnoses of atopic diseases were obtained, with allergic rhinitis being the most prevalent. Fungiform papillary glossitis was the most frequent oral lesion in both groups, while geographic tongue was present in 2 cases (2%) in the test group and 2 (2%) in the control group. Atopic patients with fungiform papillary glossitis presented high serum IgE levels. In atopic patients with geographic tongue, the prick test positively identified extracts of Dermatophagoides pteronyssinus (100%) and Dermatophagoides farinae (100%). CONCLUSION: Due to the low frequency of geographic tongue lesions found in the study, it is no possible to conclude if that could be an oral manifestation of atopy. However fungiform papillary glossitis is a common alteration in atopic and non-atopic patients and has a relationship with high IgE serum levels. However, the consolidation of this result requires a larger sample size.

Asunto(s)

Glositis Migratoria Benigna , Glositis , Adulto , Femenino , Glositis/diagnóstico , Glositis/epidemiología , Glositis/etiología , Glositis Migratoria Benigna/complicaciones , Glositis Migratoria Benigna/diagnóstico , Glositis Migratoria Benigna/epidemiología , Humanos , Prevalencia , Pruebas Cutáneas , Adulto Joven

RESUMEN

The Amazon river dolphin Inia geoffrensis and tucuxi Sotalia fluviatilis are classified as Data Deficient species. Despite very limited knowledge on health and disease aspects of these species, the main threats to their conservation include incidental mortality in fishing gear, population fragmentation, habitat loss and environmental pollution. It is also suggested that underlying diseases may contribute to their mortality rates. Herein, we retrospectively describe gross and microscopic pulmonary lesions in free-ranging I. geoffrensis (n = 24) and S. fluviatilis (n = 28) found dead. Nearly 85% of the examined animals presented some kind of primary lung disease, wherein the main etiological diagnoses were verminous pneumonia by Halocercus brasiliensis (25%), bacterial pneumonia (25%) and a single case of meconium aspiration syndrome (1.9%). An etiology was not determined in 36.5% (19/52) of animals. These results indicate a high incidence of pulmonary pathology in these species, raising concerns about population impacts and potential zoonotic implications in some instances. These data may provide a scientific basis for future medical and conservation efforts focused on Amazonian dolphins.

Asunto(s)

Delfines , Enfermedades Pulmonares Parasitarias/veterinaria , Neumonía por Aspiración/veterinaria , Neumonía Bacteriana/veterinaria , Animales , Brasil , Femenino , Pulmón/patología , Enfermedades Pulmonares Parasitarias/epidemiología , Enfermedades Pulmonares Parasitarias/patología , Masculino , Neumonía por Aspiración/epidemiología , Neumonía por Aspiración/patología , Neumonía Bacteriana/epidemiología , Neumonía Bacteriana/patología , Estudios Retrospectivos

RESUMEN

This review focuses on the subject of acne in women, a disease that is increasingly common and that can also affect men. Adult acne differs from the type of acne that occurs in teenagers, and it may persist beyond adolescence or have its onset at an older age (adult-onset acne or late acne). Acne can have a negative impact on the quality of life of patients at any age, leading to a negative body image and decrease in self-esteem, and in older patients it can result in discrimination in the workplace and in other social environments. Acne in women must be understood as a specific problem, and here we discuss the pathogenesis, clinical presentation, psychology and treatment of this very prevalent problem.

Asunto(s)

Acné Vulgar/terapia , Acné Vulgar/diagnóstico , Acné Vulgar/etiología , Adulto , Antagonistas de Andrógenos/uso terapéutico , Antibacterianos/uso terapéutico , Cicatriz/terapia , Dermabrasión/métodos , Fármacos Dermatológicos/uso terapéutico , Femenino , Humanos , Retinoides/uso terapéutico

RESUMEN

BACKGROUND: Geographic tongue (GT) is the most frequent oral lesion in psoriatic patients (PP), and genetic involvement in these conditions has been described. The association of psoriasis with GT is still not clear, and the study of human leucocyte antigen (HLA) may help clarify this relation. OBJECTIVE: The aim of this study was to investigate the association of HLA alleles with psoriasis vulgaris and GT. METHODS: Fifty-eight Brazilian PP, 29 GT patients and 125 healthy controls individuals were selected. Information on demographic and clinical characteristics was collected. All patients underwent an oral examination and blood collection for HLA typing. RESULTS: HLA-A did not show significant differences in frequencies among the groups. HLA-B*57 allele was more frequently found in PP and was not found in GT. HLA-B*58 allele was more frequently found in GT. HLA-C*06 and -C*18 alleles were associated with psoriasis. No significant differences in HLA-DRB1 and HLA-DQB1 were observed. CONCLUSION: HLA-B*58 was associated with GT and HLA-B*57 was possibly associated with psoriasis. This suggested that some GT cases may represent true oral psoriasis and some may represent only GT. Therefore, it is necessary to make this distinction and increase our sample size to improve the correct diagnosis and treatment of these conditions.

Asunto(s)

Glositis Migratoria Benigna/genética , Antígenos HLA/genética , Psoriasis/genética , Adolescente , Adulto , Alelos , Estudios de Casos y Controles , Femenino , Glositis Migratoria Benigna/inmunología , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-C/genética , Cadenas beta de HLA-DQ/genética , Cadenas HLA-DRB1/genética , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/inmunología , Adulto Joven

RESUMEN

The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment.

Asunto(s)

Agotamiento Profesional/epidemiología , Cirugía Ortognática , Cirujanos/psicología , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios

Asunto(s)

Dermatitis Seborreica/genética , Frecuencia de los Genes/genética , Antígenos HLA-A/genética , Cadenas beta de HLA-DQ/genética , Cadenas HLA-DRB1/genética , Adulto , Brasil , Estudios de Casos y Controles , Femenino , Predisposición Genética a la Enfermedad/genética , Haplotipos/genética , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios

RESUMEN

OBJECTIVES: To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. METHODS: A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 ± 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 151 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). RESULTS: Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low back pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life, as well as physicians and patient's global assessment, were similar in all the groups. Radiographic indices showed worse results in the younger age groups. CONCLUSIONS: There are two different clinical patterns in SpA defined by age at disease onset: one with predominance of axial symptoms in the group with disease onset ≤ 40 years and another favouring the peripheral manifestations in those with later disease onset.

Asunto(s)

Índice de Severidad de la Enfermedad , Espondiloartritis/epidemiología , Espondiloartritis/fisiopatología , Espondilitis Anquilosante/epidemiología , Espondilitis Anquilosante/fisiopatología , Adolescente , Adulto , Distribución por Edad , Edad de Inicio , Anciano , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven

RESUMEN

AIM: To evaluate the influence of thermomechanical compaction (Tagger's hybrid technique - THT) on the push-out strength of several root filling materials to root dentine. METHODOLOGY: Root canals of eighty roots in human canines were prepared with the ProTaper system and filled with one of the following materials, using either lateral compaction (LC) (n = 40) or THT (n = 40): AH Plus/gutta-percha (GP) (n = 10), Sealer 26/GP (n = 10), Epiphany SE/Resilon (n = 10) and Epiphany SE/GP (n = 10). Three 2-mm-thick dentine slices were obtained from each third of each root. The root filling in the first slice was subjected to a push-out test to evaluate the bond strength of the materials to intraradicular dentine. Data (in MPa) were analysed using anova and post hoc Tukey's test (P < 0.05). Failure mode was determined at × 25 magnification. The other two slices were prepared for scanning electron microscopy (SEM) to examine the surface of the filling materials. RESULTS: Lateral compaction (1.34 ± 1.14 MPa) was associated with a significantly higher bond strength (P < 0.05) than the THT (0.97 ± 0.88 MPa). AH Plus/GP (2.23 ± 0.83 MPa) and Sealer 26/GP (1.86 ± 0.50 MPa) had significantly higher bond strengths than the other materials and differed significantly from each other (P < 0.05). There was a significant difference (P < 0.05) between the coronal (1.36 ± 1.15 MPa), middle (1.14 ± 1.05 MPa) and apical thirds (0.95 ± 0.83 MPa). Considering the technique and root filling material interaction, AH Plus/GP-LC was associated with the highest mean values (2.65 ± 0.66 MPa) (P < 0.05). Sealer 26/GP-LC (2.10 ± 0.46 MPa), AH Plus/GP-THT (1.81 ± 0.78 MPa) and Sealer 26/GP-TH (1.63 ± 0.44 MPa) had intermediate values that were not significantly different from each other (P > 0.05). Epiphany SE was associated with the lowest mean values (3.70 ± 0.86 MPa) (P < 0.05), regardless of the root filling technique and type of solid material (cone). Adhesive failures predominated in the specimens filled with Epiphany SE, whilst mixed and cohesive failures were more frequent in those filled with AH Plus and Sealer 26, regardless of the root filling technique. SEM analysis revealed that LC produced a dense and well-compacted filling whilst the use of a hybrid thermomechanical technique resulted in the solid material (GP or Resilon) intermingled within sealer to form a nonhomogenous mass. CONCLUSION: Lateral compaction was associated with higher bond strengths of the materials to intraradicular dentine than a hybrid technique using thermomechanical compaction. The greatest push-out strengths were obtained when the canals were filled with LC of AH Plus and GP cones.

Asunto(s)

Recubrimiento Dental Adhesivo , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Adhesividad , Bismuto/química , Hidróxido de Calcio/química , Diente Canino , Cavidad Pulpar/ultraestructura , Análisis del Estrés Dental/instrumentación , Dentina/ultraestructura , Resinas Epoxi/química , Gutapercha/química , Humanos , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Presión , Preparación del Conducto Radicular/métodos , Estrés Mecánico , Propiedades de Superficie , Temperatura , Ápice del Diente/ultraestructura , Cuello del Diente/ultraestructura

RESUMEN

Temporomandibular joint (TMJ) dislocation is defined as an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. The aim of this study was to describe a modified miniplate designed for treating chronic mandibular dislocations and evaluate the results of its placement in one patient, who was followed for 18 months. The treatment of chronic mandibular dislocation using this modified miniplate was shown to be efficient in relation to the postoperative maximal mouth opening, recurrence and articular function.

Asunto(s)

Placas Óseas , Luxaciones Articulares/cirugía , Cóndilo Mandibular/cirugía , Trastornos de la Articulación Temporomandibular/cirugía , Materiales Biocompatibles/química , Cefalometría/métodos , Enfermedad Crónica , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Estudios de Seguimiento , Humanos , Cápsula Articular/cirugía , Miniaturización , Diseño de Prótesis , Rango del Movimiento Articular/fisiología , Hueso Temporal/diagnóstico por imagen , Titanio/química

RESUMEN

The magnetic resonance imaging contrast agent, the so-called Endorem colloidal suspension on the basis of superparamagnetic iron oxide nanoparticles (mean diameter of 5.5 nm) coated with dextran, were characterized on the basis of several measurement techniques to determine the parameters of their most important physical and chemical properties. It is assumed that each nanoparticle is consisted of Fe3O4 monodomain and it was observed that its oxidation to gamma-Fe2O3 occurs at 253.1 degrees C. The Mössbauer spectroscopy have shown a superparamagnetic behavior of the magnetic nanoparticles. The Magnetic Resonance results show an increase of the relaxation times T1, T2, and T2* with decreasing concentration of iron oxide nanoparticles. The relaxation effects of SPIONs contrast agents are influenced by their local concentration as well as the applied field strength and the environment in which these agents interact with surrounding protons. The proton relaxation rates presented a linear behavior with concentration. The measured values of thermo-optic coefficient dn/dT, thermal conductivity kappa, optical birefringence delta n0, nonlinear refractive index n2, nonlinear absorption beta' and third-order nonlinear susceptibility |chi(3)| are also reported.

Asunto(s)

Materiales Biocompatibles , Coloides , Medios de Contraste , Compuestos Ferrosos/química , Imagen por Resonancia Magnética , Magnetismo , Nanopartículas del Metal , Espectroscopía de Mossbauer

RESUMEN

The present work is a report of the characterization of superparamagnetic iron oxide nanoparticles coated with silicone used as a contrast agent in magnetic resonance imaging of the gastrointestinal tract. The hydrodynamic size of the contrast agent is 281.2 nm, where it was determined by transmission electron microscopy and a Fe3O4 crystalline structure was identified by X-ray diffraction, also confirmed by Mössbauer Spectroscopy. The blocking temperature of 190 K was determined from magnetic measurements based on the Zero Field Cooled and Field Cooled methods. The hysteresis loops were measured at different temperatures below and above the blocking temperature. Ferromagnetic resonance analysis indicated the superparamagnetic nature of the nanoparticles and a strong temperature dependence of the peak-to-peak linewidth deltaH(pp), giromagnetic factor g, number of spins N(s) and relaxation time T2 were observed. This behavior can be attributed to an increase in the superexchange interaction.

Asunto(s)

Medios de Contraste , Compuestos Férricos/química , Tracto Gastrointestinal/anatomía & histología , Imagen por Resonancia Magnética/métodos , Siliconas/química , Microscopía Electrónica de Transmisión , Espectroscopía de Mossbauer

RESUMEN

In this work we report on a study of the morphological changes of LDL induced in vitro by metallic ions (Cu(2+) and Fe(3+)). These modifications were characterized by transmission electron microscopy, nuclear magnetic resonance and the Z-scan technique. The degree of oxidative modification of LDL was determined by the TBARS and lipid hydroperoxides assays. It is shown that distinct pathways for modifying lipoproteins lead to different morphological transformations of the particles characterized by changes in size and/or shape of the resulting particles, and by the tendency to induce aggregation of the particles. There were no evidence of melting of particles promoted by oxidative processes with Cu and Fe.

Asunto(s)

Cobre/química , Hierro/química , Lipoproteínas LDL/química , Cationes/química , Espectroscopía de Resonancia Magnética , Microscopía Electrónica de Transmisión , Oxidación-Reducción , Sustancias Reactivas al Ácido Tiobarbitúrico/química

RESUMEN

In this work we report on a study of the morphological changes of LDL induced in vitro by metallic ions (Cu2+ and Fe3+). These modifications were characterized by transmission electron microscopy, nuclear magnetic resonance and the Z-scan technique. The degree of oxidative modification of LDL was determined by the TBARS and lipid hydroperoxides assays. It is shown that distinct pathways for modifying lipoproteins lead to different morphological transformations of the particles characterized by changes in size and/or shape of the resulting particles, and by the tendency to induce aggregation of the particles. There were no evidence of melting of particles promoted by oxidative processes with Cu and Fe.

Asunto(s)

Masculino , Femenino , Humanos , Lipoproteínas

RESUMEN

Magnetic nanoparticles coated with silica have been subjected of extensive,and, in many aspects, also intensive investigations because of their potentialapplication in different technological fields, particularly in biomedicine. This work was conceived and is being carried out in two main parts: (1) synthesis of the ferrimagnetic nanoparticles, specifically magnetite, and (2) coating these particles with tetraethyl orthosilicate (TEOS). The nanosized magnetite sample was preparedby the reduction–precipitation and the nanomagnetite particles were coated by the sol-gel method, based on the hydrolysis of tetraethyl orthosilicate (TEOS). The so obtained materials were characterized with powder X-ray diffraction (XRD), FTIR spectroscopy, saturation magnetization measurements, and 57Fe Mössbauer spectroscopy at room temperature.

Asunto(s)

Nanopartículas de Magnetita/análisis , Nanopartículas de Magnetita/química , Nanopartículas/análisis

RESUMEN

Lobomycosis is a cutaneous infection of tropical and subtropical regions caused by the fungus Lacazia loboi, which still has a controversial taxonomical position. The first description of the disease and fungus was made in 1930 by Jorge Lobo. It is a chronic disease with predominance of lesions similar to keloids, in exposed areas, limited to skin and semimucosa. There is no systemic involvement and patients maintain a good general health. Diagnosis is confirmed by direct or histopathologic exam and, until present, the fungus has not been cultivated. Surgery is the treatment of choice for isolated lesions, but there are frequent recurrences. Good therapeutic responses have been reported with clofazimine, with or without itraconazole, and with 5-fluorocytosine. This disease should be recognized by dermatologists worldwide because, although restricted to the Amazon region, it has been observed in other locations. Research development and achievement of new knowledge in molecular biology and genetic engineering of lobomycosis are of utmost importance because they may, in the future, lead to the culture of the fungus in the laboratory and to a better understanding of its pathogenesis, transmission mechanism, and new methods of diagnosis, prevention and treatment.

Asunto(s)

Dermatomicosis/diagnóstico , Predicción , Humanos

RESUMEN

Superparamagnetic iron oxide nanoparticles (SPIONs) are applied in stem cell labeling because of their high magnetic susceptibility as compared with ordinary paramagnetic species, their low toxicity, and their ease of magnetic manipulation. The present work is the study of CD133+ stem cell labeling by SPIONs coupled to a specific antibody (AC133), resulting in the antigenic labeling of the CD133+ stem cell, and a method was developed for the quantification of the SPION content per cell, necessary for molecular imaging optimization. Flow cytometry analysis established the efficiency of the selection process and helped determine that the CD133 cells selected by chromatographic affinity express the transmembrane glycoprotein CD133. The presence of antibodies coupled to the SPION, expressed in the cell membrane, was observed by transmission electron microscopy. Quantification of the SPION concentration in the marked cells using the ferromagnetic resonance technique resulted in a value of 1.70 x 10(-13) mol iron (9.5 pg) or 7.0 x 10(6) nanoparticles per cell (the measurement was carried out in a volume of 2 muL containing about 6.16 x 10(5) pg iron, equivalent to 4.5 x 10(11) SPIONs).

Asunto(s)

Antígenos CD/química , Compuestos Férricos/química , Glicoproteínas/química , Nanopartículas/química , Péptidos/química , Células Madre/química , Antígeno AC133 , Citometría de Flujo , Humanos , Imagen por Resonancia Magnética/métodos , Microscopía Electrónica de Transmisión , Células Madre/citología , Células Madre/ultraestructura

RESUMEN

BACKGROUND: The need and frequency of hepatic biopsies during methotrexate (MTX) therapy are still controversial. OBJECTIVES: The purpose of this investigation is to assess MTX liver toxicity in patients with psoriasis through percutaneous liver biopsy, and compare liver morphology changes with increasing cumulative dosages (1, 2, 3 and 4 g) of MTX. RESULTS: Cumulative dosages of 1 to 2 g MTX did not cause significant liver toxicity. From a cumulative dosage of 3 to 4 g, there is fibrosis formation, inflammation enhancement in the portal area and fibrous septa, configuring regenerative nodes. CONCLUSION: In patients with no risk factors for liver disease, with normal physical examination and liver tests, biopsy can be done after a cumulative MTX dosage of approximately 1 to 1.5 g and repeated for each gram. In patients with risk factors, liver biopsy should be done before use of MTX, or within the first 2 months of treatment at the most, and repeated for each gram of cumulative dosage.

Asunto(s)

Fármacos Dermatológicos/efectos adversos , Cirrosis Hepática/inducido químicamente , Hígado/fisiopatología , Metotrexato/efectos adversos , Psoriasis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Biopsia , Fármacos Dermatológicos/uso terapéutico , Relación Dosis-Respuesta a Droga , Femenino , Hepatocitos/efectos de los fármacos , Hepatocitos/patología , Humanos , Hígado/efectos de los fármacos , Hígado/patología , Cirrosis Hepática/patología , Cirrosis Hepática/fisiopatología , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Factores de Riesgo

RESUMEN

BACKGROUND: Psoriasis vulgaris is a skin disease with a complex immunological and genetic background, triggered by environmental factors. The association of human leukocyte antigens (HLA) and psoriasis has long been reported on population and familial studies. OBJECTIVES: To review and discuss studies on psoriasis vulgaris and HLA, in Caucasian and non-Caucasian populations. METHODS: The major population studies on psoriasis vulgaris and the associated HLA antigens and alleles are described and discussed based on a review of the current literature. RESULTS: Population studies demonstrate the presence of different HLA specificities as well as extended haplotypes in patients with psoriasis, when compared to controls. Some alleles occur in a lower frequency in patients with psoriasis, indicating they could be protection alleles. In all studies which HLA class I was typed, Cw6 or Cw*0602 was present in a significant frequency in patients with psoriasis, mainly when early onset and positive family history were considered. HLA-DRB1*0701 was also present in a higher frequency in patients in different populations. CONCLUSIONS: Different antigens and alleles from both HLA classes I and II were seen in a significantly higher frequency in patients with psoriasis vulgaris. HLA Cw*0602 and DRB1*0701 were represented in different reports, and the former was related mainly to psoriasis type I.

Asunto(s)

Antígenos HLA/genética , Antígenos HLA/inmunología , Haplotipos , Psoriasis/genética , Psoriasis/inmunología , Alelos , Humanos