RESUMEN
Los linfangiomas son malformaciones del desarrollo caracterizadas por una proliferación benigna de los vasos linfáticos y representan hamartomas de los linfáticos malformados y tienen una marcada predilección por la región de la cabeza y el cuello. La localización más frecuente en la boca es el dorso de la lengua, seguido por los labios, la mucosa bucal, el paladar blando y el piso de la boca. Se presenta un caso clínico de una paciente con secuela de cirugías de linfangioma de piso de boca y lengua, con pérdida prematura de piezas dentarias y caries de aparición temprana, y su rehabilitación completa con restauraciones de resina, coronas de celuloide y mantenedores de espacio tipo prótesis parcial superior e inferior...
Lymphangiomas are developmental malformations wich are characterized by a benign proliferation of lymphatic vessels. They represent hamartomas of malformed lymphatics and have a strong predilection for the region of the head and neck. The most common location in the mouth is the dorsum of the tongue, followed by the lips, buccal mucosa, soft palate and fIoor of the mouth. The following case report is of a patient with lymphangioma sequel surgerie on fIoor of mouth and tongue, with premature loss of teeth and early childhood caries, and her complete rehabilitation with resin restorations, strip crowns, and removable space maintainers with artificial tooth...
Asunto(s)
Humanos , Femenino , Preescolar , Linfangioma , Prótesis Dental , Rehabilitación Bucal , PerúRESUMEN
En estudios centellográficos con 131I (CCT) para seguimiento, postablación o tratamiento de pacientes portadores de carcinoma diferenciado de tiroides (CDT) se observan frecuentemente en tiempos precoces áreas de captación del radiotrazador en macizo facial. Estas áreas corresponden, generalmente, a glándulas salivares y extremo anterior de mucosa nasal y se mantienen durante las primeras 48 horas y no son observadas generalmente a las 72 horas. Pero con menor frecuencia se presentan otras que persisten durante varias semanas; estas áreas fueron consideradas como posibles retención en glándulas salivares, en tejido tiroideo ectópico en piso de boca, o proteínas yodas entre otras causas. En 1996 Valdivieso y col. (Cong. Arg. Biol. Med. Nuclear, Mar del Plata) y Gutiérrez y col. (SLAT, Chile) consideraron además de las mencionadas posibilidades, que la fijación se podría realizar en hueso maxilar en relación con procesos dentales y esta idea se vio favorecida por dos presentaciones sobre pocos casos que coincidían con la idea sobre el lugar de fijación del radioelemento con producción de imágenes falsas-positivas de enfermedad metastática. Con el propósito de determinar la frecuencia de observación de estas imágenes se procedió a la revisión de 636 CCT efectuados entre el 1 de enero de 2002 y el 31 de diciembre de 2007 en 502 pacientes. En el 31,5 % de los pacientes se observaron áreas activas en maxilares que persistían por varias semanas; la intensidad de concentración fue del 0,3 al 1,2 % de la actividad administrada. En 10 pacientes se efectuaron áreas de interés sobre las zonas activas que se controlaron durante 3 semanas, determinándose el T ½ efectivo registrándose valores promedio de 6,87 ± 0,94 días muy próximos al T ½ físico del 131I, indicando fuerte unión del compuesto radiactivo formado. La intensidad de concentración del radioyodo es variable dependiendo de la intensidad de la lesión dental, (caries, prótesis, pulpitis, granulomas periapicales) y en especial se incrementa en pacientes provenientes del interior que habitaban en zonas con aguas con contenido de flúor o arsénico. Seis pacientes tratados con actividades altas de radioyodo de entre 5,55 y 11,1 MBQ (150 a 300 mCi) mostraron lesiones actínicas en mucosa bucal y lingual. En 5 pacientes se efectuaron inmediatamente después del CCT con radioyodo, estudios panorámicos de Rx maxilar y de centellograma óseo coincidiendo las imágenes maxilares positivas de ambos estudios con las áreas positivas con radioyodo, confirmándose la localización de las mismas. En 13 pacientes que se sometieron a intensos tratamientos odontológicos, en estudios de CCT posteriores se apreció la disminución de intensidad de las imágenes o su desaparición. Ninguno de los pacientes presentó metástasis de CDA en las áreas activas maxilares. Estos hallazgos confirman la concentración del radioyodo en hueso maxilar en relación con alteraciones, dentales debiendo efectuarse investigaciones más profundas sobre la naturaleza de la molécula formada y los mecanismo de fijación de la misma. Deberá tenerse en cuenta el estado de salud dentario del pacientes antes de someterlo a tratamiento de metástasis o ablaciones, en especial cuando las actividades de radioyodo a utilizar sean mayores de 3,7 GBq (100 mCi) y aún indicar tratamiento de las lesiones dentales en forma previa.
In the whole body scans (WBS) with 131I in the follow-up or treatment of patients bearing DTC it is observed frequently fixation areas of the tracer apparently in relation with salivary glands. These areas generally belong to the salivary glands and are present during the first 48/72 hours, but others are kept during more than 3 weeks. These latter ones were considered as possible uptake in ectopic thyroid cells in the mouth floor, iodized proteins, retention of salivary glands and other assertions. Valdivieso et al (Cong. Arg. Biol. Med. Nuclear, 1996) and Gutiérrez et al (SLAT,Chile, 1997) considered that the fixation took place also in maxillary bones probably in areas in relation with dental illness (inflammation, pulpitis, dental caries, perionditis, periapical granuloma, periapical cyst and resorption of surrounding bone seen radiologically as periapical radiolucency). This presumption was sustained for two publications (Clin. Nucl. Med. 1998;23. 747-749, and Clin. Nucl. Med. 2000; 23; 314-315). This end the review of 638 131I WBS carried out between January 1st, 2002 and December 31st of 2007 in 502 patients that were studied for ablation, treatment of metastasis or relapses or follow up. In 31,5% of the patients were observed areas of activity in maxilla. The intensity of concentration of the tracer was 0.3 to 1.2 % of the activity administered. In 10 patients was determinate the effective T ½ and in 5 a panoramic Rx of the maxilla and a bone scintigraphy with 99mTc-MDP; there were correlation between both images, the 131I one an the 99mTc-MDP with radiology. The effective T½ mean value was 6,87 days ± 0,94 (S.D.) very close to the physical T ½ of the radioiodine tracer indicating a strongly labeled molecule. In 6 patients treated with high activities of radioiodine (5,55 to 11,1 MBq - 150 to 300 mCi) actinic lesions were observed in mouth and lingual mucous membrane, including ulcers. The intensity of the images and of the lesions correlate with the intensity of the administered activity of radioiodine, the previous condition of dental integrity and in patients living in the interior of our country in zones of "bad" water containing tracers of arsenic and fluorine. In 13 patients submitted to intense treatment of dental problems posterior WBS showed a decrease of the positive maxilla areas or they were not found. The presence of metastasis in the active maxilla area was in all cases negative. Our observations confirm that radioiodine is deposited in maxillary bone in relation of dental lesions and that this 131I move in a very slow place. This mechanism of fixation has to be determined. We fully recommended taking into account the existence of dental illness or incomplete dental treatments when the administration of higher activities than 3.7 GBq (150 mCi).
Asunto(s)
Humanos , Masculino , Femenino , Neoplasias de la Tiroides/diagnóstico por imagen , Carcinoma/diagnóstico por imagen , Cintigrafía/efectos adversos , Metástasis de la Neoplasia/diagnóstico , Reacciones Falso Positivas , Usos Diagnósticos de Compuestos Químicos , Radioisótopos de Yodo/efectos adversos , Maxilares/diagnóstico por imagenRESUMEN
OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STD) and the use of condoms by sex workers, assisted in a health module. MATERIAL AND METHODS: A cross sectional study, was performed with prostitutes in Coatzacoalcos, Veracruz through a self-administered questionnaire in a period from January 3 to February 9, 2001. The questionnaire evaluated gynecology-obstetric background, STD and the use of condoms. Clinical records and laboratory tests were evaluated for STD screening. RESULTS: A total number of 196 sex workers from 71 work places were evaluated. The average age was 29.5 +/- 3.3 years. One hundred and eleven (57%) reported being single. 189 (96.4%) presented at least a case of vaginosis during the year 2000 and 148 (75.5%) were diagnosed having vulvovaginitis due to fungus. Syphilis was identified in 4 (2%) cases and (0.5%) acquired immune deficiency syndrome. 45 (23%) reported they always use a condom and 113 (58%) use condoms very often. CONCLUSIONS: There is a high prevalence of vulva and vagina disorders, as well as syphilis. High rates of sex workers use condoms.
Asunto(s)
Condones/estadística & datos numéricos , Trabajo Sexual , Enfermedades de Transmisión Sexual/epidemiología , Adulto , Estudios Transversales , Femenino , Humanos , Prevalencia , Enfermedades de Transmisión Sexual/prevención & controlRESUMEN
The efflux of [(3)H]noradrenaline (NA) and of the non transmitter, non metabolizable, amino acid [(14)C]?-aminoisobutyrate (AIB), was followed simultaneously from superfused rat brain cortex thin slices, that had been preloaded with those substances. Short (2 min) "pulses" of increasing veratridine concentrations were applied at 10 min intervals. When calcium in the superfusion fluid was 1 mM, [(3)H]NA efflux increased progressively with pulses of 1, 3, 10 and 30 ?M veratridine, but further increase to 100 ?M resulted in a decrease of the induced (3)H-efflux. Veratridine-enhanced [(3)H]NA efflux decreased considerably in 0.1 mM calcium and was virtually suppressed when no calcium was added to the superfusion fluid. In 1 mM calcium, the efflux of [(14)C] AIB was increased progressively by pulses of 10, 30 and 100 ?M veratridine, but no increase in efflux was seen with 1 or 3 ?M drug. In 0.1 mM, or without added calcium, the induced efflux of [(14)C]AIB was markedly increased. Similar findings were seen when a long (10 min) pulse of 10 ?M veratridine was given. After such long pulses there was a rapid return of AIB efflux to pre-veratridine levels if calcium was 1 mM, but in the absence of added calcium, the return to baseline levels of both [(3)H]NA and, especially, that of [(14)C]AIB efflux, was greatly impaired. The veratridine enhanced efflux of both NA and AIB was entirely blocked by 1 ?M tetrodotoxin.