RESUMEN
OBJECTIVE: To identify the effects of amygdala neuromodulation in the management disruptive behavior in patients, as well as changes in their quality of life and its relationship with epilepsy. METHODS: MEDLINE, OVID, WoS, Central Cochrane, and Scopus databases were systematically searched up to March 2023 for studies examining extremely aggressive patients who underwent ablative surgeries or deep brain stimulation (DBS) of the amygdala as the unique therapeutic target, with a six-month follow-up at least. RESULTS: The search yielded 1352 studies excluding duplicates, but only 11 case series, and 3 case reports met the inclusion criteria. They were published between 1963-2023 with a total of 1033 patients, mostly male, aged between 5 and 61 years. Most studies implemented amygdalotomy and only one DBS. More than 70% of the patients improved their behavior; approximately 30% had seizures, of which 40% presented improvement. Two studies reported worsening behavior. CONCLUSIONS: Although we found that amygdalotomy has a positive effect on the behavior of patients and the control of their seizures, it is necessary to carry out updated studies with greater epidemiological power. Future research should analyze the DBS use and the role of connectomics of the different neural networks involved with this brain structure.
RESUMEN
Introduction: It is essential not to delay behavior management and control for aggression, violence, and impulsive behavior in young people. Clozapine has been widely used in adolescents and adults to manage violence and aggression in Schizophrenia. However, there are limited data on the use of clozapine in children, and no systematic review has addressed its use in this population. Objective and Methods: To better understand the conditions under which clozapine is used as a therapeutic alternative for nonschizophrenic diagnoses and to assess the current evidence supporting its prescription to children, a systematic review was conducted. The review followed PRISMA guidelines and was registered in PROSPERO under the ID CRD42024537707. Results: The review identified that all the studies used clozapine to address externalizing behavior, particularly aggressive behavior, and found positive outcomes supporting its use for treating children with treatment-resistant aggression. The studies also found that clozapine was well-tolerated in all cases. However, the studies were limited and mainly consisted of open trials without a control group. Conclusion: Further high-quality research is needed to establish precise guidelines for using clozapine in children.
RESUMEN
Most patients with schizophrenia (SCZ) do not exhibit violent behaviors and are more likely to be victims rather than perpetrators of violent acts. However, a subgroup of forensic detainees with SCZ exhibit tendencies to engage in criminal violations. Although numerous models have been proposed, ranging from substance use, serotonin transporter gene, and cognitive dysfunction, the molecular underpinnings of violence in SCZ patients remains elusive. Lithium and clozapine have established anti-aggression properties and recent studies have linked low cholesterol levels and ultraviolet (UV) radiation with human aggression, while vitamin D3 reduces violent behaviors. A recent study found that vitamin D3, omega-3 fatty acids, magnesium, and zinc lower aggression in forensic population. In this review article, we take a closer look at aryl hydrocarbon receptor (AhR) and the dysfunctional lipidome in neuronal membranes, with emphasis on cholesterol and vitamin D3 depletion, as sources of aggressive behavior. We also discuss modalities to increase the fluidity of neuronal double layer via membrane lipid replacement (MLR) and natural or synthetic compounds. This article is part of the Special Issue on "Personality Disorders".
Asunto(s)
Antipsicóticos , Esquizofrenia , Humanos , Esquizofrenia/metabolismo , Antipsicóticos/uso terapéutico , Colesterol/metabolismo , Animales , Colecalciferol/metabolismo , Agresión/fisiología , Agresión/efectos de los fármacosRESUMEN
Somatic alpha thalassemia/mental retardation syndrome X-linked (ATRX) pathogenic variants have been shown to predict a malignant phenotype in neuroendocrine tumors. They were recently identified in aggressive pituitary tumors and carcinomas, mainly of corticotrophic origin. To our knowledge, these tumors are rare in a general cohort of pituitary tumors, with no cases described in null cell tumors. These variants can lead to loss of protein expression as revealed by immunohistochemistry. We describe a case of an aggressive null cell pituitary tumor with loss of ATRX expression. The patient underwent two transsphenoidal surgeries and radiotherapy and exhibited tumor growth despite conventional therapy. Analysis of the tumor samples revealed loss of ATRX expression in both surgical specimens, suggesting that ATRX may be a useful biomarker for the early identification of aggressive pituitary tumors.
RESUMEN
Different resources, such as environmental enrichment, are being evaluated in order to minimize animal stress and promote better conditions during the life cycle of animals, as consumers are increasingly concerned about animal welfare issues. Lairage represents an important stage in the swine production chain and is directly related to animal welfare. The aim of this study was to evaluate the effect of lairage time in the slaughterhouse and environmental enrichment on the level of skin lesions and behavioral responses in pigs. A total of 648 finishing pigs of both sexes were assessed before and after lairage at the slaughterhouse with a five-point scale (0 = none, to 4 = ≥16 superficial lesions or >10 deep lesions). After lairage (after slaughter), lesions were also classified according to their source (mounting, fighting, and handling). Pigs were distributed into two treatments groups during lairage: with environmental enrichment (EE) on the pen, with hanging metal chains, and with no enrichment (NE). Behavior was monitored during the first four hours of lairage. Proportional odds, mixed linear model for longitudinal data, and non-parametric Wilcoxon signed rank tests were used to analyze the relation between treatments, skin lesions, and behavior. The simple metal chains did not affect skin lesion score or pigs' behavior (p > 0.05), whereas lairage duration influenced standing (SA), sitting (S), lying (L), idleness (I), and drinking water (D) (p < 0.001). The main source of skin lesions was handling, which did not differ between treatments (EE and NE) (p > 0.05). It was observed that the severity of the lesions (highest scores of 3, 4, and 5) increased in the different anatomical regions of the pigs when compared before and after slaughter, with the exception of the frontal area, which was the same (p = 0.7547). Lairage time has a proportional relation with skin lesions, and hanging chains at the slaughterhouse pens was not enough to reduce the number of lesions and to change pig behavior.
RESUMEN
Photuris female fireflies attract males of different firefly species by responding to their flashing signals; then, they try to capture and feed on them. This aggressive mimicry is considered a major selective pressure on the communication systems of the fireflies of the American continent. The intensity of this selective pressure is a function of its efficiency in prey capture. In this study, the rates of attraction and capture of males of the synchronous firefly Photinus palaciosi by the predatory females of Photuris lugubris are reported. Although the females attract numerous males, their hunting success is low. This result is consistent with the few previous measurements published. In agreement with the predicted coevolutionary race between predator and prey, behaviors consistent with predation avoidance in P. palaciosi and increasing prey encounters and prey deception by P. lugubris were observed.
RESUMEN
Aggressive osteoblastoma (AO) is an uncommon bone tumor that represents a borderline lesion between osteoblastoma and osteosarcoma. The vertebral column, the sacrum, the pelvis, and jaw/craniofacial bones are primarily affected. Aggressive osteoblastoma does not metastasize and is treated by surgical resection. The authors report a case of AO in a 9-year-old female patient presenting with 5th and 7th cranial nerve palsy. Prior pathological history included resection of an expansile nodule in the left temporal bone. Conventional radiological examination and computed tomography (CT) of the skull revealed an osteoblastic lesion arising in the petrous portion of the left temporal bone, measuring 5.2 cm in the largest dimension. The patient was subjected to partial surgical resection of the process. Microscopy revealed a primary neoplastic bone composed of numerous epithelioid round osteoblasts disposed in solid sheets and with mild atypia, large eosinophilic cytoplasm, and an eccentric, ovoid nucleus. The process exhibited loose stroma, low mitotic index, osteoid formation, and a few osteoclast-like multinucleated giant cells. The diagnosis of AO was thus established. After 5 months of clinical follow-up, the patient is asymptomatic, without evidence of tumoral growth on CT scans.
O osteoblastoma agressivo (AO) é um tumor ósseo incomum que representa uma lesão limítrofe entre osteoblastoma e osteossarcoma. A coluna vertebral, o sacro, a pelve e os ossos maxilares/craniofaciais são afetados principalmente. O osteoblastoma agressivo não metastatiza sendo tratado por ressecção cirúrgica. Os autores relatam um caso de OA em paciente do sexo feminino, de 9 anos, com paralisia de V e VII pares cranianos. A história patológica prévia incluiu ressecção de nódulo expansivo no osso temporal esquerdo. O exame radiológico convencional e a tomografia computadorizada (TC) de crânio revelaram lesão osteoblástica surgindo na porção petrosa do osso temporal esquerdo, medindo 5,2 cm em sua maior dimensão. O paciente foi submetido à ressecção cirúrgica parcial do processo. A microscopia revelou osso neoplásico primário composto por numerosos osteoblastos epitelióides redondos dispostos em lâminas sólidas e com leve atipia, grande citoplasma eosinofílico e núcleo ovoide excêntrico. O processo exibiu estroma frouxo, baixo índice mitótico, formação de osteóide e algumas células gigantes multinucleadas semelhantes a osteoclastos. O diagnóstico de OA foi assim estabelecido. Após 5 meses de acompanhamento clínico, o paciente encontra-se assintomático, sem evidência de crescimento tumoral na tomografia computadorizada.
RESUMEN
In snakes that are known to be ambush predators, tail luring, in which the movement of a snake’s tail resembles that of a worm or insect larva and is used to attract prey, has emerged as a complementary hunting strategy. In certain species, some individuals may present a conspicuously bright colour at the tail tip, which eventually disappears with age. Some authors argue that the bright colour enhances the resemblance of the snake’s tail with a potential food item, increasing the success of capture. Here, we tested the influence of geographic variation, sex, and environmental factors on the probability that Common Lanceheads Bothrops jararaca (Wied-Neuwied, 1824) from southeastern Brazil were born with this contrasting tail tip and whether snakes retain this trait throughout adulthood. None of the predictors affected the probability of births with a contrasting tail tip. However, a higher proportion of individuals from the coastal populations retained this trait into adulthood. The absence of difference in the probability of being born with this trait indicates that there are other factors influencing tail tip colour, such as phylogenetic correlates, rather than intrinsic or environmental factors. A higher proportion of ectothermic prey in the diet of coastal populations may explain why this population retains tail luring throughout adulthood.
RESUMEN
The structuring of plant-hummingbird networks can be explained by multiple factors, including species abundance (i.e., the neutrality hypothesis), matching of bill and flower morphology, phenological overlap, phylogenetic constraints, and feeding behavior. The importance of complementary morphology and phenological overlap on the hummingbird-plant network has been extensively studied, while the importance of hummingbird behavior has received less attention. In this work, we evaluated the relative importance of species abundance, morphological matching, and floral energy content in predicting the frequency of hummingbird-plant interactions. Then, we determined whether the hummingbird species' dominance hierarchy is associated with modules within the network. Moreover, we evaluated whether hummingbird specialization (d') is related to bill morphology (bill length and curvature) and dominance hierarchy. Finally, we determined whether generalist core hummingbird species are lees dominant in the community. We recorded plant-hummingbird interactions and behavioral dominance of hummingbird species in a temperate forest in Northwestern Mexico (El Palmito, Mexico). We measured flowers' corolla length and nectar traits and hummingbirds' weight and bill traits. We recorded 2,272 interactions among 13 hummingbird and 10 plant species. The main driver of plant-hummingbird interactions was species abundance, consistent with the neutrality interaction theory. Hummingbird specialization was related to dominance and bill length, but not to bill curvature of hummingbird species. However, generalist core hummingbird species (species that interact with many plant species) were less dominant. The frequency of interactions between hummingbirds and plants was determined by the abundance of hummingbirds and their flowers, and the dominance of hummingbird species determined the separation of the different modules and specialization. Our study suggests that abundance and feeding behavior may play an important role in North America's hummingbird-plant networks.
Asunto(s)
Flores , Néctar de las Plantas , Animales , México , Filogenia , Bosques , Aves , PlantasRESUMEN
ABSTRACT Facultative kleptoparasites face the risk of trying to steal food resources from competitors. This type of interaction is little known, but anecdotal observations indicate that birds of prey may take advantage of their accurate sight to detect the best opportunities for kleptoparasitism. We recorded a camera trap video of an attempt of kleptoparasitism by the white hawk, Pseudastur albicollis, that tried to steal food from a greater grison, Galictis vittata, in a recently selectively-logged forest site in central Brazilian Amazonia. The attempt was unsuccessful as the greater grison responded aggressively to the attack. The event occurred in a linear clearing, which may have increased the bird's ability to detect its potential host. Kleptoparasitic interactions are difficult to detect in forest environments. Recording opportunistic kleptoparasitic interactions in tropical forests may not only depend on the increasing use of camera traps, but also on habitat conditions that facilitate the detection of potential hosts.
RESUMO Cleptoparasitas facultativos enfrentam os custos envolvidos no roubo do alimento em troca da compensação pelo valor nutricional do item roubado. Essa interação é pouco conhecida, mas observações anedóticas indicam que aves de rapina podem se beneficiar de sua visão acurada para cleptoparasitar. Reportamos uma tentativa de cleptoparasitismo de um furão-grande, Galictis vittata, por um gavião-branco, Pseudastur albicollis, em uma floresta na Amazônia central brasileira recentemente manejada para corte seletivo de impacto reduzido. Como o furão-grande respondeu agressivamente ao ataque, a tentativa de roubo falhou. O evento foi registrado por uma armadilha fotográfica em uma clareira linear. O ambiente mais aberto pode ter aumentado a habilidade do gavião-branco em encontrar o seu hospedeiro. Eventos de cleptoparasitismo são dificilmente registrados em ambientes florestais. Registros de cleptoparasitismo em florestas tropicais podem não depender apenas do uso intensivo de armadilhas fotográficas, mas também de condições ambientais favoráveis à detecção de possíveis hospedeiros pelo cleptoparasita.
RESUMEN
Primary penile lymphomas are extremely rare. They are aggressive neoplasms that can present as double-or triple-hit lymphomas, and because the associate with a high risk of central nervous system dissemination, treatment consists of high-dose chemotherapy regimens plus intrathecal prophylaxis. Pathology can be confused with squamous cell carcinoma of the penis, leading to inappropriate treatments and unnecessary amputations. We report the case of a patient diagnosed with clinical Stage IV penile non-Hodgkin lymphoma that was treated with a complete and durable response. In addition, we review the available literature on penile lymphoma.
Asunto(s)
Linfoma no Hodgkin , Linfoma , Masculino , Humanos , Rituximab/uso terapéutico , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfoma/tratamiento farmacológico , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/tratamiento farmacológico , Pene/cirugía , Pene/patologíaRESUMEN
Aggressive periodontitis (AP) is the most serious entity of periodontal disease (stage III/IV, grade C periodontitis according to the latest classification, 2017). Aim: to enhance knowledge of periodontal microbiota in AP in native Argentine patients and describe the effect of a combined pharmacologicalmechanical periodontal treatment on clinical and microbiological parameters. Materials and Method: The study analyzed 42 periodontal sites in 11 patients diagnosed with AP. Clinical periodontal parameters were recorded at baseline, 45, 90 and 180 days. Microbiological samples were taken before treatment and at 180 days. PCR was used to determine presence of the periodontopathic bacteria Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn). Patients underwent periodontal therapy including antibiotics (Amoxicillin 500mg + Metronidazole 250mg; 8hs/7 days), and were reevaluated at 45, 90 and 180 days. Results: Mean age was 28.4 ± 7.9 years. The initial PCR detected the following frequencies: Aa 14.3%, Pi 61.9%, Pg 71.4%, Tf 81.0%, Fn 95.2% and Td 97.6%. Baseline microbiological samples revealed significantly higher prevalence of Pg over Aa (p=0.012). Clinical parameters improved significantly after treatment (73.8% PS<5 mm; PS, NIC, SS p<0.001). At 180 days, a significant decrease in microbiological detection rates was observed (Fn, Td, Tf, Pi, Aa p<0.05). Aa was no longer detectable while Pg did not decrease significantly (p=0.052). Fn was the only study species detected in 100% (n=11:42) of residual pockets (PS≥5 mm) (p=0.053). Conclusion: In the initial samples, there was significant prevalence of Pg over Aa. Significant clinical improvement was achieved after the mechanical-pharmacological treatment, with undetectable levels of Aa, while Fn persisted in residual pockets, and Pg was present at most of the treated sites.
La periodontitis agresiva (PA) es la entidad más grave de la enfermedad periodontal (clasificación 2017: periodontitis estadio III/IV, grado C). Objetivo: mejorar el conocimiento sobre la microbiota periodontal de la PA en sujetos nativos argentinos y describir el efecto de un tratamiento mecánicofarmacológico periodontal sobre los parámetros clínicos y microbiológicos. Materiales y Método: se estudiaron 42 sitios periodontales correspondientes a 11 pacientes con PA. Los parámetros clínicos se registraron a 0, 45, 90 y 180 días. Las tomas microbiológicas se realizaron antes de iniciar el tratamiento y a los 180 días. La determinación de especies periodontopáticas (Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi) y Fusobacterium nucleatum (Fn)) se realizó por PCR. Los pacientes iniciaron terapia básica periodontal junto con antibioticoterapia (Amoxicilina 500 mg + Metronidazol 250 mg; 8 hs/7 días) y fueron evaluados a los 45, 90 y 180 días. Resultados: la edad media fue 28,4 ± 7,9 años. Las detecciones iniciales fueron: Aa 14,3%, Pi 61,9%, Pg 71,4%, Tf 81,0%, Fn 95,2% y Td 97,6%. En las muestras iniciales la prevalencia de Pg sobre Aa fue significativamente superior (p=0,012). Los pacientes tuvieron una respuesta clínica favorable al tratamiento (73,8% PS<5 mm; PS, NIC, SS p<0,001). A 180 días, se observó una disminución estadísticamente significativa en la detección microbiana (Fn, Td, Tf, Pi, Aa p<0,05). En igual plazo, Aa no fue detectado, mientras que Pg mostró una disminución no significativa (p=0,052). Fn fue el único detectado en el 100% (n=11:42) de las bolsas periodontales residuales (PS≥5 mm) (p=0,053). Conclusión: Las muestras iniciales evidenciaron prevalencia significativa de Pg sobre Aa. El tratamiento logró una significativa mejora clínica con niveles indetectables de Aa. La persistencia de Fn en las bolsas residuales y de Pg en la mayoría de los sitios tratados, caracterizaron la muestra poblacional estudiada
Asunto(s)
Periodontitis Agresiva , Humanos , Adulto Joven , Adulto , Porphyromonas gingivalis , Aggregatibacter actinomycetemcomitans , Amoxicilina , Antibacterianos/uso terapéuticoRESUMEN
Desmoid tumors are rare. They account for roughly 0.03% of all neoplasms and less than 3% of all soft tissue tumors. They are locally aggressive tumors with no known metastatic potential or dedifferentiation. A 29-year-old woman with no family history of neoplasms presented with a mass in the cervical region and moderate pain that had developed a year before. The patient underwent marginal resection of the bilateral posterior and lateral compartments of the neck. The histopathological report confirmed the diagnosis of desmoid tumor with nuclear positivity for beta-catenin. The patient received radiotherapy but did not show a favorable response; she has stable disease and takes colchicine at one-year follow-up.
RESUMEN
Somatotroph adenomas are usually controlled with standard therapy, which can include surgery, medical treatment and radiotherapy. Some tumors have a more aggressive behavior and are refractory to standard therapy. In this review, we summarize the phenotype of these tumors and the current options for their management.
Asunto(s)
Acromegalia , Adenoma , Adenoma Hipofisario Secretor de Hormona del Crecimiento , Humanos , Adenoma Hipofisario Secretor de Hormona del Crecimiento/cirugía , Somatostatina , Acromegalia/patología , Adenoma/cirugíaRESUMEN
Resumen El objetivo de esta investigación fue analizar el papel que los factores de personalidad pertenecientes a los Cinco Grandes y la Tríada Oscura -maquiavelismo, narcisismo y psicopatía- tienen en la conducción agresiva. La muestra se compuso de 318 estudiantes universitarios con permiso de conducir, quienes contestaron a una batería de pruebas que evaluaba los factores de personalidad de los Cinco Grandes (TIPI), la Tríada Oscura (DD) y la conducción agresiva (DAS y DAX). Los análisis de regresión jerárquica controlando las variables de edad y sexo, respaldan la utilidad predictiva de los factores de personalidad de los Cinco Grandes y la Tríada Oscura. Los resultados mostraron cómo la afabilidad, la estabilidad emocional y la apertura a la experiencia predicen de manera significativa diversos aspectos de la conducción agresiva. El maquiavelismo y el narcisismo son predictores significativos de diversas formas de expresión de la ira en la conducción, una vez controlados los efectos de los Cinco Grandes.
Abstract The aim of this paper was to analyze the role that personality traits belonging to the Big Five and the Dark Triad (Machiavellianism, narcissism, and psychopathy) have on aggressive driving. 318 undergraduate students with a driver's license completed a battery of tests assessing Big Five personality traits (TIPI), Dark Triad (DD) and aggressive driving (DAS and DAX). Hierarchical regressions analyses controlling for respondents' age and gender variables supported the predictive utility of the Big Five personality traits and the Dark Triad. Results showed that agreeableness, emotional stability and openness to experience predict various aspects of aggressive driving. Machiavellianism and narcissism are significant predictors of various forms of anger expression in driving after controlling for the effects of the Big Five personality traits.
RESUMEN
Introduction: Periodontitis is an inflammatory disease that affects the supporting tissues of teeth, the effects of excess of nitric oxide, may contribute to the symptoms of periodontitis. Objective: To determine the serum nitric oxide concentration in generalized chronic and aggressive periodontitis patients and to compare it with a healthy subject group from the Mexican population. Materials and methods: A case and control study was performed. Sixty-nine individuals were recruited from the Clínica de Posgrado de Periodoncia of the Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México. Patients with clinical features of generalized chronic periodontitis (GCP group, n=19), generalized aggressive periodontitis (GAP group, n=11), and a group of healthy subjects (HS group, n=39) were included in the study. Informed consent was obtained from each subject, and serum nitric oxide concentration was measured by an enzyme-linked immunosorbent assay. Results: Nitric oxide concentration in the study groups was greater in the GCP group (462.57 ± 16.57 µmol/L) than in the GAP group (433.84 ± 18.61 µmol/L) and the HS group (422.46 ± 12.07 µmol/L). A comparison using Student's t-test (one-tailed) between healthy subjects and generalized chronic periodontitis showed borderline significance (p<0.04), whereas no significant differences were observed in HS and GAP groups, with a p-value of 0.64, and the GAP vs. GCP p-value was 0.33. Conclusion: The serum nitric oxide concentration observed in the present study suggests that nitric oxide plays a major role in the inflammatory process, which cannot necessarily be linked to the severity of the disease and periodontal tissue destruction.
Introducción. La periodontitis es una enfermedad inflamatoria que afecta los tejidos de soporte dental; los efectos del exceso de óxido nítrico pueden contribuir a los síntomas de la periodontitis. Objetivo. Determinar la concentración de óxido nítrico en el suero de los pacientes con periodontitis agresiva y crónica generalizada, y compararla con la de individuos sanos de población mexicana. Materiales y métodos. Se trata de un estudio de casos y controles. Se incluyeron 69 individuos de la Clínica de Posgrado de Periodoncia del Centro Universitario de Ciencias de la Salud de la Universidad de Guadalajara. Se dividieron en tres grupos: pacientes con periodontitis crónica generalizada (GCP, n=19), pacientes con periodontitis agresiva generalizada (GAP, n=11) e individuos sanos periodontalmente (HS, n=39). Se obtuvo el consentimiento informado de todos los participantes. Se utililizó la prueba ELISA para medir la concentración de óxido nítrico en suero. Resultados. Las concentraciones de óxido nítrico observadas fueron mayores en el grupo GCP (462,57 ± 16,57 µmol/L) que en los grupos GAP (433,84 ± 18,61 µmol/L) y HS (422,46 ± 12,07 µmol/L). La comparación entre HS y GCP mediante la prueba estadística t de Student (una cola), mostró diferencias significativas (p<0,04), y no se observaron diferencias entre los grupos HS y GAP (p=0,64), ni entre GAP y GCP (p=0,33). Conclusiones. La concentración de óxido nítrico en suero, observada en el presente estudio, sugiere que el óxido nítrico desempeña un importante papel en el proceso inflamatorio, lo que no necesariamente está ligado a la gravedad de la enfermedad ni a la destrucción del tejido periodontal.
RESUMEN
ABSTRACT Aggressive periodontitis (AP) is the most serious entity of periodontal disease (stage III/IV, grade C periodontitis according to the latest classification, 2017). Aim: to enhance knowledge of periodontal microbiota in AP in native Argentine patients and describe the effect of a combined pharmacological-mechanicalperiodontal treatment on clinical and microbiological parameters. Materials andMethod: The study analyzed 42 periodontal sites in 11 patients diagnosed with AP. Clinical periodontal parameters were recorded at baseline, 45, 90 and 180 days. Microbiological samples were taken before treatment and at 180 days. PCR was used to determine presence of the periodontopathic bacteria Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn). Patients underwent periodontal therapy including antibiotics (Amoxicillin 500mg + Metronidazole 250mg; 8hs/7 days), and were reevaluated at 45, 90 and 180 days. Results: Mean age was 28.4 ± 7.9 years. The initial PCR detected the following frequencies: Aa 14.3%, Pi 61.9%, Pg 71.4%, Tf 81.0%, Fn 95.2% and Td 97.6%. Baseline microbiological samples revealed significantly higher prevalence of Pg over Aa (p=0.012). Clinical parameters improved significantly after treatment (73.8% PS<5 mm; PS, NIC, SS p<0.001). At 180 days, a significant decrease in microbiological detection rates was observed (Fn, Td, Tf, Pi, Aa p<0.05). Aa was no longer detectable while Pg did not decrease significantly (p=0.052). Fn was the only study species detected in 100% (n=11:42) of residual pockets (PS>5 mm) (p=0.053). Conclusion: In the initial samples, there was significant prevalence of Pg over Aa. Significant clinical improvement was achieved after the mechanical-pharmacological treatment, with undetectable levels ofAa, while Fn persisted in residual pockets, and Pg was present at most of the treated sites.
RESUMEN La periodontitis agresiva (PA) es la entidad más grave de la enfermedad periodontal (clasificación 2017: periodontitis estadio III/IV, grado C). Objetivo: mejorar el conocimiento sobre la microbiota periodontal de la PA en sujetos nativos argentinos y describir el efecto de un tratamiento mecánico-farmacológico periodontal sobre los parámetros clínicos y microbiológicos. Materiales y Método: se estudiaron 42 sitios periodontales correspondientes a 11 pacientes con PA. Los parámetros clínicos se registraron a 0, 45, 90 y 180 días. Las tomas microbiológicas se realizaron antes de iniciar el tratamiento y a los 180 días. La determinación de especies periodontopáticas (Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf, Treponema denticola (Td), Prevotella intermedia (Pi) y Fusobacterium nucleatum (Fn)) se realizó por PCR. Los pacientes iniciaron terapia básica periodontal junto con antibioticoterapia (Amoxicilina 500 mg + Metronidazol 250 mg; 8 hs/7 días) y fueron evaluados a los 45, 90 y 180 días. Resultados: la edad media fue 28,4 ± 7,9 años. Las detecciones iniciales fueron: Aa 14,3%, Pi 61,9%, Pg 71,4%, Tf 81,0%, Fn 95,2% y Td 97,6%. En las muestras iniciales la prevalencia de Pg sobre Aa fue significativamente superior (p=0,012). Los pacientes tuvieron una respuesta clínica favorable al tratamiento (73,8% PS<5 mm; PS, NIC, SS p<0,001). A 180 días, se observó una disminución estadísticamente significativa en la detección microbiana (Fn, Td, Tf, Pi, Aa p<0,05). En igual plazo, Aa no fue detectado, mientras que Pg mostró una disminución no significativa (p=0,052). Fn fue el único detectado en el 100% (n=11:42) de las bolsas periodontales residuales (PS>5 mm) (p=0,053). Conclusión: Las muestras iniciales evidenciaron prevalencia significativa de Pg sobre Aa. El tratamiento logró una significativa mejora clínica con niveles indetectables de Aa. La persistencia de Fn en las bolsas residuales y de Pg en la mayoría de los sitios tratados, caracterizaron la muestra poblacional estudiada.