RESUMO
Rearrangements and overexpression of CRLF2 are hallmarks of poor outcomes in BCR::ABL1-like B-ALL, and CRLF2 overexpression is a high-risk marker in T-ALL. However, CRLF2 alterations in pediatric hematologic malignancies other than B-ALL have not been reported. In this study, we analyzed the CRLF2 overexpression, rearrangements (P2RY8::CRLF2 and IGH::CRLF2), activation (pSTAT5 and pERK), and the expression of dominant-negative IKZF1 isoforms (Ik6 and Ik8), implied in CRLF2 dysregulation, in 16 pediatric patients (AML, n = 9; T-ALL, n = 3; LBL, n = 2; HL, n = 1; cytopenia, n = 1). A high frequency of CRLF2 rearrangements and overexpression was found in the 16 patients: 28.6% (4/14) showed CRLF2 overexpression, 93.8% (15/16) were positive for CRLF2 total protein (cell-surface and/or cytoplasmic), while 62.5% (10/16) were positive for P2RY8::CRLF2 and 12.6% (2/16) for IGH::CRLF2. In addition, 43.8% (7/16) expressed Ik6 and Ik8 isoforms. However, only a few patients were positive for the surrogate markers pSTAT5 (14.3%; 2/14) and pERK (21.4%; 3/14).
RESUMO
Ph-like subtypes with CRLF2 abnormalities are frequent among Hispano-Latino children with pre-B ALL. Therefore, there is solid ground to suggest that this subtype is frequent in Mexican patients. The genomic complexity of Ph-like subtype constitutes a challenge for diagnosis, as it requires diverse genomic methodologies that are not widely available in diagnostic centers in Mexico. Here, we propose a diagnostic strategy for Ph-like ALL in accordance with our local capacity. Pre-B ALL patients without recurrent gene fusions (104) were classified using a gene-expression profile based on Ph-like signature genes analyzed by qRT-PCR. The expressions of the CRLF2 transcript and protein were determined by qRT-PCR and flow cytometry. The P2RY8::CRLF2, IGH::CRLF2, ABL1/2 rearrangements, and Ik6 isoform were screened using RT-PCR and FISH. Surrogate markers of Jak2-Stat5/Abl/Ras pathways were analyzed by phosphoflow. Mutations in relevant kinases/transcription factors genes in Ph-like were assessed by target-specific NGS. A total of 40 patients (38.5%) were classified as Ph-like; of these, 36 had abnormalities associated with Jak2-Stat5 and 4 had Abl. The rearrangements IGH::CRLF2,P2RY8::CRLF2, and iAMP21 were particularly frequent. We propose a strategy for the detection of Ph-like patients, by analyzing the overexpression/genetic lesions of CRLF2, the Abl phosphorylation of surrogate markers confirmed by gene rearrangements, and Sanger sequencing.
Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras B , Leucemia-Linfoma Linfoblástico de Células Precursoras , Rearranjo Gênico , Humanos , México , Leucemia-Linfoma Linfoblástico de Células Precursoras B/metabolismo , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Receptores de Citocinas/genética , Receptores de Citocinas/metabolismo , Fator de Transcrição STAT5/metabolismoRESUMO
The P2RY8-CRLF2 and IGH-CRLF2 rearrangements induce the overexpression of cytokine receptor-like factor 2 (CRLF2) and have been associated with relapse and poor prognosis in B-cell acute lymphoblastic leukemia (B-ALL). Additionally, they are frequently documented in high-risk Hispanic populations. To better understand the potential causes of the adverse prognosis of childhood B-ALL in Mexico, we analyzed these rearrangements and the CRLF2 mRNA and protein levels in 133 Mexican children with B-ALL. We collected bone marrow samples at diagnosis and evaluated the CRLF2 gene expression by qRT-PCR and the total CRLF2 protein by flow cytometry. P2RY8-CRLF2 and IGH-CRLF2 were detected by RT-PCR and FISH, respectively. The median time of follow-up to determine the prognostic significance of the CRLF2 abnormalities was three years. In 82% of the participants, the mRNA levels correlated with the cell-surface and intracellular CRLF2 protein levels. The P2RY8-CRLF2 rearrangement was present in 31.5% (42/133) of the patients, while the IGH-CRLF2 rearrangement was detected in 13.5% (9/67) of patients with high expression of CRLF2 (6.8% of the total sample). CRLF2 copy number variations (gain) were also detected in 7.5% (5/67) of patients with high protein levels. The overall survival (OS) presented significantly lower rates in patients with high white blood cell count (≥50x109/L) regardless of CRLF2 expression, but high levels of CRLF2 gene expression appears to contribute to the reduction of OS within this group of patients. In conclusion, in our cohort, a high occurrence of CRLF2 abnormalities was documented, particularly the P2RY8-CRLF2 rearrangement, which might represent a characteristic of the Mexican population. Targeted therapy to treat this group of patients could improve OS.
Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras B , Leucemia-Linfoma Linfoblástico de Células Precursoras , Variações do Número de Cópias de DNA , Humanos , México , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Prognóstico , RNA Mensageiro/genética , Receptores de Citocinas/genéticaRESUMO
The gene fusions BCR-ABL1, TCF3-PBX1, and ETV6-RUNX1 are recurrent in B-cell acute lymphoblastic leukemia (B-ALL) and are found with low frequency in coexistence with CRLF2 (cytokine receptor-like factor 2) rearrangements and overexpression. There is limited information regarding the CRLF2 abnormalities and dominant-negative IKZF1 isoforms associated with surrogate markers of Jak2, ABL, and Ras signaling pathways. To assess this, we evaluated 24 Mexican children with B-ALL positive for recurrent gene fusions at diagnosis. We found CRLF2 rearrangements and/or overexpression, dominant-negative IKZF1 isoforms, and surrogate phosphorylated markers of signaling pathways coexisting with recurrent gene fusions. All the BCR-ABL1 patients expressed CRLF2 and were positive for pCrkl (ABL); most of them were also positive for pStat5 (Jak2/Stat5) and negative for pErk (Ras). TCF3-PBX1 patients with CRLF2 abnormalities were positive for pStat5, most of them were also positive for pCrkl, and two patients were also positive for pErk. One patient with ETV6-RUNX1 and intracellular CRLF2 protein expressed pCrkl. In some cases, the activated signaling pathways were reverted in vitro by specific inhibitors. We further analyzed a TCF3-PBX1 patient at relapse, identifying a clone with the recurrent gene fusion, P2RY8-CRLF2, rearrangement, and phosphorylation of the three surrogate markers that we studied. These results agree with the previous reports regarding resistance to treatment observed in patients with recurrent gene fusions and coexisting CRLF2 gene abnormalities. A marker phosphorylation signature was identified in BCR-ABL1 and TCF3-PBX1 patients. To obtain useful information for the assessment of treatment in B-ALL patients with recurrent gene fusions, we suggest that they should be evaluated at diagnosis for CRLF2 gene abnormalities and dominant-negative IKZF1 isoforms, in addition to the analyses of activation and inhibition of signaling pathways.
Assuntos
Fusão Gênica , Fator de Transcrição Ikaros/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Receptores de Citocinas/genética , Transdução de Sinais/genética , Biomarcadores/análise , Criança , Pré-Escolar , Proteínas de Fusão bcr-abl/genética , Rearranjo Gênico , Humanos , México , Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Isoformas de Proteínas/genéticaRESUMO
A standardized immunochemistry method for the diagnosis of clostridial myonecrosis was applied to 38 formalized tissue samples from ruminants with clinical and post mortem history suggestive of blackleg or gas gangrene. The diagnosis of clostridial myonecrosis was confirmed in 37 out of 38 (97.4%) samples tested. Clostridium chauvoei and Clostridium perfringens type A were the most common agents found alone, being detected in ten (26.3%) and six (15.8%) samples, respectively. The other cases showed an association of two or three clostridia, with C. perfringens type A detected in 11 (29%) cases. Based on the findings of the present study, polyvalent vaccines against clostridial infections of animals incorporating C. perfringens would be more adequate for preventative purposes in the endemic areas.(AU)
Imuno-istoquímica padronizada para avaliar o diagnóstico etiológico de mionecrose por agentes do gênero Clostridium foi utilizada em 38 tecidos formalizados de ruminantes com suspeita clínica e macroscópica, além de histopatologia compatível com carbúnculo sintomático ou gangrena gasosa. O diagnóstico de mionecrose foi confirmado em 37 das 38 (97,4%) amostras avaliadas. Clostridium chauvoei e Clostridium perfringens tipo A foram os únicos agentes encontrados sozinhos, sendo detectados em dez (26,3%) e seis (15,8%) amostras, respectivamente. Os outros casos foram causados por combinações de dois ou mais agentes, sendo que C. perfringens type A foi detectado em dez (29,9%) dessas amostras. Baseado nos resultados obtidos, sugere-se que vacinas polivalentes contendo C. perfringens seriam mais adequadas para prevenção de mionecrose causada por clostrídios.(AU)
Assuntos
Animais , Bovinos , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/veterinária , Edema/veterinária , Ovinos , Clostridium perfringens , Clostridium chauvoei , Gangrena Gasosa/veterinária , Imuno-Histoquímica/veterináriaRESUMO
A standardized immunochemistry method for the diagnosis of clostridial myonecrosis was applied to 38 formalized tissue samples from ruminants with clinical and post mortem history suggestive of blackleg or gas gangrene. The diagnosis of clostridial myonecrosis was confirmed in 37 out of 38 (97.4%) samples tested. Clostridium chauvoei and Clostridium perfringens type A were the most common agents found alone, being detected in ten (26.3%) and six (15.8%) samples, respectively. The other cases showed an association of two or three clostridia, with C. perfringens type A detected in 11 (29%) cases. Based on the findings of the present study, polyvalent vaccines against clostridial infections of animals incorporating C. perfringens would be more adequate for preventative purposes in the endemic areas.
Imuno-istoquímica padronizada para avaliar o diagnóstico etiológico de mionecrose por agentes do gênero Clostridium foi utilizada em 38 tecidos formalizados de ruminantes com suspeita clínica e macroscópica, além de histopatologia compatível com carbúnculo sintomático ou gangrena gasosa. O diagnóstico de mionecrose foi confirmado em 37 das 38 (97,4%) amostras avaliadas. Clostridium chauvoei e Clostridium perfringens tipo A foram os únicos agentes encontrados sozinhos, sendo detectados em dez (26,3%) e seis (15,8%) amostras, respectivamente. Os outros casos foram causados por combinações de dois ou mais agentes, sendo que C. perfringens type A foi detectado em dez (29,9%) dessas amostras. Baseado nos resultados obtidos, sugere-se que vacinas polivalentes contendo C. perfringens seriam mais adequadas para prevenção de mionecrose causada por clostrídios.
Assuntos
Animais , Bovinos , Clostridium chauvoei , Clostridium perfringens , Edema/veterinária , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/veterinária , Ovinos , Gangrena Gasosa/veterinária , Imuno-Histoquímica/veterináriaRESUMO
Extracellular nucleotides are signaling elements present in the tumor microenvironment; however, their role in tumor growth is not completely understood. In the present study, we asked whether nucleotides regulate cell migration in ovarian carcinoma-derived cells. We observed that 100 µM UTP induced migration in SKOV-3 cells (1.57 ± 0.08 fold over basal), and RT-PCR showed expression of transcripts for the P2RY2 and P2RY4 receptors. Knockdown of P2RY2 expression in SKOV-3 cells (P2RY2-KD) abolished the UTP-induced migration. The mechanism activated by UTP to induce migration involves transactivation of the epidermal growth factor receptor (EGFR) since we observed that the EGFR kinase inhibitor AG1478 and the PI3K inhibitor Wortmannin inhibit this response (to 0.76 ± 0.23 and 0.46 ± 0.14 relative to the control, respectively). In agreement with these observations, UTP was able to modify the phosphorylation state of the EGFR; likewise, the induction of ERK1/2 phosphorylation promoted by UTP was abolished by a 30-60 min treatment with AG1478. Our data also suggested that the enhanced cell migration involves the epithelium to mesenchymal transition (EMT) process, since a 12 h stimulation of SKOV-3 cells with 100 µM UTP showed an increase in vimentin and SNAIL protein levels (459.8 ± 132.4% over basal for SNAIL). Interestingly, treatment with apyrase (10 U/mL) reduces the migration of control cells and induces a considerable enrichment of E-cadherin in the cell-cell contacts, favoring an epithelial phenotype and strongly suggesting that the nucleotides released by tumor cells and acting through the P2RY2 receptor are potential regulators of invasiveness.
Assuntos
Células Epiteliais/efeitos dos fármacos , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Receptores ErbB/genética , Regulação Neoplásica da Expressão Gênica , Receptor Cross-Talk/efeitos dos fármacos , Receptores Purinérgicos P2Y2/genética , Uridina Trifosfato/farmacologia , Androstadienos/farmacologia , Caderinas/genética , Caderinas/metabolismo , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Receptores ErbB/metabolismo , Feminino , Humanos , Proteína Quinase 1 Ativada por Mitógeno/antagonistas & inibidores , Proteína Quinase 1 Ativada por Mitógeno/genética , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/antagonistas & inibidores , Proteína Quinase 3 Ativada por Mitógeno/genética , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Ovário/efeitos dos fármacos , Ovário/metabolismo , Ovário/patologia , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase , Fosforilação/efeitos dos fármacos , Inibidores de Proteínas Quinases/farmacologia , Quinazolinas/farmacologia , Receptores Purinérgicos P2Y2/metabolismo , Transdução de Sinais , Fatores de Transcrição da Família Snail , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Tirfostinas/farmacologia , Uridina Trifosfato/metabolismo , Vimentina/genética , Vimentina/metabolismo , WortmaninaRESUMO
Twenty horses were used in the experiment, for composed control group, (Cg) instrumented group, (Ig;without intestinal obstruction), treated group (Tg;submitted to intestinal obstruction and hydrocortisone treatment) and non-treated group (Ntg;submitted to intestinal obstruction without treatment). Immunohistochemistry and zymography techniques were used for researches on MMPs 2 and 9 in horse hoof laminae. There was an increase in the expression of MMP-2 in animals of Tg and Ntg. MMP-9 increased on animals from groups Ntg and Ig, however there was no rise of this MMP on the Tg when compared to the other groups in the immunohistochemistry analysis. Based on the results, it was observed that the intestinal injury caused by enterotomy and intestinal obstruction raise the quantities of MMPs in the hoof laminae.
Vinte cavalos foram usados no experimento: para compor o grupo controle (Cg), grupo instrumentado, Ig (sem obstrução intestinal), grupo tratado, Tg (submetidos à obstrução intestinal e tratamento com hidrocortisona) e grupo não tratado, Ntg (submetidos à obstrução intestinal, sem tratamento. Técnicas de zimografia e imunoistoquímica foram utilizadas para pesquisa de MMP-2 e MMP-9 no tecido laminar do casco dos equinos. Houve um aumento na expressão de MMP-2 nos animais dos grupos Tg e Ntg. A MMP-9 aumentou nos animais dos grupos Ig e Ntg. Houve aumento desta MMP no Tg quando comparado aos demais grupos na análise por zimografia. Observou-se que a injúria intestinal, causada pela enterotomia e obstrução intestinal, eleva a quantidade de MMPs no tecido laminar do casco.
RESUMO
Twenty horses were used in the experiment, for composed control group, (Cg) instrumented group, (Ig;without intestinal obstruction), treated group (Tg;submitted to intestinal obstruction and hydrocortisone treatment) and non-treated group (Ntg;submitted to intestinal obstruction without treatment). Immunohistochemistry and zymography techniques were used for researches on MMPs 2 and 9 in horse hoof laminae. There was an increase in the expression of MMP-2 in animals of Tg and Ntg. MMP-9 increased on animals from groups Ntg and Ig, however there was no rise of this MMP on the Tg when compared to the other groups in the immunohistochemistry analysis. Based on the results, it was observed that the intestinal injury caused by enterotomy and intestinal obstruction raise the quantities of MMPs in the hoof laminae.
Vinte cavalos foram usados no experimento: para compor o grupo controle (Cg), grupo instrumentado, Ig (sem obstrução intestinal), grupo tratado, Tg (submetidos à obstrução intestinal e tratamento com hidrocortisona) e grupo não tratado, Ntg (submetidos à obstrução intestinal, sem tratamento. Técnicas de zimografia e imunoistoquímica foram utilizadas para pesquisa de MMP-2 e MMP-9 no tecido laminar do casco dos equinos. Houve um aumento na expressão de MMP-2 nos animais dos grupos Tg e Ntg. A MMP-9 aumentou nos animais dos grupos Ig e Ntg. Houve aumento desta MMP no Tg quando comparado aos demais grupos na análise por zimografia. Observou-se que a injúria intestinal, causada pela enterotomia e obstrução intestinal, eleva a quantidade de MMPs no tecido laminar do casco.
RESUMO
A 2-year-old Japanese quail (Coturnix coturnix japonica), female, which stopped egg production presented: weight loss, increased abdominal volume, and death. Macroscopically, it was observed: ascites, whitish left lung, whitish masses measuring 1.0cm in diameter in the caudal right lobe of the liver and in the gizzard serosa; 0.1-0.5cm masses in the mesentery and intestinal serosa; and a 5.0x2.0cm mass in synsacral area that encompassed 90% of the renal parenchyma and part of ovary and oviduct. Histologically, epithelial cells proliferation with formation of tubules, sometimes without lumen supported by mild fibrovascular stroma and multifocal necrosis was observed in the renal mass. The neoplastic cells were cuboidal, with round to oval nuclei, and evident nucleolus, abundant eosinophilic cytoplasm, moderated pleomorphism. Mitotic figures were rare. Metastasis was seen diffuse in ovary, oviduct, left lung, multifocal in intestinal serosa, focal in liver and serosal and muscular layer in gizzard. Immunohistochemically, tumors cells were positive for cytokeratin (clones AE1+AE3) and negative for cytokeratin 5/6, CD10 and placental alkaline phosphatase. According to localization, morphology features and immunohistochemistry evaluation, the present study reports a metastatic renal adenocarcinoma.
Uma codorna japonesa (Coturnix coturnix japonica), fêmea, adulta com 2 anos apresentou parada de postura, emagrecimento, aumento de volume abdominal e morte. Ao exame macroscópico, observou-se ascite, pulmão esquerdo difusamente esbranquiçado, massas esbranquiçadas, de aproximadamente 1,0cm de diâmetro, na região caudal do lobo direito do fígado e na serosa da moela; massas de 0,1 a 0,5cm no mesentério e serosa intestinal; e uma massa de 5,0x2,0cm na fossa do sinsacro, que acometia 90% do parênquima renal e estendia-se ao ovário e oviduto. Na avaliação histopatológica da neoformação renal, observou-se proliferação de células epiteliais formando túbulos, que muitas vezes não apresentavam lúmen, sustentados por um estroma fibrovascular escasso associado à necrose multifocal. As células neoplásicas eram cuboidais, núcleos redondos a ovalados, nucléolos evidentes, citoplasma abundante e eosinofílico, pleomorfismo moderado e poucas figuras mitóticas. Metástases foram observadas de forma difusa no ovário, oviduto e pulmão esquerdo; multifocal na serosa do intestino e focal no fígado e camadas muscular e serosa da moela. Na avaliação imuno-histoquímica, as células tumorais foram positivas para a citoqueratina (clones AE1+AE3) e negativas para a citoqueratina 5/6, o CD10 e a fosfatase alcalina placentária. De acordo com a localização, achados morfológicos e o perfil imuno-histoquímico, conclui-se que o presente relato trata-se de um adenocarcinoma renal metastático.
RESUMO
A 2-year-old Japanese quail (Coturnix coturnix japonica), female, which stopped egg production presented: weight loss, increased abdominal volume, and death. Macroscopically, it was observed: ascites, whitish left lung, whitish masses measuring 1.0cm in diameter in the caudal right lobe of the liver and in the gizzard serosa; 0.1-0.5cm masses in the mesentery and intestinal serosa; and a 5.0x2.0cm mass in synsacral area that encompassed 90% of the renal parenchyma and part of ovary and oviduct. Histologically, epithelial cells proliferation with formation of tubules, sometimes without lumen supported by mild fibrovascular stroma and multifocal necrosis was observed in the renal mass. The neoplastic cells were cuboidal, with round to oval nuclei, and evident nucleolus, abundant eosinophilic cytoplasm, moderated pleomorphism. Mitotic figures were rare. Metastasis was seen diffuse in ovary, oviduct, left lung, multifocal in intestinal serosa, focal in liver and serosal and muscular layer in gizzard. Immunohistochemically, tumors cells were positive for cytokeratin (clones AE1+AE3) and negative for cytokeratin 5/6, CD10 and placental alkaline phosphatase. According to localization, morphology features and immunohistochemistry evaluation, the present study reports a metastatic renal adenocarcinoma.
Uma codorna japonesa (Coturnix coturnix japonica), fêmea, adulta com 2 anos apresentou parada de postura, emagrecimento, aumento de volume abdominal e morte. Ao exame macroscópico, observou-se ascite, pulmão esquerdo difusamente esbranquiçado, massas esbranquiçadas, de aproximadamente 1,0cm de diâmetro, na região caudal do lobo direito do fígado e na serosa da moela; massas de 0,1 a 0,5cm no mesentério e serosa intestinal; e uma massa de 5,0x2,0cm na fossa do sinsacro, que acometia 90% do parênquima renal e estendia-se ao ovário e oviduto. Na avaliação histopatológica da neoformação renal, observou-se proliferação de células epiteliais formando túbulos, que muitas vezes não apresentavam lúmen, sustentados por um estroma fibrovascular escasso associado à necrose multifocal. As células neoplásicas eram cuboidais, núcleos redondos a ovalados, nucléolos evidentes, citoplasma abundante e eosinofílico, pleomorfismo moderado e poucas figuras mitóticas. Metástases foram observadas de forma difusa no ovário, oviduto e pulmão esquerdo; multifocal na serosa do intestino e focal no fígado e camadas muscular e serosa da moela. Na avaliação imuno-histoquímica, as células tumorais foram positivas para a citoqueratina (clones AE1+AE3) e negativas para a citoqueratina 5/6, o CD10 e a fosfatase alcalina placentária. De acordo com a localização, achados morfológicos e o perfil imuno-histoquímico, conclui-se que o presente relato trata-se de um adenocarcinoma renal metastático.
RESUMO
Este trabalho relata o caso de uma paciente felina que estava sendo tratada para rinite crônica há cerca de sete meses, sem apresentar qualquer recuperação. Ao exame físico foi constatada mobilida¬de do dente canino superior direito, associada a severo comprometimento periodontal. Após exame físico e radiológico, diagnosticou-se abscesso periapical e fístula oronasal, com drenagem tanto para a narina quanto para o saco conjuntival. O tratamento foi executado sob anestesia geral dissociativa, e incluiu exodontia do dente canino relacionado à fístula oronasal, e de diversos outros elementos dentais também severamente comprometidos. Adicionalmente realizou-se tratamento periodontal nos dentes remanescentes, e a paciente recebeu cuidados de enfermagem e medicação antibiótica e anti-inflamatória. O tratamento surtiu excelente efeito, e apesar de suas péssimas condições prévias, a evolução da paciente foi extremamente satisfatória, em curto espaço de tempo. Esse caso mostra a grande importância de um exame clínico odontológico completo e acurado, viabilizando diagnóstico adequado e tratamento apropriado. A demora em diagnosticar problemas dessa natureza e instituir precocemente o tratamento adequado, redunda em grande sofrimento e importante comprometimen¬to da qualidade de vida, especialmente em pacientes geriátricos(AU)
This paper reports the case of a feline patient treated for chronic rhinitis for seven months, without any results. The physical examination showed mobility and severe periodontal disease in the upper right canine tooth. After physical and radiographic evaluation the diagnosis was periapical abscess and oronasal fistula draining to the nare and the conjunctival sac. Treatment was performed under dissociative general anesthesia and included extraction of that canine tooth and other diseased teeth, as well as periodontal treatment for the remaining teeth. The patient also received antibiotic and an¬tinflamatory drugs, and pos-op nursing. The treatment was successful and even with its bad previous conditions; patient' s evolution was extremely satisfactory in a short period of time. This case shows the great importance of a complete and accurate physical examination, making possible the correct diagnostic and treatment. Delay in diagnosing this kind of problem and establish the appropriated treatment causes suffering and compromises the quality of life, especially in geriatric patients(AU)
Assuntos
Animais , Ratos , Fístula , Cirurgia Bucal , Periodontia , Gatos , Abscesso Periapical/veterináriaRESUMO
Este trabalho relata o caso de uma paciente felina que estava sendo tratada para rinite crônica há cerca de sete meses, sem apresentar qualquer recuperação. Ao exame físico foi constatada mobilida¬de do dente canino superior direito, associada a severo comprometimento periodontal. Após exame físico e radiológico, diagnosticou-se abscesso periapical e fístula oronasal, com drenagem tanto para a narina quanto para o saco conjuntival. O tratamento foi executado sob anestesia geral dissociativa, e incluiu exodontia do dente canino relacionado à fístula oronasal, e de diversos outros elementos dentais também severamente comprometidos. Adicionalmente realizou-se tratamento periodontal nos dentes remanescentes, e a paciente recebeu cuidados de enfermagem e medicação antibiótica e anti-inflamatória. O tratamento surtiu excelente efeito, e apesar de suas péssimas condições prévias, a evolução da paciente foi extremamente satisfatória, em curto espaço de tempo. Esse caso mostra a grande importância de um exame clínico odontológico completo e acurado, viabilizando diagnóstico adequado e tratamento apropriado. A demora em diagnosticar problemas dessa natureza e instituir precocemente o tratamento adequado, redunda em grande sofrimento e importante comprometimen¬to da qualidade de vida, especialmente em pacientes geriátricos
This paper reports the case of a feline patient treated for chronic rhinitis for seven months, without any results. The physical examination showed mobility and severe periodontal disease in the upper right canine tooth. After physical and radiographic evaluation the diagnosis was periapical abscess and oronasal fistula draining to the nare and the conjunctival sac. Treatment was performed under dissociative general anesthesia and included extraction of that canine tooth and other diseased teeth, as well as periodontal treatment for the remaining teeth. The patient also received antibiotic and an¬tinflamatory drugs, and pos-op nursing. The treatment was successful and even with its bad previous conditions; patient' s evolution was extremely satisfactory in a short period of time. This case shows the great importance of a complete and accurate physical examination, making possible the correct diagnostic and treatment. Delay in diagnosing this kind of problem and establish the appropriated treatment causes suffering and compromises the quality of life, especially in geriatric patients
Assuntos
Animais , Ratos , Abscesso Periapical/veterinária , Cirurgia Bucal , Fístula , Gatos , PeriodontiaRESUMO
Se realizó un ensayo clínico fase II temprano, unicéntrico, abierto y secuencial en la Clínica Estomatológica "Tula Aguilera", desde Octubre de 2004 a Mayo de 2005, con el objetivo de evaluar la eficacia del tratamiento homeopático en la alveolitis dental. Se incluyeron en la investigación a los pacientes con este diagnóstico clínico y sin tratamiento previo. La muestra quedó conformada por 31 pacientes, a los que se les aplicó caléndula homeopática a la 30cH en el alvéolo y se les indicó, según la modalización de sus síntomas, los remedios homeopáticos: cinco gotas sublinguales tres veces al día. El resultado del tratamiento se determinó clínicamente a las 24, 48 y 72h según una escala establecida, donde se consideraron las variables inflamación y dolor. De forma general se evalúo como eficaz el tratamiento realizado y los resultados más significativos se obtuvieron a las 48h del mismo, además se detectó una relación entre factores generales y el retardo en la reparación tisular. La presencia de agravaciones homeopáticas se pudo identificar en dos pacientes y éstas no obstaculizaron la realización del tratamiento. La mayoría de los pacientes manifestaron su satisfacción con el tratamiento recibido.
An early phase II clinical trial, unicentric, open and sequential was conducted at "Tula Aguilera", Odontology Clinic from October 2004 to May 2005, with the objective to evaluate the efficacy of the homeopathic treatment in the dental alveolitis. It were included in the investigation the patients with this clinical diagnosis and without previous treatment. The sample remained conformed by 31 patients, to the ones it were applied homeopathic calendula to the 30cH in the socket and it were indicated them, according to the modalization of its symptoms, the homeopathic remedies: five sublingual drops three times a day. The result of the treatment was clinically determined at 24, 48 and 72h according to an established scale, where inflammation and pain variables were considered. In general, it was evaluated as efficient the applied treatment and the most significant results were obtained at the 48h after that, besides a relation between general factors and the retardation in the tissular repair, was detected. The presence of homeopathic aggravations could be only identified in two patients and these did not hinder carrying out the treatment. The majority of the patients declared their satisfaction with the treatment received.