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Article ; Online: Bone pattern changes in post liver transplant patients using bisphosphonates.

Bueno, Marcus Vinícius / Munhoz, Luciana / Ortega, Karem L / Peres, Maria Paula Siqueira de Melo / Franco, Juliana Bertoldi

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry

2024

Abstract: Objective: To identify radiographic findings suggestive of drug-induced osteonecrosis and evaluate radiomorphometric patterns indicative of changes in bone mineral density in individuals transplanted for liver disorders using bisphosphonates.: Study ... ...

Abstract	Objective: To identify radiographic findings suggestive of drug-induced osteonecrosis and evaluate radiomorphometric patterns indicative of changes in bone mineral density in individuals transplanted for liver disorders using bisphosphonates. Study design: The study group included panoramic x-rays of liver transplant patients who are being monitored and who present a clinical status of osteoporosis and use bisphosphonates. The control group was made up of liver transplant patients who did not have osteoporosis. On panoramic radiographs, mental index (MI) and mandibular cortical index (MCI) and the presence of radiographic anomalies suggestive of osteonecrosis were evaluated. Results: There were significant statistical results when comparing the groups in relation to the decrease in bone mineral density (BMD) with MCI-C3 (p = 0.036), however, there were none in relation to MI (p = 0.14). There were no valid statistical results when relating MCI (p = 0.94) and MI (p = 0.66) with reduced BMD and use of bisphosphonates. Conclusion: Liver transplant individuals using bisphosphonates present greater radiographic signs of bone sclerosis suggestive of a greater propensity to develop osteonecrosis of the jaw and an increased risk of presenting changes suggestive of reduced bone mineral density on panoramic radiographs when compared to liver transplant individuals not using bisphosphonates.
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	604118-8
ISSN	1754-4505 ; 0275-1879
ISSN (online)	1754-4505
ISSN	0275-1879
DOI	10.1111/scd.12992
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Article ; Online: Mucocutaneous histoplasmosis as the first manifestation of AIDS.

Medina, Janaina B / Monguilhott-Falbo, Francèle / Teixeira-Leite, Cristiane / Trierveiler, Marilia / Braz-Silva, Paulo Henrique / Ortega, Karem L

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry

2024

Abstract: Immunosuppressed patients can present with opportunistic infections resulting from an intrinsic systemic disease, which easily evolves into more aggressive and less common conditions. This work reports a clinical case of a female patient with ... ...

Abstract	Immunosuppressed patients can present with opportunistic infections resulting from an intrinsic systemic disease, which easily evolves into more aggressive and less common conditions. This work reports a clinical case of a female patient with histoplasmosis lesions in the nasal and oral mucosa, including pulmonary, hematological, and hepatic impairment, which led to the diagnosis of HIV seropositivity. In the presence of severe immunosuppression, morbidity is increased due to deep fungal infections and their unusual clinical characteristics can make diagnosis difficult. Therefore, it can be very helpful to recognize these clinical characteristics in order to determine early diagnostic interventions. It is important to recognize mucocutaneous manifestations of histoplasmosis because the biopsy of these lesions, and subsequent histopathological analysis, is one of the quickest, safest, and cheapest methods of diagnosis.
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Case Reports
ZDB-ID	604118-8
ISSN	1754-4505 ; 0275-1879
ISSN (online)	1754-4505
ISSN	0275-1879
DOI	10.1111/scd.12972
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Article ; Online: Nitrogenous compounds in the saliva and blood of cirrhotic patients: a cross-sectional study.

Duarte, Nathália Tuany / Tenório, Jefferson R / Andrade, Natália Silva / Martins, Fabiana / Gallottini, Marina / Ortega, Karem L

Clinical oral investigations

2022 Volume 26, Issue 6, Page(s) 4587–4592

Abstract: Objectives: Serum increase of nitrogenous compounds (NC) in cirrhotic patients has been associated with the development of hepatic encephalopathy (HE). However, the relation between NC in saliva and HE is unclear. The objective of this study is to ... ...

Abstract	Objectives: Serum increase of nitrogenous compounds (NC) in cirrhotic patients has been associated with the development of hepatic encephalopathy (HE). However, the relation between NC in saliva and HE is unclear. The objective of this study is to measure the levels of nitric oxide and urea in the blood and saliva in 38 cirrhotic patients and correlate them with clinical characteristics and presence and grades of HE. Material and methods: Automated enzymatic colourimetric assays were performed to determine the levels of NC. Diagnosis and severity of HE were determined based on the West Haven criteria and by using the inhibitory control test. Results: HE was diagnosed in 89.47% of the patients, with the majority (60.50%) presenting covert HE. With regard to the measurement of NC, although nitric oxide is moderately correlated with its amount in blood and saliva (r = 0.630; P < 0.001), only salivary levels were associated with the presence of ascites and ecchymosis (P = 0.013 and P = 0.030, respectively). In patients with HE, the serum levels of urea were higher (P = 0.013) than those in patients without HE or minimal HE. Conclusions: Nitrogenous compounds in the saliva were correlated with neither the presence nor grades of HE, whereas in the blood, only urea was positively correlated with the severity and presence of HE. Clinical relevance: Saliva is an excellent fluid for diagnosing several diseases, but it does not seem to be able to collaborate with the identification of HE.
MeSH term(s)	Cross-Sectional Studies ; Hepatic Encephalopathy/complications ; Hepatic Encephalopathy/diagnosis ; Humans ; Liver Cirrhosis/complications ; Nitric Oxide ; Nitrogen Compounds ; Saliva ; Urea
Chemical Substances	Nitrogen Compounds ; Nitric Oxide (31C4KY9ESH) ; Urea (8W8T17847W)
Language	English
Publishing date	2022-02-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1364490-7
ISSN	1436-3771 ; 1432-6981
ISSN (online)	1436-3771
ISSN	1432-6981
DOI	10.1007/s00784-022-04426-9
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Article ; Online: Photobiomodulation and antimicrobial photodynamic therapy for the prevention of osteonecrosis of the jaw in an oncologic patient.

Martins, Fabiana / Macedo, Debora / Palma, Luiz Felipe / Ortega, Karem L / Campos, Luana

Photodiagnosis and photodynamic therapy

2021 Volume 36, Page(s) 102587

MeSH term(s)	Anti-Infective Agents/therapeutic use ; Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy ; Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control ; Diphosphonates/therapeutic use ; Humans ; Photochemotherapy/methods
Chemical Substances	Anti-Infective Agents ; Diphosphonates
Language	English
Publishing date	2021-10-17
Publishing country	Netherlands
Document type	Letter
ZDB-ID	2149918-4
ISSN	1873-1597 ; 1572-1000
ISSN (online)	1873-1597
ISSN	1572-1000
DOI	10.1016/j.pdpdt.2021.102587
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Article ; Online: Bleeding during tooth extraction in patients with chronic kidney disease: A cross-sectional pilot study.

Figueiredo, Marilia Andrade / Andrade, Natalia Silva / Blanco Carrión, Andrés / Medina, Janaina Braga / Gallottini, Marina / Ortega, Karem L

Oral diseases

2023

Abstract: Objective: This work measures the intra-operative bleeding in end-stage renal disease patients and assesses whether laboratory coagulation tests and nitrogenous compounds are related to a higher bleeding risk.: Methods: Laboratory tests were ... ...

Abstract	Objective: This work measures the intra-operative bleeding in end-stage renal disease patients and assesses whether laboratory coagulation tests and nitrogenous compounds are related to a higher bleeding risk. Methods: Laboratory tests were performed on the day of surgery and some patients with thrombocytopenia and values above the normal levels of international normalised ratio (INR), thrombin time (TT) and activated partial thromboplastin time (aPTT) were identified. Results: Haemostatic time ranged from 2 to 35 min (mean of 8.51 min) after suture. Bleeding volume ranged from 0.02 to 67.06 mL (mean of 4.38 mL) and the bleeding volume per minute ranged from 0.05 to 2.10 mL/min (median of 0.6 mL/min). Only seven patients (16.27%) had abnormal bleeding (more than 0.6 mL/min). Spearman's coefficient showed weak correlations between bleeding volume (mL/min) and serum urea (r = 0.226), TT (r = 0.227), plasma urea (r = 0.148) and creatinine (r = 146), as well as very weak correlations with all other variables (r < 0.140) such as age, haemodialysis time, glycaemia, glycated haemoglobin, platelets, INR, aPTT and fibrinogen. Conclusion: It was not possible to associate any laboratory test or nitrogenous compounds present in the blood and saliva with an increased bleeding.
Language	English
Publishing date	2023-08-14
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1290529-x
ISSN	1601-0825 ; 1354-523X
ISSN (online)	1601-0825
ISSN	1354-523X
DOI	10.1111/odi.14709
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Article ; Online: Oral lichen planus and HCV infection

Jefferson R. Tenório / Alessandra Rodrigues de Camargo / Celso Lemos / Karem L. Ortega

Autopsy and Case Reports, Vol 10, Iss

2021 Volume 4

Abstract: Chronic infection by hepatitis C virus (HCV) can lead not only to the development of hepatic cirrhosis, but also to the emergence of extra-hepatic manifestations (EHMs), such as oral lichen planus (OLP). Here, we describe a clinical presentation of ... ...

Abstract	Chronic infection by hepatitis C virus (HCV) can lead not only to the development of hepatic cirrhosis, but also to the emergence of extra-hepatic manifestations (EHMs), such as oral lichen planus (OLP). Here, we describe a clinical presentation of massive, erosive OLP in an HCV-positive patient whose clinical management was difficult. Full remission was achieved after sustained virological response by using direct-acting anti-retrovirals. This case report demonstrates not only the importance of diagnosing EHMs for identification of HCV infection, but also the importance of controlling it for management of OLP and EHMs.
Keywords	Hepatitis C ; Chronic ; Lichen Planus ; Oral ; Medicine ; R ; Internal medicine ; RC31-1245
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	University of São Paulo
Document type	Article ; Online
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Article ; Online: Can "COVID-19 tongue" be considered a pathognomonic finding in SARS-CoV-2 infection?

Pérez-Sayáns, Mario / Ortega, Karem L / Braz-Silva, Paulo Henrique / Martín Carreras-Presas, Carmen / Blanco Carrión, Andrés

Oral diseases

2021 Volume 28 Suppl 2, Page(s) 2579–2580

MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Tongue
Language	English
Publishing date	2021-03-03
Publishing country	Denmark
Document type	Letter ; Comment
ZDB-ID	1290529-x
ISSN	1601-0825 ; 1354-523X
ISSN (online)	1601-0825
ISSN	1354-523X
DOI	10.1111/odi.13807
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Article ; Online: Complications related to dental extractions in patients with chronic kidney failure undergoing hemodialysis: a pilot study.

Andrade, Natália Silva / Caliento, Rubens / Sarmento, Dmitry / Figueiredo, Marília / Ortega, Karem L / Gallottini, Marina

Oral surgery, oral medicine, oral pathology and oral radiology

2021 Volume 133, Issue 2, Page(s) 174–181

Abstract: Objective: To clinically assess socket healing after tooth extraction and the occurrence of intra- and postoperative complications in patients with chronic kidney failure (CKF) receiving hemodialysis (HD) by comparing them with a control group.: Study ...

Abstract	Objective: To clinically assess socket healing after tooth extraction and the occurrence of intra- and postoperative complications in patients with chronic kidney failure (CKF) receiving hemodialysis (HD) by comparing them with a control group. Study design: This prospective study involved 48 patients with CKF receiving HD (study group [SG]) and 29 participants without CKF (control group [CG]) undergoing tooth extractions. No prophylactic antibiotic was administered to the participants. One calibrated dentist evaluated all individuals at 3, 7, 21, and 60 days after the tooth extractions and assessed hemostasis time, occurrence of local or distant infection, epithelialization, and deposition of alveolar bone. Results: In the SG, 87 teeth were extracted through 65 interventions, and in the CG, 76 teeth were extracted through 36 interventions. Bleeding beyond 30 minutes was observed in 12 interventions (18.5%) in SG participants and was controlled with local hemostatic agents. Neither group had individuals presenting with postoperative infectious complications at the surgical site or at a distance. After 21 days, we observed delayed epithelialization in 29.9% (26 of 87) of the individuals in the SG compared with 3.9% (3 of 37) of those in the CG (P < .001). After 60 days, all the sockets were epithelialized and showing radiographic signs of alveolar bone neoformation. Conclusions: Individuals with CKF receiving hemodialysis tend to heal well after dental extractions. They did not have an increased risk of infectious complications after simple tooth extractions, but they showed prolonged bleeding events more often than control subjects. Additional research studies using larger sample sizes of patients with CKF receiving hemodialysis are needed to confirm our findings.
MeSH term(s)	Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Pilot Projects ; Prospective Studies ; Renal Dialysis ; Tooth Extraction/adverse effects
Language	English
Publishing date	2021-08-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2650843-6
ISSN	2212-4411 ; 2212-4403
ISSN (online)	2212-4411
ISSN	2212-4403
DOI	10.1016/j.oooo.2021.08.004
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Article ; Online: Cytomorphometric Evaluation of Oral Mucosa of Patients with Duchenne Muscular Dystrophy.

Macedo, Débora S / Jacomo, Thierry S / Moraes, Bruna / Ortega, Karem L / Braz-Silva, Paulo H / Zonta, Marco A / Pallos, Debora / Martins, Fabiana

Head and neck pathology

2022 Volume 16, Issue 3, Page(s) 703–706

Abstract: Duchenne muscular dystrophy (DMD) is a rare genetic disorder in which patients progressive muscle deterioration and low life expectancy. Since DMD has no cure, treatment slows the deterioration process using corticosteroids and other medications, ... ...

Abstract	Duchenne muscular dystrophy (DMD) is a rare genetic disorder in which patients progressive muscle deterioration and low life expectancy. Since DMD has no cure, treatment slows the deterioration process using corticosteroids and other medications, including oral bisphosphonates (BP). These drugs can lead to toxicities in both soft and hard tissues. The objective of this study was to present cytological changes in DMD patients, comparing to young, healthy individuals. Cytological smears were obtained from buccal mucosa from nine DMD patients and five healthy patients. The Papanicolaou technique was used to stain the slides. Images were captured using a photomicroscope, and 50 clearly defined cells were selected. The size and ratio between the nucleus and cytoplasmic areas (NA/CA) diameter were measured using a computer program. All the DMD patients presented a statistical difference (p < 0.0001) in the size of the cytoplasm (0.60 ± 0.33 μm) and the NA/CA ratio (0.17 ± 0.07 μm) was seen when compared to the control group (cytoplasm 0.60 ± 0.15 µm and nucleus 0.14 ± 0.05 µm). Furthermore, in one DMD in use of BP who presented Medication-Related Osteonecrosis of the Jaw (MRONJ), presented higher differences in the cytoplasmic (1.20 ± 0.65 µm) and nuclear (0.20 ± 0.12 µm) sizes (p < 0.0001) compared with all others DMD patients. These results suggest that the drugs used or the systemic condition of individuals with DMD may contribute to these changes.
MeSH term(s)	Case-Control Studies ; Humans ; Mouth Mucosa ; Muscular Dystrophy, Duchenne
Language	English
Publishing date	2022-01-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2407834-7
ISSN	1936-0568 ; 1936-055X
ISSN (online)	1936-0568
ISSN	1936-055X
DOI	10.1007/s12105-022-01413-0
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Article: Oral lichen planus and HCV infection.

Tenório, Jefferson R / de Camargo, Alessandra Rodrigues / Lemos, Celso / Ortega, Karem L

Autopsy & case reports

2020 Volume 10, Issue 4, Page(s) e2020210

Abstract	Chronic infection by hepatitis C virus (HCV) can lead not only to the development of hepatic cirrhosis, but also to the emergence of extra-hepatic manifestations (EHMs), such as oral lichen planus (OLP). Here, we describe a clinical presentation of massive, erosive OLP in an HCV-positive patient whose clinical management was difficult. Full remission was achieved after sustained virological response by using direct-acting anti-retrovirals. This case report demonstrates not only the importance of diagnosing EHMs for identification of HCV infection, but also the importance of controlling it for management of OLP and EHMs.
Language	English
Publishing date	2020-11-20
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2815488-5
ISSN	2236-1960
ISSN	2236-1960
DOI	10.4322/acr.2020.210
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