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Gijón, Spain

Blanco I.,Valle Del Nalon Hospital | Beritze N.,Cabuenes Hospital | Arguelles M.,Cabuenes Hospital | Carcaba V.,Valle Del Nalon Hospital | And 6 more authors.
Clinical Rheumatology | Year: 2010

Formalin-fixed, paraffin-embedded skin tissue sections were collected from a matched cohort of 63 fibromyalgia syndrome (FMS) patients and 49 volunteers from the general population with both alpha1-antitrypsin (AAT) normal and deficiency variants. These tissues were examined for the expression of the broad-spectrum inhibitor AAT, the serine proteinases elastase and tryptase, the proinflammatory cytokines MCP-1 and TNFα, the endothelium biomarker VEGF, and the inflammation/nociception-related receptor PAR2. The most relevant finding of the study was a significantly increased number of mast cells (MCs) in the papillary dermis of all FMS patients (greater than or equal to five to 14 per microscopic high power field) compared to zero to one in controls (p<0.001). MCs strongly stained with tryptase, AAT and PAR2 antibodies, exhibited a spindle-like shape and were uniformly distributed around blood vessels and appendages. MCP-1 and VEGF expressed weak/moderate positivity in most samples, with a higher expression in controls than in FMS patients (p<0.001 and 0.051, respectively). No differences in elastase and TNFα were found between both groups. Moreover, no histological differences were found between samples from AAT deficiency and normal AAT phenotypes. Our results indicate that FMS is a MC-associated condition. MCs are present in skin and mucosal surfaces throughout the human body, and are easily stimulated by a number of physical, psychological, and chemical triggers to degranulate, releasing several proinflammatory products which are able to generate nervous peripheral stimuli causing CNS hypersensitivity, local, and systemic symptoms. Our findings open new avenues of research on FMS mechanisms and will benefit the diagnosis of patients and the development of therapeutics. © 2010 Clinical Rheumatology.

Gallego L.,Cabuenes Hospital | Junquera L.,University of Oviedo | Pelaz A.,University of Oviedo | Hernando J.,University of Oviedo | Megias J.,University of Oviedo
Medicina Oral, Patologia Oral y Cirugia Bucal | Year: 2012

The use of pedicled buccal fat pad flap (BFP) has proved of value for the closure of oroantral and oronasal communications and is a well-established tool in oral and maxillofacial surgery. Otherwise, the perceived limitations of surgical therapy for bisphosphonate-related osteonecrosis of the jaws (BRONJ) have been widely discussed, and recommendations have largely been made to offer aggressive surgery only to stage 3 patients refractary to conservative management. Oroantral communication may be a common complication after sequestrectomy and bone debridement in upper maxillary BRONJ. We report a case series of stage 3 recalcitrant maxillary BRONJ surgically treated with extensive sequestrectomy and first reconstruction using pedicled BFP. All the cases presented an uneventful postoperative healing was uneventful without dehiscence, infection, necrosis or oroantral communication. We postulate that managing initially the site with BFP and primary closure may ensure a sufficient blood supply and adequate protection for an effective bone-healing response to occur. This technique may represent a mechanic protection and an abundant source of adipose-derived adult stem cells after debridement in upper maxillary BRONJ. We evaluate in this work results, advantages and indications of this technique. © Medicina Oral S. L.

Llaneza P.,University of Oviedo | Gonzalez C.,University of Oviedo | Fernandez-Inarrea J.,Cabuenes Hospital | Alonso A.,University of Oviedo | And 2 more authors.
Climacteric | Year: 2012

Objective To investigate the effect of a soy isoflavone extract over insulin sensitivity and plasma leptin levels. Methods Eighty postmenopausal women were randomly assigned to participate for 24 months either to a physical exercise and Mediterranean diet program (Control group: CG) or this intervention plus a daily oral intake of a soy isoflavone extract (Soy isoflavone group: SIG). Anthropometry, body composition analysis, blood biochemistry, menopausal symptoms and health-related quality of life were assessed at baseline and every 6 months. Results Sixty-five women completed the protocol with no differences found among groups at baseline in age and time since the menopause. At month 24, body mass index (BMI) was lower in the SIG as compared to the CG. Fat mass, glucose, insulin, HOMA-IR, tumor necrosis factor-α (TNF-α), Kupperman Index and Cervantes Scale values significantly decreased in the SIG as compared to baseline and to CG values. Kupperman scores and serum TNF-α levels significantly decreased in both studied groups. No changes in plasma leptin levels were observed after 24 months within and between groups. When analysis was stratified according to BMI values, changes in the aforementioned parameters displayed a similar trend; however, the impact over glucose, insulin and HOMA-IR values was more evident among obese women assigned to the SIG. Conclusion Diet, physical exercise and a daily oral intake of soy isoflavones exerted a beneficial effect on the homeostatic model in postmenopausal women which was not related to significant changes in plasma leptin levels, despite a decrease in TNF-α, fat mass and Kupperman values. © 2012 International Menopause Society.

Llaneza P.,University of Oviedo | Gonzalez C.,University of Oviedo | Fernandez-Inarrea J.,Cabuenes Hospital | Alonso A.,University of Oviedo | And 3 more authors.
Menopause | Year: 2010

Objective: The aim of this study was to evaluate whether a standard dose of 40 mg of soy isoflavones prescribed in routine clinical practice for treatment of menopausal symptoms has some influence on glucose homeostasis in postmenopausal women with insulin resistance (IR). Methods: A total of 116 postmenopausal women with IR were randomly assigned to a group of Mediterranean diet and physical exercise (control group) or a group of Mediterranean diet, physical exercise, and daily oral ingestion of 40 mg of soy isoflavones (soy isoflavones group). Anthropometric measures, Kupperman Index values, Cervantes Scale score, and blood samples for glucose, insulin, lipid profile, creatinine, uric acid, homocysteine, folic acid, vitamin B12, selenium, and estradiol were determined at baseline and at intervals of 6, 12, 18, and 24 months. Results: Mean homeostasis model assessment of IR (HOMA-IR) values remained unchanged from the baseline in the control group but steadily decreased in the soy isoflavones group at 6 months (P = 0.042). There were no statistically significant differences between both groups in mean HOMA-IR scores at baseline, but statistically significantly lower values were found in the soy isoflavones group at 6 months (P = 0.009), 12 months (P = 0.011), 18 months (P = 0.018), and 24 months (P = 0.012). Changes in HOMA-IR values were also clearly related to body mass index (P < 0.001), abdominal circumference (P < 0.001), and treatment (P = 0.044) when a linear regression analysis was carried out. Conclusions: Daily intake of 40 mg of soy isoflavones together with a Mediterranean diet and exercise reduced IR in postmenopausal women who had IR in the first place. It was significantly better than lifestyle changes alone. If corroborated, this may be a useful intervention for these women. Copyright © 2010 The North American Menopause Society.

Gallego L.,Cabuenes Hospital | Junquera L.,University of Oviedo | Pelaz A.,University of Oviedo | Costilla S.,University of Oviedo
Medicina Oral, Patologia Oral y Cirugia Bucal | Year: 2010

Osteogenesis imperfecta (OI), is a heterogeneous group of inherited disorders of connective tissue characterized by bone fragility. Patients with this disease frequently suffer fractures, over 80% of the extremities due to the more intensive mechanical load. Fractures of the facial bones occur very infrequently. Several studies have proved that bisphosphonate therapy may be effective in reducing fracture risk in OI patients. We report here an unusual case of pathological mandibular fracture following simple molar extraction in an adult patient with OI type I and oral alendronic acid treatment. Extraction was atraumatical and without bone removal . Fracture was treated by internal fixation by plate osteosynthesis and additional mandibulomaxillary fixation (MMF). Bone healing after fracture treatment was completely normal and no clinical signs of osteoneocrosis were observed. To the best of our knowledge, this is an unusual complication even in this type of patients. Particular care is necessary is these patients during oral surgery, even when they have been treated and controlled. © Medicina Oral S. L.

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