References to the identified CCTs are now available in CENTRAL, the Cochrane Collaboration repository for these studies. We call for adherence to the CONSORT statement in dentistry to improve reporting of CCTs in journals published in Spanish language.
Neonatal programming with sex hormones produces long-term functional changes in various tissues, including the brain. Previously, we demonstrated a higher content of dopamine and an increase in potassium-induced dopamine release in the nucleus accumbens of adult rats exposed to estradiol valerate. On the other hand, sex hormones also affect the opioid system increasing the expression of the μ opioid receptor and β-endorphins. Here, we investigated if neonatal programming with sex hormones alters the response to morphine during adulthood in rats and predispose them to neurochemical, rewarding and behavioral activating effects. We examined the effects of neonatal exposure to a single dose of estradiol valerate or testosterone propionate on morphine-induced (5 mg/kg, i.v.) dopamine release in the nucleus accumbens and morphine-induced (3 mg/kg, s.c.) locomotor activity and conditioned place preference when these rats were adults. Our results showed a significant increase in morphine-induced dopamine release in the nucleus accumbens of rats that were exposed neonatally to estradiol compared with control rats. This effect was correlated with higher place preference and locomotor activity induced by morphine in adult rats neonatally exposed to estradiol valerate. However, the effect of morphine on dopamine release and behaviors was similar in rats treated with testosterone compared to control rats. Additionally, the expression of mu (μ) opioid receptor, dopamine receptor type 1 (D 1 ) and dopamine receptor type 2 (D 2 ) in the nucleus accumbens of adult rats was not different after treatment with sex hormones. Taken together, our results demonstrated an enhancement of pharmacological effects produced by morphine in rats neonatally programmed with estradiol valerate, suggesting that early exposure to sex hormones could represent a vulnerability factor in the development of addiction to opioid drugs such as morphine and heroin in adulthood.
Pigmented malignant oral mucosa lesions are infrequent, but with high rates of morbidity and mortality, and have a poor prognosis despite aggressive treatments that can combine large surgical resection with chemotherapy and radiotherapy. Given this scenario, the clinical conduct associated with pigmented lesions is the immediate biopsy to confirm or rule out the disease and thus the early initiation of treatment. This article is about a patient attended in a public hospital about six months after the first signs of an injury to maxillary mucosa, which then confirmed the diagnosis of a malignant lesion, who was referred and treated by a cancer team of the same center. KEY WORDSOral melanoma; pigmented lesions; oral mucosa; oral pathology.
Neonatal programming with sex hormones produces long-term functional changes in various tissues, including the brain. For example, neonatal exposure to estrogens and androgens increases the catecholamine content and dopamine release in brain circuits related to reward and locomotion. On the other hand, sex hormones can increase the expression of muopioid receptor and beta-endorphins. Therefore, neonatal programming with sex hormones could alter the morphine response during adulthood in rats and predispose them to addiction-like behaviors. The aim of this work was to evaluate the behavior (locomotor activity and conditioned place preference) and neurochemical (content and release of dopamine in Nucleus Accumbens) induced by morphine in Sprague-Dawley adult rats exposed during the first postnatal day to sesame oil, estradiol valerate or testosterone propionate. The locomotor activity and conditioned place preference protocol were performed using morphine (3 mg/Kg s.c.) or saline (1 mL/Kg s. c.). On the other hand, dopamine release was measured in vivo in Nucleus Accumbens using morphine (5 mg/Kg i.v.). The results show that locomotor activity and conditioned place preference induced by morphine was significantly higher in animals treated with estradiol than control animals. At neurochemical level, the dopamine release in Nucleus Accumbens of rats treated with estradiol was greater than the observed in control rats. However, animals treated with testosterone had a place preference behavior and morphine-induced neurochemistry similar to control rats, although they showed an increase in locomotor activity. Our results demonstrated an enhancement of pharmacological effects produced by morphine in rats programmed with estradiol valerate. Despite that, the expression of the morphine pharmacological target has not been measured, it can hypothesized that this potentiation could be explained by a greater expression of mu-opioid receptors in GABAergic interneurons of Ventral Tegmental Area or Nucleus Accumbens. Our results could show that early exposure to sex hormones is a factor of vulnerability for addiction to opioidergic drugs such as morphine and heroin in adulthood.
resumen introducción: el objetivo de esta revisión fue determinar el riesgo de hemorragia postoperatoria en pacientes con tratamiento anticoagulante oral (TACO) sometidos a cirugía oral que no suspenden su tratamiento comparado con quienes lo modifican o suspenden. materiales y métodos: se realizó una búsqueda en CENTRAL, Medline y EMBASE, junto con una revisión manual de revistas especializadas y resúmenes de la IADR. Dos revisores realizaron la selección de estudios, evaluación de riesgo de sesgo y extracción de datos de forma independiente. Se seleccionaron los ensayos clínicos aleatorizados que miden la aparición de hemorragias en pacientes sometidos a procedimientos quirúrgicos orales con TACO en comparación con un grupo que interrumpió o modificó su terapia. resultados: Solo 5 estudios cumplieron los criterios de inclusión (549 pacientes). El metanálisis mostró que el mantenimiento de la TACO no aumenta el riesgo de hemorragia postoperatoria (riesgo relativo: 1,41 [0,93-2,16], IC del 95% p = 0,11) en comparación con la interrupción del tratamiento. conclusión: Aunque se encontró una mayor cantidad de hemorragia postoperatoria en pacientes con TACO comparado con quienes lo interrumpieron o modificaron, esta diferencia no fue estadística ni clínicamente significativa. Por lo tanto, TACO no debe suspenderse en pacientes sometidos a cirugía oral. Palabras clave Cirugía oral, Hemorragia, Anticoagulantes orales. rev. clin. Periodoncia implantol. rehabil. Oral vol. 11(2); 121-127, 2018. abstract introduction: This systematic review aims to determine the postoperative bleeding risk in patients on oral anticoagulant therapy (OAT) undergoing oral surgical procedures when continuing with the treatment, compared with those modifying or discontinuing the treatment. materials and methods: A search was performed using CENTRAL,Medline and EMBASE, in conjunction with a manual review of indexes of specialized journals and abstracts of the IADR. Study selection, assessments of risk of bias and data extraction were performed independently by 2 reviewers. Randomized clinical trials measuring the occurrence of bleeding in patients on OAT undergoing oral surgical procedures compared with a group discontinuing or modifying their therapy were selected. results: A total of 5 studies were included based on inclusion criteria (549 patients). The metaanalysis showed that the maintenance of OAT does not increasethe risk of postoperative bleeding (relative risk [RR] 1.41 [0.93-2.16]; 95% CI p= 0,11)compared with the discontinuation of therapy. conclusion: Although a larger quantityof oral postoperative bleeding episodes were found in patients continuing with OATcompared with patients discontinuing or modifying their therapy, this difference was neither statistically nor clinically significant. Therefore, OAT should not be discontinued in patients undergoing oral surgery.
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