Capsule Endoscopy in Refractory Diarrhea-Predominant Irritable Bowel Syndrome and Functional Abdominal Pain

Manuel Valero,Gladys Bravo-Velez,Roberto Oleas,Miguel Puga-Tejada,Miguel Soria-Alcívar,Haydee Alvarado Escobar,Jorge Baquerizo-Burgos,Hannah Pitanga-Lukashok,Carlos Robles-Medranda 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.6

Background/Aims: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosedlesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractorydiarrhea-predominant irritable bowel syndrome and functional abdominal pain. Methods: This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractorydiarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 wereincluded. Capsule endoscopy was used to detect small bowel pathologies in both groups. Results: Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (±standard deviation) age of 50.9±15.9 years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% ofthe patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominalpain and the diarrhea groups, respectively. Conclusions: Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, inpatients with refractory conditions, capsule endoscopy may identify abnormalities.

Clinical and Molecular Study of the Extracellular Matrix Protein 1 Gene in a Spanish Family with Lipoid Proteinosis

Rufino Mondejar,Jose Manuel Garcia-Moreno,Rocio Rubio,Francisca Solano,Mercedes Delgado,Begona Garcia-Bravo,Juan Jose Rios-Martin,Amalia Martinez-Mir,Miguel Lucas 대한신경과학회 2014 Journal of Clinical Neurology Vol.10 No.1

Background Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized bya hoarse voice, variable scarring, and infiltration of the skin and mucosa. This disease is associated with mutations of the gene encoding extracellular matrix protein 1 (ECM1). Case Report This was a clinical and molecular study of a new case of LP with a severe phenotype. A 35-year-old female born to nonconsanguineous parents developed dermatologicaland extracutaneous symptoms in her 9th month of life. The neurological abnormalities of thedisease began to appear at the age of 19 years. Computed tomography revealed cranial calcifications. Conclusions The diagnosis of LP was confirmed by histopathological findings and direct sequencing of ECM1. A new homozygous nonsense mutation was identified in exon 7 of ECM1, c.1076G>A (p.Trp359*). This mutation was not detected in 106 chromosomes of healthy individuals with a similar demographic origin. Microsatellite markers around ECM1 were used to construct the haplotype in both the parents and the patient. Reports on genotype-phenotype correlations in LP point to a milder phenotype in carriers of missense mutations in the Ecm1a isoform, whereas mutations in the Ecm1b isoform are thought to be associated with more severe phenotypes. The present findings in a Spanish patient carrying a truncating mutation in exon 7 revealed complete dermatological and neurological manifestations.

Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

Sanchez-Fernandez, Elena,Magan-Fernandez, Antonio,O'Valle, Francisco,Bravo, Manuel,Mesa, Francisco Korean Academy of Periodontology 2020 Journal of Periodontal & Implant Science Vol.50 No.-

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.

Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

Elena Sánchez-Fernández,Antonio Magán-Fernández,Francisco O’Valle,Manuel Bravo,Francisco Mesa 대한치주과학회 2021 Journal of Periodontal & Implant Science Vol.51 No.1

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)- 1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, −1.66, −0.40 mm; control 2: 95% CI, −1.07, −0.01 mm) and 90 days (control 1: 95% CI, −1.72, −0.54 mm; control 2: 95% CI, −1.13, −0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03157193

Clinical comparison of marginal fit of ceramic inlays between digital and conventional impressions

Franklin Guillermo Vargas-Corral,Américo Ernesto Vargas-Corral,Miguel Angel Rodríguez Valverde,Manuel Bravo,Juan Ignacio Rosales Leal 대한치과보철학회 2024 The Journal of Advanced Prosthodontics Vol.16 No.1

Purpose. To evaluate the metameric disparities among monolithic zirconia materials with differing yttrium compositions across various lighting conditions. Materials and Methods. Thirty-six square-shaped zirconia samples measuring 10 × 10 × 0.5 mm were prepared from monolithic zirconia materials with three different yttrium contents. A 0.2 mm thick layer of polymerized dual-polymerizable self-adhesive resin cement was created using a silicone mold with the same dimensions as the prepared zirconia specimens. To evaluate metamerism, color measurements were conducted using a spectrophotometer device on a neutral gray background in a color measurement cabinet that offers four different illumination environments. All samples underwent aging by subjecting them to 10000 thermal cycles using a thermal cycle tester. Following thermal aging, color measurements were taken once more, and the data were recorded using the CIE L*, a*, b* color system. Two-way ANOVA and Post-hoc Bonferroni tests were employed to analyze the data. Results. It was observed that there was no statistical difference among the color measurements made in different illumination environments of the monolithic zirconia ceramics used to evaluate metamerism (P > .05). This observation remained consistent both before and after thermal aging. After thermal aging, the color of monolithic zirconia materials exhibited a tendency towards red and yellow hues, accompanied by a decrease in brightness levels. Conclusion. It can be stated that different illumination conditions did not affect the metamerism of monolithic zirconia materials, but there was a color change in monolithic zirconia materials after a thermal aging period equivalent to one year.