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Cocaine-induced oronasal communication of the midline of the palate: A case report
(Medwave Estudios Limitada, 2025-02-24)
María Jesús Vergara
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Javiera Cordero Escalona
;
Valentina Veloso Casado
Cocaine abuse poses a significant public health challenge, leading to severe systemic and localized complications. Intranasal cocaine use can result in chronic rhinitis, septal perforation, and palatal perforation due to its vasoconstrictive effects, which cause ischemia and tissue necrosis. We present the case of a 44- year-old woman with a 10-month history of palatal perforation, attributed to 12 years of chronic cocaine use, presented with nasal regurgitation, feeding difficulties, and cachexia. Examination revealed a 3 x 2 cm palatal perforation, nasal asymmetry, and a saddle nose deformity. Computerized tomography scans showed extensive nasal septum perforation and sinus mucosal thickening. Initial treatment involved antibiotics for sinusitis, followed by the fabrication of an obturator prosthesis to improve speech and feeding. The chronicity and extent of the palatal and nasal damage illustrates the severe consequences that can arise from sustained abuse. This case highlights not only the physical manifestations but also the challenges in managing such cases, emphasizing the necessity of a multidisciplinary approach. The integration of dental, otolaryngological, and psychological care is crucial for both immediate and long-term management. The main lesson from this case is the importance of comprehensive, patient-centered care that prioritizes stabilization and quality of life while supporting the patient’s path to rehabilitation. Provisional treatment with an obturator prosthesis can provide significant improvement in speech and feeding, providing a viable solution until the patient can maintain abstinence. Conservative management and prosthetic rehabilitation remain effective options, reinforcing the need for individualized, multidisciplinary care strategies.
1
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Women with polycystic ovary syndrome (PCOS): Likelihood of cooccurring neuropsychiatric conditions and the dual hit hypothesis
(Elsevier BV, 2025-04)
Juan Pablo Del Río
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Alexandros Tsompanidis
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Pablo A. Gaspar
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Alejandro Maturana-Hurtado
;
Gonzalo M. Rojas-Costa
Scopus© Citations 7 6
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Evidence-based clinical standard for the diagnosis and treatment of invasive lung aspergillosis in the patient with oncohematologic disease
(Elsevier BV, 2025-03)
Jorge Alberto Cortés
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Diego Andrés Rodríguez-Lugo
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Martha Carolina Valderrama-Rios
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Ricardo Rabagliati
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Domenico Capone
2
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A case report of sarcoidosis and ulcerative colitis: overlap or coexistence
(Sociedad Espanola de Patologia Digestiva (SEPD), 2024)
Alex Fabián Arenas Aravena
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Diego Ruedi
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Matías Sanhueza
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IBAÑEZ VODNIZZA, SEBASTIAN EDUARDO
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Gonzalo Carrasco-Avino
4
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White matter volume and microstructural integrity are associated with fatigue in relapsing multiple sclerosis
(Springer Science and Business Media LLC, 2025-05-12)
FIGUEROA VARGAS, ALEJANDRA MABEL
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Sebastián Navarrete-Caro
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Claudia Cárcamo
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Ethel Ciampi
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Macarena Vásquez-Torres
10
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TGFβ links EBV to multisystem inflammatory syndrome in children
(Springer Science and Business Media LLC, 2025-03-12)
Carl Christoph Goetzke
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Mona Massoud
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Stefan Frischbutter
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Gabriela Maria Guerra
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Marta Ferreira-Gomes
<jats:title>Abstract</jats:title> <jats:p>In a subset of children and adolescents, SARS-CoV-2 infection induces a severe acute hyperinflammatory shock<jats:sup>1</jats:sup> termed multisystem inflammatory syndrome in children (MIS-C) at four to eight weeks after infection. MIS-C is characterized by a specific T cell expansion<jats:sup>2</jats:sup> and systemic hyperinflammation<jats:sup>3</jats:sup>. The pathogenesis of MIS-C remains largely unknown. Here we show that acute MIS-C is characterized by impaired reactivation of virus-reactive memory T cells, which depends on increased serum levels of the cytokine TGFβ resembling those that occur during severe COVID-19 (refs. <jats:sup>4,5</jats:sup>). This functional impairment in T cell reactivity is accompanied by the presence of TGFβ-response signatures in T cells, B cells and monocytes along with reduced antigen-presentation capabilities of monocytes, and can be reversed by blocking TGFβ. Furthermore, T cell receptor repertoires of patients with MIS-C exhibit expansion of T cells expressing TCRVβ21.3, resembling Epstein–Barr virus (EBV)-reactive T cell clones capable of eliminating EBV-infected B cells. Additionally, serum TGFβ in patients with MIS-C can trigger EBV reactivation, which is reversible with TGFβ blockade. Clinically, the TGFβ-induced defect in T cell reactivity correlates with a higher EBV seroprevalence in patients with MIS-C compared with age-matched controls, along with the occurrence of EBV reactivation. Our findings establish a connection between SARS-CoV-2 infection and COVID-19 sequelae in children, in which impaired T cell cytotoxicity triggered by TGFβ overproduction leads to EBV reactivation and subsequent hyperinflammation.</jats:p>
Scopus© Citations 4 2
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Latin American association for the study of the liver (ALEH) guidance on postoperative care after liver transplantation
(Elsevier BV, 2025-07)
Liana Codes
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ZAPATA LARRAIN, RODRIGO
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Manuel Mendizabal
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Alfeu de Medeiros Fleck Junior
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Juan Carlos Restrepo
7Scopus© Citations 1
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New Dermoscopy Pattern in Nevus‐Associated Melanomas
(Wiley, 2025-04-19)
Nelson Lobos‐Guede
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Dan Hartmann
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Valentina Darlic
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Cristina Carrera
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Llucia Alos
Melanomas can appear de novo or in association with a pre‐existing nevus. The association of melanomas with pre‐existing nevi and its role as a melanoma precursor is a controversial issue. Dermoscopy can increase melanoma's diagnostic accuracy and help us suspect nevus‐associated melanomas (NAM). Differentiating NAMs clinically and dermoscopically can be challenging. There are few published studies so far describing dermoscopic features of NAM that have differentiated from <jats:italic>de novo</jats:italic> melanomas, such as multi‐component pattern, multifocal pigmentation, atypical pigment network, regression structures, negative pigment network, irregular globules, and streaks. Here, we report four acquired compound NAMs showing a starburst pattern (SP) within the lesion. No publications have reported NAMs with melanoma components in the form of SP arising within the center of the lesion. Therefore, when faced with a compound or intradermal nevus with incipient central reticulated pigmentation, especially if there is no history of trauma or previous surgery, we must pay alert to the possibility of an early development of melanoma.
2
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Digital Bowen disease: a case report and systematic review
(JLE, 2024-12)
CABRERA MORAGA, RAUL ALEJANDRO
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Cristóbal Lecaros
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Edinson López
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Nelson Lobos
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Nadia Vega
5
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Pregabalin for Neuropathic Pain and Itch in Recessive Dystrophic Epidermolysis Bullosa
(American Medical Association (AMA), 2024-12-01)
Margarita Calvo
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Macarena Tejos-Bravo
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Alvaro Passi-Solar
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Fernanda Espinoza
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FUENTES BUSTOS, MARIA IGNACIA
<jats:sec><jats:title>Importance</jats:title><jats:p>Patients with recessive dystrophic epidermolysis bullosa (RDEB) experience neuropathic pain and itch. There is a lack of evidence on any treatment for these symptoms in patients with RDEB.</jats:p></jats:sec><jats:sec><jats:title>Objectives</jats:title><jats:p>To test the efficacy of pregabalin in the treatment of neuropathic pain and itch in patients with RDEB.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>A randomized, double-blinded, crossover trial of oral pregabalin (50-300 mg/d) vs placebo was conducted at 2 sites, Toronto (Canada) and Santiago (Chile) from January 1, 2019, to December 31, 2020. Patients eligible to participate were diagnosed with RDEB, aged 8 to 40 years, not pregnant or lactating (if female), and had evidence of probable neuropathic pain and itching defined as distal thermal sensory loss (confirmed by thermal roller), score of 4 or greater on the <jats:italic>Douleur Neuropathique</jats:italic> 4 questionnaire (DN4), and score greater than 4 on the 10-point visual analog scale [VAS]). Patients with a clinically important or poorly controlled medical or psychiatric condition or pregabalin intolerance or allergy were excluded. Of 41 patients screened, 3 were not eligible and 28 declined enrollment. Data analyses were performed in 2021 through 2023.</jats:p></jats:sec><jats:sec><jats:title>Intervention</jats:title><jats:p>Participants received both pregabalin and matched placebo (titrated to a maximum-tolerated dose of 300 mg/day) in a randomized sequence so that comparisons could be made within participants and between groups.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>Difference in the mean pain and itch scores between pregabalin and placebo treatment (measured using VAS) before and after intervention.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In all, 10 participants were randomized to 2 groups, 6 patients (mean [SD] age, 26.7 [8.1] years; 3 females [50%]) in group 1, and 4 patients (mean [SD] age, 26.5 [7.8] years, 2 females [50%]) in group 2. Group 1 received a sequence of pregabalin-placebo while group 2 received placebo-pregabalin. Pregabalin significantly reduced mean (SD) pain scores by 1.9 (1.5) points when controlling for sequence and treatment period vs baseline, while placebo had 0.1 (2.0) points of reduction. The effect of pregabalin was a mild but significant reduction in itch compared to baseline (mean [SD] points, 0.9 [2.2]), whereas the placebo produced no reduction (0.1 [2.5]). The mean pregabalin dose was generally well tolerated.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>The results of this randomized crossover trial indicate that pregabalin significantly reduced pain and itch scores from baseline compared to placebo in patients with RDEB. This feasibility study provided preliminary data on the efficacy of pregabalin in managing pain and itch in RDEB and gathered essential data to inform the design of a larger cohort trial.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/study/NCT03928093">NCT03928093</jats:ext-link></jats:p></jats:sec>
Scopus© Citations 3 2

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