No abstract

Gingival overgrowth (GO) is one of the most important clinical features of gingival pathology. Amlodipine is a comparatively new III generation calcium channels blocker, used for management of cardiovascular disorders. Although it is considered safe, it can also rarely induce GO. A case of severe amlodipine-induced GO, complicated by inflammatory changes due to plaque accumulation is presented in a 54 years old patient.Treatment was performed as follows: drug substitution; initial periodontal therapy –scaling and root planning (reduction of inflammatory component in the gingival tissues); Er:YAG laser-performed gingivectomy and gingivoplasty; maintenance care. The healing process went uneventful and the postoperative results were extremely esthetically and functionally satisfactory

BackgroundOver the years, the number of patients with an affected hip joint has been increasing. The pathology of the illness is moving towards a younger age and often handicaps the patients. As their age increases, the symptoms become more acute and endoprosthesis is required. With the complex rheumatologic and physiotherapy treatment, a surgery intervention can be postponed in time, and the symptoms significantly reducedObjectivesTo measure the effect of conducting a one-year complex drug treatment combined with a physiorehabilitation program in patients with hip joint osteoarthritis.MethodsBetween 2010 and 2014, 147 patients with coxarthrosis were hospitalized and treated at the Rheumathology Ward at UMHAT “Georgi Stranski” – Pleven. 58 of them were male and 89 female, aged between 42 and 81, with active arthrosis (ESR<25 mm, fibrinogen and CRP at relevant values, AST and RF (-).In addition to the drug therapy with NSAIDs and chondoprotectors, the patients also undergo a complex physical and rehabilitation program consisting of: electrostimulation, therapeutic massages, kinesitherapy and ergotherapy.Functional tests and measurements were made for the purpose of the study: the movement volume in the affected joints, VAS for the pain, locomotion tests, necessity for any walking aids.ResultsAn individual patient file is created for every patient where his results from the tests and measurements are stored in order to track the patient's condition over the course of one year (which consists of treatment in the Rheumathology ward, treatment in the Medical Rehabiltation ward and ambulatory physiorehabilitation courses).The Wilcoxon rank test (a statistical method for analysis and spreading of non-parametric data) was used to measure the daily activities test results. The Wilcoxon curve shifts to the right, which indicates an improvement of the patients' self-sufficiency and of their quality of life. When applying the VAS test for pain and goniometry, the average values at the beginning and at the end of the observed period are measured and compared. The results show a pain decrease by around 30%, and an increase in the joint movement volume. The ANOVA statistical analysis method was applied to the results of the locomotion test.ConclusionsThe collaboration between rheumatologists and physiotherapists for treatment of patients with coxarthrosis widens the range of daily activities that the patients can perform without experiencing pain, slows down the progression of the deterioration process and makes the daily life of patients more complete and self-sufficient.For patients who are still at working age, the duration of their temporary inability to work is decreased, and they can resume working activities sooner, or they can acquire new professional skills with a lower degree of physical stress which suits their condition and physical abilities. The advent of permanent disability for patients and early endoprosthesis are delayed.The complex physiorehabilitational and rheumathological treatment for patients with hip joi...

Клиники ревматологии Медицинских унивеситов, Пловдив1, София2, Болгария Резюме. Цель. Установить частоту и вид неврологических проявлений у больных с первичным синдромом Шегре на среди болгарской популяции. Материал и методы. В течение 5 лет наблюдали за 65 больными, удовлетворяющими Европейским клас сификационным критериям первичного синдрома Шегрена. Оценены общий и неврологический статус пациентов. Проведены электромиография, компьютерная томография, аудиометрическое исследование (при наличии показаний). Результаты. Неврологические проявления и отклонения в диагностических тестах зарегистрированы у 28 больных-43.06%. Некоторые симптомы имели рецидивирующий характер (невропатия n. trigeminus), другие привели к частичной инвалидности (множественный мононеврит). Заключение. У значительной части больных с первичным синдромом Шегрена наблюдается поражение нервной системы. Прогноз неврологических проявлений зависит от своевременной постановки диагноза и от проведенного лечения. Ключевые слова: первичный синдром Шегрена. неврологические проявления.

I wish to respond to the article by Woods et al 1 suggesting that there should be reasons other than hormones for menopausal dysphoric disorder (MDD). The apparent association between attention deficit hyperactivity disorder (ADHD) and MDD suggests that new biological treatment options for ADHD might also be beneficial in treating patients with MDD.Of interest, not only the DAT-1, DRD-4, and DRD-5 genes have been shown to be responsible for ADHD but the serotonergic system (as a modulating system) also seems to be involved. Eight polymorphisms that encode the 5hydroxytryptamine transporter (LPR, VNTR-2, and 3-UTR) have been investigated for both ADHD and MDD. 1,2 Although results were inconsistent, the similarity of both disorders suggests that there may be an association between them and also that treatments with some benefit for one disorder might also have some benefit for the other disorder.There also seems to be a higher prevalence of MDD (20%/40%) among patients with ADHD than in healthy control individuals with no psychiatric disorders. We observed six female patients with ADHD and found that four of them also had MDD, which corresponds to a prevalence rate of 65%.To our knowledge, no systematic studies of the treatment of MDD with methylphenidate (MPH) have been conducted. MPH is a proven and well-tolerated medication for ADHD, which has also been reported to show some benefit in treating severe major depression. 3 Our 41-year-old female patient had ADHD and MDD. Therapy with MPH, 20 mg daily, was initiated and was associated with a significant improvement in ADHD symptomatology (Wender Utah Scale) and also with a significant reduction of MDD symptoms.We assume that MPH may also show some benefit in the treatment of MDD. Polymorphisms in the estrogen synthesis and metabolism pathways and symptoms during the menopausal transition: observations from the Seattle Midlife Women`s Health Study. Menopause 2006;13:902<910. 2. Heiser P, Dempfle A, Friedel S. Family-based association study of serotonergic candidate genes and attention-deficit/hyperactivity disorder in a German sample. In reply:Thank you for your interest in our research relating polymorphisms in the estrogen synthesis, metabolism, and receptors pathways to vasomotor symptoms. Although the association of attention deficit hyperactivity disorder and dysphoric mood during the menopausal transition was not a component of our study, it is likely that other investigators who have completed a comprehensive mental health assessment during the menopausal transition may have data regarding these comorbidities. Our research efforts have not yet included genotyping for polymorphisms other than those addressed in our article.The hypothesized relationship between the polymorphisms encoding the 5-hydroxytryptamine transporter and depression during the menopausal transition is of great interest. Because serotonin is also implicated in the etiology of hot flashes, the relationship to both depressed mood and hot flashes should be considered in future work.Such pro...