Search

Solitary myofibroma (SM) is a proliferation of myofibroblasts that primarily develops in children, with a predilection for the head and neck, being uncommon in the jaws and mouth, where clinically it has been described as a variable-sized nodule and imagenologically as a unilocular radiolucent lesion with well-defined borders, with or without erosion of the mandible. An 18-year-old female patient went to the Maxillofacial Surgery Department of the General Hospital of León with symptomatic tissue growth of approximately 6 cm in the left mandibular body. A hypodense, well-defined lesion was identified on tomography, and an excisional biopsy was performed. The histopathological study was carried out at the histopathological diagnosis service of ENES Unidad León, as well as an immunohistochemical panel and histochemical stains, determining the diagnosis of SM. The presence of SM in the mandible is rare, as evidenced by limited case reports and is even unusual in adults. Its clinical presentation can vary, and its histopathological appearance is very similar to other spindle cell lesions, which is why the similarities and differences between related lesions are discussed. MF represents a diagnostic challenge and, although rare, should be considered as a differential diagnosis of benign and malignant spindle cell mesenchymal proliferations. The diagnosis of these types of lesions should be based on histomorphology, with the use of immunohistochemistry and histochemistry being important to achieve their correct identification by exclusion and to implement appropriate management. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The response to hepatitis B (HB) vaccine remains suboptimal among chronic kidney disease patients. The aim of this study was to analyze the efficacy of a hepatitis B vaccination schedule with two 4-double doses of conventional vaccine and four doses of adjuvant vaccine in chronic kidney disease patients evaluated for renal transplantation. Methods: In this prospective study, we recruited chronic kidney disease patients evaluated for renal transplantation to receive four 40-μg doses of hepatitis B virus vaccine (0, 1, 2 and 6 months) and another four 40 μg doses of hepatitis B virus vaccine and four 20 μg doses of adjuvant vaccine if they were nonresponders. AntiHBs titers were analyzed before every vaccine dose and 1 month after the fourth dose. Results: One hundred fifty-five patients were enrolled in the study. The response to the vaccination increased until the seventh dose: first dose, 5.4%; second, 29.5%; third, 66.7%; fourth, 75.9%; fifth, 83.3%; sixth, 87.3%; seventh, 92.5%; and eighth, 93.8%. AntiHBs titers after the first and second vaccination with Engerix were 10 to 99 mIU/mL in the 12% and 7.7%, 100 to 999 mIU/mL in the 30.1%, and 46.2%, and 1000 mIU/mL in the 34.9% and 15.4%, respectively. Fendrix was administrated in 6.2% of the patients and 75% of them obtained a response. AntiHBc-positive patients obtained a response with one vaccination cycle in the 71.4%. The response was influenced by age and was greater in women. Adverse events were found in 11.5% of the patients (inflammation and/or local pain), which were less frequent in men (8.9% versus 16.1%) and similar for both vaccines. Conclusion: The response to the hepatitis B vaccination with four double doses of conventional vaccine and revaccination with the same schedule and adjuvanted vaccine shows a high response rate in chronic kidney disease evaluated for renal transplantation. [Copyright &y& Elsevier]