Renato Nicolás Hopp

Osteonecrosis after administration of intravitreous bevacizumab.

Bevacizumab is a recombinant humanized monoclonal immunoglobulin G1 antibody (149 kDa) that binds to and inhibits the biologic activity of all isoforms of human vascular endothelial growth factor. It has been used for the treatment of a myriad of malignancies, including metastatic colon and nonsmall cell lung cancers. Retinal afflictions and neovascular diseases are currently being treated with this medication, a therapy performed as an off-label use based on its short-term safety and low cost, turning bevacizumab into a widely used medication in ophthalmology. Its antineoplastic use has been related to a series of adverse effects such as hypertension, proteinuria; mild to moderate hemorrhage, wound-healing complications, thromboembolic events, and impaired wound healing. Adverse effects after intravitreal dministration have also been described and consist f local ocular events such as subconjunctival hemorhage and systemic effects such as increased blood ressure. Cases of osteonecrosis of the jaw (ONJ) related to chemotherapy using bevacizumab were first described in 2008. To the best of the present investigators’ knowledge, there are only 4 reports published in the medical literature reporting jaw bone osteonecrosis related to bevacizumab (Table 1). No cases f ONJ after intravitreal administration of bevacizumab or treatment of ocular ailments have been reported n the literature. A case of ONJ occurring after intraitreal bevacizumab therapy is presented.

Right hand digit ratio (2D:4D) is associated with oral cancer.

Finger length ratio has been proposed as a putative marker for prenatal hormone exposure, as well as the action of HOX, AR, and a variant of the LIN28b genes. These genes have been recently connected to carcinogenesis and digit ratio could help to identify patients with this predisposition.

Oral vascular malformation in a patient with hereditary hemorrhagic telangiectasia: a case report

Hereditary hemorrhagic telangiectasia (HHT) is an inherited mucocutaneous disease characterized by recurrent epistaxis, lesions on skin and oral mucosa, and arteriovenous malformations of the soft tissues. This article describes the treatment of a 64-year-old woman with a bleeding nodule, which was diagnosed as an arteriovenous malformation of the gingival mucosa. She was treated using sclerotherapy. Patients with HHT can be treated in the dental office and vascular malformations of these patients can be successfully managed with sclerotherapy, which eliminates the need for invasive surgical procedures and the possibility of postsurgical complications.

Digit Ratio is Associated with Colorectal Cancer

Background: Prenatal testosterone and estrogen exposure may influence disease susceptibility. Digit ratio (2D:4D) is a putative marker for prenatal hormone exposure and sensitivity, as well as the action of genes related to malignancies. Therefore, 2D:4D could act as a marker for cancer predisposition. Aims: Investigate the possible correlation between R2D:4D, L2D:4D and right minus left. 2D:4D (Δr-l) and colorectal cancer (CRC) in men and women and assess correlations with tumor staging and histological diagnosis. Methods: Digital images of the right and left hand palms of patients diagnosed with CRC (n=139) and age and sex-matched controls (n=139) were used to measure the 2nd and 4th fingers. Means for 2D:4D were compared. Data were analyzed by intraclass correlation coefficient, Students t-test, Kendall’s tau b and Spearman’s rho (α=0.05). Results: CRC group presented significantly higher right and left 2D:4D (p=0.00001 and p=0.00005, respectively) in comparison to healthy controls. R2D:4D was negatively correlated to tumor differentiation (p=0.02) while L2D:4D was positively correlated to tumor size (p=0.03). Conclusions: Prenatal estrogen and testosterone seem to play a role on the malignant transformation and progression of colorectal cancer. The findings suggest that 2D:4D could add to the list of etiological factors and be a putative marker for the screening of patients’ susceptibility to develop colorectal cancer.

Oral vascular malformation in a patient with hereditary hemorrhagic telangiectasia: a case report: SCLEROTHERAPY FOR VASCULAR LESION IN A PATIENT WITH HHT

Hereditary hemorrhagic telangiectasia (HHT) is an inherited mucocutaneous disease characterized by recurrent epistaxis, lesions on skin and oral mucosa, and arteriovenous malformations of the soft tissues. This article describes the treatment of a 64-year-old woman with a bleeding nodule, which was diagnosed as an arteriovenous malformation of the gingival mucosa. She was treated using sclerotherapy. Patients with HHT can be treated in the dental office and vascular malformations of these patients can be successfully managed with sclerotherapy, which eliminates the need for invasive surgical procedures and the possibility of postsurgical complications.