[Food consumption patterns and risk of gallstone disease (GD): Case and Control Study in Rosario Argentina.] / Patrones de consumo alimentario y riesgo de enfermedad colelitiásica (EC): Estudio de Casos y Controles en Rosario Argentina.

Introduction: Nutritional exposure is considered the main environmental influence that contributes to gallstone disease (GD). Aim: The aim of this study was to determine food intakes patters and estimate risk of GD. Methods: A nested case-control study was carried out within the framework of a previous screening study conducted on a representative sample in Rosario, Argentina. Participants underwent a personal interview. Average amount of each food intake and quantity nutrients were estimated applying a food-frequency questionnaire. Food consumption patterns were identified by principal component analysis, and logistic regression analysis was used to estimate risks. Results: The sample was conformed by 51 cases and 69 controls. Two dietary patterns were identified. Cases were characterised by the unhealthy intake pattern (high intakes of animal fats, sugar, cereals, grains, cold cuts, processed meats, chicken with skin, fat beef and low intake of red vegetables and yellows, cabbages, fruits and fish). Conclusion: Controls were characterised by the healthy intake pattern (high intake of skinless chicken, nuts, lean beef, vitamin A and C rich fruits, and low consumption of chicken with skin, green leaves vegetables and sprouts). The unhealthy pattern showed an increased risk of developing GD while healthy patter behaved as a protective factor.

Introducción: La exposición nutricional se considera la principal exposición ambiental que contribuye a la formación de cálculos biliares. Objetivo: El objetivo de este trabajo fue determinar el patrón de consumo alimentario de casos y controles de EC y estimar el riesgo de desarrollar la enfermedad según los distintos patrones constituidos. Métodos: Se llevó a cabo un estudio analítico retrospectivo transversal de casos y controles, anidado a un estudio de prevalencia realizado en Rosario. Todos los participantes fueron entrevistados personalmente. El consumo de alimentos se consignó a través de un cuestionario semi-cuantitativo de frecuencia de consumo. Para determinar patrones de consumo alimentario se realizó un análisis de componentes principales, y análisis de regresión logística múltiple para evaluar riesgos. Resultados: La muestra quedó conformada por 51 casos y 69 controles. Se determinaron dos componentes que permitían diferenciar los casos de los controles, a través de las cuales se establecieron 2 patrones de consumo. Los casos se caracterizaron por un consumo determinado por el Patrón Poco saludable (altas ingestas de grasas animales, azúcar, cereales, granos, fiambres y embutidos) y los controles por el consumo del patrón Saludable (altas ingestas de pollo sin piel, frutas secas, carne vacuna magra, frutas, lácteos enteros). El patrón Poco saludable, aumentó el riesgo de desarrollar EC mientras que el patrón Saludable, se comportó como protector. Conclusión principal: Los patrones constituidos diferencian los casos de los controles, y la ingesta propia de los casos se correlaciona con un perfil de consumo que caracteriza a las culturas occidentales modernas y urbanas.

La alimentación en estudiantes del primer ciclo de la carrera de medicina de la Universidad Nacional de Rosario, Argentina / Eating habits of medical students of the National University of Rosario, Argentina

Con el objetivo de indagar sobre los hábitos alimentarios de los estudiantes de la carrera de Medicina de la Facultad de Ciencias Médicas de la Universidad Nacional de Rosario (UNR), y compararlos con las Guías Alimentarias para la Población Argentina se llevó a cabo un estudio cuali-cuantitativo, descriptivo, observacional y transversal. Se aplicó una encuesta y un recordatorio de 24 horas. La muestra quedó conformada por 140 alumnos. El consumo de alimentos declarado mostró que el 70% había consumido leche o yogur, el 56,4% frutas, el 79,3% verduras, el 75,7% carnes, el 62,1% cereales, el 20% huevos y el 25% fiambres. El 46,4% declaró haber utilizado azúcar y el 20% edulcorante. El 81,4% expresó haber consumido panificados blancos y sólo el 15,7% integrales. Los vegetales y el edulcorante fueron más consumidos por las mujeres y las carnes y los panificados blancos por los hombres. Respecto del hábito de desayunar fue importante el número de estudiantes que cumplió la recomendación de las Guías. El número de ingestas diarias recomendado (mínimo 4) lo cumplió el 77%. Sólo el 12,8% declaró consumir frutas y verduras tal como es recomendado (5 porciones al día). Respecto de los panificados, esta muestra no cumple la recomendación de seleccionar granos integrales.

The aim of this study was to investigate the dietary habits of the students at the School of Medicine, Faculty of Medical Sciences of the National University of Rosario (UNR), and to compare them with the Dietary Guidelines for the Argentinian population. We carried out a quantitative, descriptive, observational cross-sectional study using a 24- hour dietary recall questionnaire. The sample was made up of 140 students. The declared food consumption showed that 70% consumed milk or yogurt, 56.4% fruits, 79.3% vegetables, 75.7% meats, 62.1% cereals, 20% eggs and 25% cold cuts. Sugar consumption was reported by 46.4% of the students, and use of artificial sweeteners by 20% of them. Most students (81.4%) consumed white bread and only 15.7% whole wheat. While vegetables and sweeteners were more consumed by women, meat and white bread were more consumed by men. Many students met the recommendation for breakfast consumption. The recommended number of daily meals (minimum 4) was met by 77%. Only 12.8% reported eating fruits and vegetables as recommended (5 servings a day). Regarding breads, this sample does not meet the recommendation of selecting whole grains.

[Study about skin cancer screening in comparison with breast and cervix cancer screening in a female sample from Concordia, Argentina.] / Estudio acerca del conocimiento, actitudes y prácticas del cribado de cáncer de piel, mama y cérvix en una muestra de mujeres en Concordia, Argentina.

Introduction: The aim of this study was to describe the knowledge, practices and attitudes regarding the screening of skin cancer, compared to the breast and cervix cancer. Methods. An observational, cross-sectional study using structured questionnaires was carried out among women in the city of Concordia, Entre Ríos. The sample consisted of 90 mothers or tutors from low (G1, n=32), middle (G2, n=29) and high (G3, n=29) socioeconomic status elementary schools students. Results. Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Methods: An observational, cross-sectional study using structured questionnaires was carried out among women in the city of Concordia, Entre Ríos. The sample consisted of 90 mothers or tutors from low (G1, n=32), middle (G2, n=29) and high (G3, n=29) socioeconomic status elementary schools students. Results. Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Results: Mean age were 37,9±6,6, 38,0±6,9 and 43,1±5,6 years, respectively. The annual skin exam has been performed by dermatologist in 30.0% (G1), 30.8% (G2) and 51.7% (G3) of these women. The annual gynecological exam has been done by 46.4% (G1), 60.7% (G2) and 86.2% (G3). The existence of the skin cancer prevention campaign was known in 35,7%, 16% and 10,7% in G1, G2 and G3 respectively, but only 3,7% of G2, 3,7% of G3 and no women in G1 had ever participated in a campaign. Major conclusion. These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening. Major conclusion: These data indicate the need to achieve effective strategies that allow improving the adherence of women to prevention campaigns, especially those for skin cancer prevention, where there is less participation when compared with breast and cervical cancer screening.

Introducción: En este estudio se describen los conocimientos, prácticas y actitudes en relación al cribado de cáncer de mama, cérvix y piel en una muestra de madres o tutoras de alumnos de sexto grado de establecimientos de educación primaria de la ciudad de Concordia, Entre Ríos. Métodos. Durante el año 2016 se realizó un estudio observacional, descriptivo, transversal, mediante entrevistas y encuestas estructuradas a 90 mujeres mayores de 18 años, madres o tutoras de alumnos de tres escuelas de la ciudad de Concordia correspondientes a diferentes niveles socioeconómicos (bajo: G1, n=32), medio (G2, n=29) y alto (G3, n=29). Resultados. La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal. Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención. Métodos: Durante el año 2016 se realizó un estudio observacional, descriptivo, transversal, mediante entrevistas y encuestas estructuradas a 90 mujeres mayores de 18 años, madres o tutoras de alumnos de tres escuelas de la ciudad de Concordia correspondientes a diferentes niveles socioeconómicos (bajo: G1, n=32), medio (G2, n=29) y alto (G3, n=29). Resultados. La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal. Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención. Resultados: La edad promedio fue 37,9±6,6; 38±6,9 y 43,1±5,6 años, respectivamente. Las proporciones de mujeres que se realizaron controles periódicos de mama, cérvix y piel por médicos especialistas fueron mayores en el grupo de madres pertenecientes al nivel socioeconómico alto. El 35,7%, 16% y 10,7% de las mujeres del G1, G2 y G3 respectivamente, conocían las campañas de prevención de cáncer cutáneo; pero sólo participó en alguna de ellas el 3,7% del G2, 3,7% del G3 y ninguna del G1. Conclusión principal: Estos datos nos indican la necesidad de lograr estrategias que permitan mejorar la adhesión de las mujeres a las campañas de prevención.

Frecuencia de fracturas en una población cerrada de Atención Primaria de la Salud (APS) del Distrito Centro de la ciudad de Rosario / Frequency of fractures in a closed Primary Health Care population in the Downtown District of Rosario, Argentina

Con el propósito de determinar la prevalencia de fracturas osteoporóticas en una población cerrada de Atención Primaria de la Salud (APS) correspondiente al Distrito Centro de la ciudad de Rosario, se realizó este estudio observacional transversal. Los datos se obtuvieron de las fichas clínicas de los pacientes correspondientes a los registrosdel consultorio de APS. Se determinó la prevalencia de las fracturas del esqueleto periférico y axial estratificadas poredad y sexo, y se exploró la asociación entre índice de masa corporal y fracturas en esta población y según sexo. Seobtuvo información de 898 pacientes; 662 mujeres (73,7%) y 236 varones (26,3%); la relación mujer/varón fuede 2,8/1. La edad promedio fue de 75 años, y similar en ambos sexos. Los varones habían perdido 4,3±2,9 cm detalla con respecto a su talla histórica (rango: 0-17 cm), y las mujeres 5,7±3,7 cm (rango: 0-19 cm)...

In order to determine the prevalence of osteoporotic fractures in a closed population of Primary Health Care (PHC)corresponding to the Downtown District of the city of Rosario, this cross-sectional observational study was performed. Data were obtained from patients’ clinical records corresponding to PHC office records. The prevalence of axial andperipheral skeletal fractures was determined and the association between fractures and age, sex and body mass index (BMI)was explored. Information was obtained from 898 patients; 662 women (73.7%) and 236 men (26.3%); The male/female ratio was 2.8/1. Mean age was 75 years, and similar in both sexes. Males had lost 4.3±2.9 cm in height withrespect to their historical height (range: 0-17 cm), and females 5.7±3.7 cm (range: 0-19 cm)...

Putative Biomarkers of Response to Treatment in Breast Cancer Patients: A Pilot Assay.

Identifying tumor biomarkers associated with clinical behavior in breast cancer patients may allow higher accuracy in the selection of treatment. Different types of cells were determined in the primary tumors of stage I, II, and III of breast cancer patients, who were assigned to one of the two groups: (1) disease-free or (2) relapsed/progressed, at 5 years after primary treatment. We studied 32 tumor samples. CD4+ lymphocytes and CD44+CD24-/low cells (cancer stem cells) showed a significant association with clinical outcome at 5 years of primary treatment, while CD8+, Foxp3+, CD34+, and myeloid-derived suppressor cells did not show any association. Coincident with the results of individual analysis, we identified CD4+ cells and CD44+CD24-/low cells as good predictors of long-term clinical outcome in a logistic regression.

Quality of life in patients with metastatic breast cancer treated with metronomic chemotherapy.

AIM: The objective of the study was to detect changes in quality of life (QoL) in metastatic breast cancer patients treated with metronomic chemotherapy with daily low doses of cyclophosphamide and celecoxib. MATERIAL & METHODS: Patients included in a Phase II trial, treated with metronomic cyclophosphamide and celecoxib were included in the QoL study. Assessment of QoL was carried out every 2 months by the Functional Assessment of Cancer Therapy Breast (FACT-B) questionnaire, Brief Pain Inventory and Eastern Cooperative Oncologic Group scale. Data were analyzed at three time points: baseline (BL); middle of treatment (MT); and end of treatment (ET). RESULTS: A total of 20 patients were included. All patients were heavily pretreated. Treatment showed a good and safe therapeutic profile. With FACT-B questionnaire, no significant differences were observed during the response period (BL-MT). However, a significant increase was observed in the Emotional well-being and Additional concerns axes, when the last time point was included in the analysis (BL-MT-ET). A significant decrease in the proportion of patients with pain was found when comparing BL with ET (p = 0.046). The assessment with Eastern Cooperative Oncologic Group scale showed that 26.7% (4/15) of the patients improved their functional status and 40% (6/15) showed no changes, while 33.3% (5/10) worsened it. CONCLUSION: Patients treated metronomically for several months did not worsen their QoL. A high proportion of patients showed improvement or no changes and there were less patients with pain at the end of the treatment.

Incidencia de fracturas de cadera en los seis distritos de Rosario / Incidence of hip fracture in the six districts of Rosario city, Argentina

Las tasas de incidencia de fracturas de cadera varían entre países vecinos de un mismo continente, entre distintas regiones de un mismo país, y aún entre distintos barrios de una misma ciudad. El objetivo de este trabajo fue determinar si existían diferencias en las tasas de incidencia de fractura de cadera en los 6 distritos en que se divide la ciudad de Rosario (provincia de Santa Fe, Argentina), con una población de alrededor de un millón de habitantes, y establecer si hay factores ambientales (indicadores sanitarios) o socioeconómicos que pudieran explicar las diferencias. Se realizó un estudio de diseño ecológico. Se calcularon las tasas de incidencia globales, específicas por sexo y grupos etarios, así como las tasas truncadas y ajustadas en cada distrito municipal de Rosario. Los indicadores sociosanitarios estudiados fueron: tasas de mortalidad, necesidades básicas insatisfechas (NBI), habitantes/vivienda, habitantes/hectárea, madres menores de 20 años, nacidos de bajo peso, asentamientos precarios, espacios libres. Se aplicó un análisis multivariado considerando las tasas como variable dependiente y los indicadores sociosanitarios, sexo y grupos de edad como variables independientes, utilizando la regresión de Poisson y calculando el riesgo relativo (razón de tasas). Como resultados de este estudio, concluimos que la incidencia de fractura de cadera no difiere entre los distritos poblacionales de Rosario, y no se individualizaron grupos poblacionales que (de acuerdo a su lugar de residencia, con condiciones sanitarias y socioeconómicas características) presenten un riesgo especial para este tipo de complicación de la osteoporosis.

The incidence rates of hip fractures vary between neighboring countries in the same continent, between different regions of the same country, and even among different neighborhoods in the same city. The aim of this study was to determine whether there were differences in the incidence rates of hip fracture in the 6 districts in which the city of Rosario (province of Santa Fe, Argentina: population 1 million) is divided. We also tried to ascertain whether there are environmental (health indicators) or socioeconomic factors that could explain the differences. The study had an ecological design. Globalincidence rates specific for sex and age groups, and the truncated rates were calculated and adjusted in each municipal district of Rosario. The social health indicators studied were mortality, unmet basic needs, housing, inhabitants/hectare, mothers under age 20, low birth weight, settlements, open spaces. Multivariate analysis considering rates as the dependent variable and social and health indicators, gender and age as independent variables, using Poisson regression and calculating the relative risk (rate ratio) was applied. As results of this study, we conclude that the incidence of hip fracture does not differ between population districts of Rosario, and that no population groups were identified presenting an increased risk for this complication of osteoporosis, based on their place of residence, health conditions or socioeconomic characteristics.

Raíces dentales humanas normales y con perlas de cemento: comparación histológica de estructuras / Normal human dental roots and withcementum pearls: structural histological comparison

Durante la vida del diente en boca se deposita cemento celular en el ápice a fin de compensar el desgaste oclusal considerado normal. Al extraer un diente, en raras ocasiones es posible visualizar excesos de cemento con forma de perlas bien delimitados y duros al tacto, ubicados en otro sector radicular diferente al ápice. Nuestro objetivo fue comparar estructuras en ambos tipos de cemento a fin de hallar diferencias histológicas. Se utilizaron 20 dientes permanentes con perlas (G1) y 20 con raíces normales (G2). Las raíces de G1 se cortaron con disco metálico de grano fino a baja velocidad en sentido transversal, a la altura de la parte más prominente de la protuberancia, las raíces de G2 se marcaron en tercios y se cortaron en sentido transversal aproximadamente a la altura de la mitad del tercio apical y de ambos grupos se obtuvieron un segmento que fue reservado y otro que fue preparado con técnica por desgaste para visualización con MO a menor y mayor aumentos. Los resultados se compararon con prueba t de student, las variables categóricas se compararon con pruebas de Fisher significación 5 por ciento. Se obtuvieron 40 dientes de pacientes adultos, 42,5 por ciento masculinos y 57,5 por ciento femeninos, edad promedio 61+/-16 en G1 y 55+/-18 en G2 (p=0,289). El contorno exterior de las perlas fue liso, conservando su perímetro, la zona granular de Tomes fue visible al igual que las lagunas, que fueron menos abundantes, de mayor tamaño y con distribución desordenada llegando en menor proporción al borde del tejido comparado con cemento normal.

During tooth life in mouth cellular cement settles in the apex in order to compensate the occlusal wear considered normal. After a tooth extraction, on rare occasions it is possible to visualize cement excesses with pearls form well delimited and hard to tact, located in another radicular sector different of the apex. Our aim was to compare structures in both types of cement in order to find histological differences. Consequently, 20 permanent teeth with pearls (G1) and 20 with normal roots (G2) were used. G1 roots were cut by a thin grain metallic disc at low speed in transverse sense, at the height of the protuberance most prominent part; G2 roots were marked in thirds and cut in transverse sense at the half of the third apical. From both groups a segment was obtained to be reserved and other one that was prepared by erosion technology to be visualized by MO at minor and major increases. Results were compared with student t test, categorical variables with Fisher's tests significance 5 percent. Forty adult patients teeth were obtained, male 42.5 percent and female 57.5 percent, age average in G1 61+/-16 and 55+/-18 in G2 (p=0.289). Pearls exterior face was smooth, with a preserved perimeter, Tomes granular zone was visible as were lagoons, which were less abundant, greater in size and with uneven distribution arriving at tissue border in a lesser proportion compared with normal cement.

Safety and therapeutic effect of metronomic chemotherapy with cyclophosphamide and celecoxib in advanced breast cancer patients.

Metronomic chemotherapy (MCT), the chronic administration, at regular intervals, of low doses of chemotherapeutic drugs without extended rest periods, allows chronic treatment with therapeutic efficacy and low toxicity. Our preclinical results suggested that combined MCT with cyclophosphamide and celecoxib could inhibit breast cancer growth. The aim of this study was to determine the toxicity, safety and efficacy of oral MCT with cyclophosphamide 50 mg per orem daily and celecoxib 400 mg (200 mg per orem two-times a day) in advanced breast cancer patients. During the first stage of the study, the therapeutic response consisted of prolonged stable disease for ≥24 weeks in six out of 15 (40%) patients with a median duration of 37.5 weeks and a partial response in one out of 15 (response rate: 6.7%) patients lasting 6 weeks. The overall clinical benefit rate was 46.7%. The median time to progression was 14 weeks. Progression-free survival at 24 weeks was 40% and the 1-year overall survival rate was 46.7%. The adverse events were mild (gastric, grade 1; and hematologic, grade 1 or 2). No grade 3 or 4 toxicities were associated with the treatment. Evaluation of patients' quality of life showed no changes during the response period. MCT with cyclophosphamide plus celecoxib is safe and shows a therapeutic effect in advanced breast cancer patients.

Patrón de consumo alimentario en una muestra de adultos con Enfermedad Colelitiasica (EC)

En un estudio realizado en una muestra aleatoria de adultos de Rosario se encontró una tasa de prevalencia de Enfermedad Colelitiásica (EC) del 20,5%. Con el objetivo de determinar el patrón de consumo alimentario de estas personas y compararlo con las Raciones Dietéticas Recomendadas (RDA) se entrevistaron 44 de dichas personas con EC. Se les realizó una encuesta sobre hábitos alimentarios 5 años previos al diagnóstico, empleando un cuestionario semi-cuantitativo de frecuencia de consumo (FFQ) y un Atlas fotográfico de porciones estandarizadas. Se calcularon los promedios (± desvío estándar) de la edad, del Índice de Masa Corporal (IMC), del consumo de cada nutriente y de la energía total consumida (Kilocalorías). La significación estadística de las diferencias entre sexos se evaluó aplicando pruebas t de student. La edad de las personas estudiadas (18 varones y 26 mujeres) fue 63,8±13,8 años y el IMC fue 28,2±5,8. Consumos promedio diarios: Kcalorias 2941±791,1 ; Carbohidratos 295,3±96,9 g; Proteínas 131,6±36,8 g; Grasa 128,9± 43 g; Ácidos grasos saturados 41,9±18,6 g; Ácidos grasos poliinsaturados 13,8±8,7 g; Colesterol 455,4±186,8 mg; Sodio 2730±1552,1 mg; Potasio 2912,8±1001,4 mg; Calcio 719,3±403,3 mg; Hierro 16±4,6 mg; Fósforo 801,6±320,3 mg; Vitamina A 3121,7±1811,9 mcg; Vitamina B1 0,80±0,30 mg; Vitamina B2 1,9±0,8 mg; Vitamina C 157,6±114,1 mg; Niacina 6,9±2,7 mg; Fibra total 12± 5,3 g; Café 70,7±104,3 cc. Se concluye que el patrón alimentario de las personas con EC se caracterizó por un alto consumo de Grasas, Ácidos grasos saturados y Colesterol, no alcanzando las recomendaciones para Carbohidratos, Calcio, Niacina y Fibra.

Food intake pattern in a sample of adults with Gallbladder Disease (GD). In Rosario, Argentina, a 20,5% prevalence rate of Gallbladder Disease (GD) was found in a random sample of adults. The aim of this study was to determine the food consumption pattern of subjects with GD nested in that sample for further comparison with the Recommended Dietary Allowances (RDA). Forty-four subjects were interviewed about the food consumption during the five years before their diagnosis, by applying a semi-quantitative food frequency questionnaire (FFQ) and a photographic atlas of standardized portions. Age, body mass index (BMI), all consumed nutrients, and total energy intake (kilocalories) were reported as Mean ± standard deviation. Comparisons according to sex (18 males and 26 females) revealed no significant differences in the variables under analysis. Age and BMI in the overall sample were as follows 63.8±13.8 years and 28.2±5.8, respectively. Mean daily consumption of nutrients was as follows: Carbohydrates 295.3±96.9 g , Protein 131.6±36.8 g , Fat 128.9±43 g , Saturated fatty acids 41.9±18,6 g, Polyunsaturated fatty acids 13.8±8.7 g, Cholesterol 455.4±186.8 mg, Sodium 2730±1552.1 mg, Potassium 2912.8±1001.4 mg, Calcium 719.3±403.3 mg, Iron 16±4.6 mg, Phosphorus 801.6±320.3 mg, Vitamin A 3121.7±1811.9 mcg, Vitamin B1 0.80±0.30 mg, Vitamin B2 1.9±0.8 mg, Vitamin C 157.6±114.1 mg, Niacin 6.9±2.7 mg, Fiber 5.3±12 g, Coffee 70.7±104.3 cc (total energy intake 2941±791.1 Kcal). Subjects with GD have a history of higher intake of fat, saturated fatty acids and cholesterol with consumption of carbohydrates, calcium, niacin and fiber below the recommended quantities.

[Food intake pattern in a sample of adults with gallbladder disease (GD)]. / Patrón de consumo alimentario en una muestra de adultos con Enfermedad Colelitiasica (EC).

In Rosario, Argentina, a 20,5% prevalence rate of Gallbladder Disease (GD) was found in a random sample of adults. The aim of this study was to determine the food consumption pattern of subjects with GD nested in that sample for further comparison with the Recommended Dietary Allowances (RDA). Forty-four subjects were interviewed about the food consumption during the five years before their diagnosis, by applying a semi-quantitative food frequency questionnaire (FFQ) and a photographic atlas of standardized portions. Age, body mass index (BMI), all consumed nutrients, and total energy intake (kilocalories) were reported as Mean +/- standard deviation. Comparisons according to sex (18 males and 26 females) revealed no significant differences in the variables under analysis. Age and BMI in the overall sample were as follows 63.8 +/- 13.8 years and 28.2 +/- 5.8, respectively. Mean daily consumption of nutrients was as follows: Carbohydrates 295.3 +/- 96.9 g, Protein 131.6 +/- 36.8 g, Fat 128.9 +/- 43 g, Saturated fatty acids 41.9 +/- 18,6 g, Polyunsaturated fatty acids 13.8 +/- 8.7 g, Cholesterol 455.4 +/- 186.8 mg, Sodium 2730 +/- 1552.1 mg, Potassium 2912.8 +/- 1001.4 mg, Calcium 719.3 +/- 403.3 mg, Iron 16 +/- 4.6 mg, Phosphorus 801.6 +/- 320.3 mg, Vitamin A 3121.7 +/- 1811.9 mcg, Vitamin B1 0.80 +/- 0.30 mg, Vitamin B2 1.9 +/- 0.8 mg, Vitamin C 157.6 +/- 114.1 mg, Niacin 6.9 +/- 2.7 mg, Fiber 5.3 +/- 12 g, Coffee 70.7 +/- 104.3 cc (total energy intake 2941 +/- 791.1 Kcal). Subjects with GD have a history of higher intake of fat, saturated fatty acids and cholesterol with consumption of carbohydrates, calcium, niacin and fiber below the recommended quantities.

Micrometric measurement of the density of stained odontoblast processes.

UNLABELLED: The embryological, structural and functional unit of the dentine-pulp complex shares the odontoblast, located in the border of the dentine pulp, with basal nuclei and organelles. The odontoblast process emerges from its apical pole. It is formed by microtubules, microfilaments and vesicles covered by membranes penetrating the dentinal tubules, isolated from the inter-tubular matrix, along the extent of the dentine. The objective of this study was to evaluate the efficacy of three staining techniques: hematoxylin-eosin, periodic acid-Schiff and Schmorl, by staining the process, from beginning to end, and compare the results with the erosion technique. Thirty human teeth were employed in the trial; after their extraction the pulp was fixated, the pieces demineralized in nitric acid at 8%, the collagen filaments eliminated with Type II Collagenase, the tissue was stained, and the measurements were made. The portions with no pulp were prepared with the erosion technique. RESULTS: Comparing the best results obtained by staining with the values obtained with the erosion technique, the former showed lower values. CONCLUSION: Staining techniques show lower density of the staining processes compared with the dentinal tubules in the erosion technique.

Hipercementosis apicales y no apicales en raíces dentarias humanas / Apical and non-apical hypercementosis in human dental root

El cemento secundario del ápice radicular se deposita en forma lenta y continua durante toda la vida útil del diente, siendo su función compensar el desgaste producido por la masticación. En raras ocasiones podemos hallar en la raíz dental, a posteriori de una extracción dentaria, excesos de cementos redondeados u ovalados, bien delimitados y duros al tacto, ubicados en un sector radicular diferente al ápice. Nuestro objetivo fue comparar las características físicas y radiológicas de raíces dentales normales con aquéllas que presentan este tipo de formaciones que alteran la anatomía radicular. Fueron incluidos 20 dientes adultos con raíces normales y 20 con raíces donde se visualizaron estos depósitos. Las variables investigadas fueron edad, sexo, patologías generales y periodontales previas, tipo de diente extraído, ubicación en el arco dental, motivo de extracción, características de consistencia, color, aspecto y textura de todas las raíces. La imagen radiológica fue crucial para la inclusión de dientes con exceso de cemento. Se recolectó un total de 40 dientes adultos, cuya edad promedio fue de 61 años (16-79), 42.5 por ciento masculinos y 57.5 por ciento femeninos. Patología general presentó el 37.5 por ciento y periodontal el 55 por ciento, los dientes mas extraídos fueron premolares superiores del lado derecho 15 por ciento. La caries fue causa principal de extracción 72.5 por ciento. En ambos grupos las raíces fueron de consistencia dura y textura lisa. El aspecto nacarado fue de 70 por ciento y 60 por ciento, los colores claros 45 por ciento y 75 por ciento, respectivamente. En las radiografías se observó que el cemento no se diferenció de la dentina en el 40 por ciento y 85 por ciento de cada grupo (p=0.004). Los adultos pueden desarrollar anomalías de cemento ubicadas en otro sector del ápice si bien las características físicas de la raíz se consideran dentro de parámetros normales.

Secondary cementum is deposited in a root apical third throughout the lifespan of a tooth to compensate occlusal erosion, keeping dental pieces in occlusion contact. Pearls are more difficult to spot, found by X-rays or after extraction. Their ovoid or spherical aspect is well outlined, hard to touch, and located in different thirds of the root. Our objective was to compare physical and radiological dental normal roots characteristics with those presenting this type of formations that alter radicular anatomy. We used 20 normal roots and 20 pearl shapes. Variables compared: age, sex, previous general pathologies and periodontals; extracted tooth type, dental arch location, extraction cause, consistency characteristics, color, aspect and texture of all roots and pearls. Radiological image was crucial for incorporation of teeth with cementum excess. Proportions between normal pieces and pearls were calculated with Fisher's Exact Test, with 5 percent significance level. Average age was 61years (16-79), and male proportion was 42.5 percent and 57.5 percent female. General pathology presented 37.5 percent and periodontal 55 percent, more extracted teeth were right side upper premolars 15 percent. Caries were extraction chief motive 72.5 percent. Roots were of hard consistency and smooth texture in both groups; nacreous aspect was 65 percent, clear colors 75 percent. Pearl consistency was hard in all of them; white color 60 percent and root similar color 40 percent; nacreous aspect 75 percent and smooth texture 90 percent. In radiographs was observed that cementum did not differ from dentine in 85 percent of pearls and in 60 percent of normal roots (p=0.004). Adults can develop cementum anomalies located in another apex sector although the root physical characteristics are considered inside normal parameters.

Micrometric measurement of the density of stained odontoblast processes

The embryological, structural and functional unit of the dentine-pulp complex shares the odontoblast, located in the border of the dentine pulp, with basal nuclei and organelles. The odontoblast process emerges from its apical pole. It is formed by microtubules, microfilaments and vesicles covered by membranes penetrating the dentinal tubules, isolated from the inter-tubular matrix, along the extent of the dentine. The objective of this study was to evaluate the efficacy of three staining techniques: hematoxylin-eosin, periodic acid-Schiff and Schmorl, by staining the process, from beginning to end, and compare the results with the erosion technique. Thirty human teeth were employed in the trial; after their extraction the pulp was fixated, the pieces demineralized in nitric acid at 8%, the collagen filaments eliminated with Type II Collage-nase, the tissue was stained, and the measurements were made. The portions with no pulp were prepared with the erosion technique. Results: Comparing the best results obtained by staining with the values obtained with the erosion technique, the former showed lower values. Conclusion: Staining techniques show lower density of the staining processes compared with the dentinal tubules in the erosion technique.

Prevalencia de sobrepeso, obesidad e hipertensión arterial en adolescentes de una escuela de arte / Prevalence of overweight, obesity and hypertension in adolescents attending an art school

Se realizó un estudio analítico de corte transversal en la población de alumnos que concurren a una Escuela Pública Secundaria y de Arte (n=213, varones 24 por ciento, mujeres 76 por ciento) en sus dos trayectos vocacionales (No-físico: Artes Visuales/Música y Físico: Danzas). Se determinaron variables antropométricas, presión arterial y frecuencia cardíaca. Se aplicó una encuesta sobre antecedentes personales de enfermedades crónicas no-transmisibles; traumatismos; ciclo menstrual; actividad física extraescolar; sedentarismo y horas de sueño. La tasa de participación fue del 70 por ciento. En los varones (edad 15,6±1,8 años) las tasas de prevalencia de bajo peso, eutrofismo, sobrepeso y obesidad fueron de 0 por ciento, 87,5 por ciento, 12,5 por ciento y 0 por ciento, respectivamente. En las mujeres (edad 15,5±1,7) estas tasas fueron 1,1 por ciento, 86 por ciento, 8,6 por ciento y 4,3 por ciento. El índice de masa corporal se encontró significativamente asociado con los perímetros de cintura y braquial tanto en varones como en mujeres (p<0,001). En el grupo de alumnos con Sobrepeso/Obesidad se detectaron 2 adolescentes con PAS aislada, centilo 90. Un joven eutrófico con PAS/PAD centilo 90 fue confirmado como "borderline" por presurometría de 24h. En las mujeres con Sp/Ob se detectaron 2 alumnas con PAS aislada centilo 90, una con PAD aislada centilo 90 y dos con PAS/PAD centilo 90. El estado nutricional de los alumnos es satisfactorio, con alta proporción de jóvenes eutróficos en ambos sexos. Sin embargo, la aplicación de este protocolo permitió detectar jóvenes con valores elevados de PA así como jóvenes con sobrepeso/obesidad. Dada la actividad escolar realizada por estos alumnos, estos factores podrían constituir un riesgo para su salud.

A cross-sectional analytical study involving the population of adolescent students attending the Nigelia Soria Public School and Art Institute (n=213, 24 percent boys, 76 percent girls) in the two career paths (non-physical: visual arts and music, and physical artistic activities: dance) was conducted. Anthropometric variables, blood pressure (systolic, SBP, and diastolic, DBP), and heart rate were measured. A semi-structured questionnaire collecting personal data regarding non-communicable chronic diseases, trauma, menstrual cycle, non-school physical activity, inactivity, and sleep duration was administered. The participation rate was 70 percent. In boys (age 15.6±1.8 years), the prevalence rates of low weight, eutrophy, overweight, and obesity were 0 percent, 87.5 percent, 12.5 percent and 0 percent, respectively. In girls (age 15.5±1.7 years), these rates were 1.1 percent, 86 percent, 8.6 percent, and 4.3 percent. Body mass index was significantly associated with waist circumference and brachial circumference in both genders (p<0.001). In the overweight/obesity group, two students were diagnosed with isolated systolic hypertension (SBP 90th percentile). A eutrophic male student with SBP/DBP 90th percentile was confirmed as borderline by 24-h blood pressure measurement. In the group of overweight/obese girls, two students were identified with isolated SBP 90th percentile, one with isolated DBP 90th percentile, and two with SBP/DBP 90th percentile. The nutritional status of students is satisfactory, with a high proportion of young healthy adolescents of both genders. However, the implementation of this protocol permitted to identify adolescents with high blood pressure, overweight, and obesity. These factors may pose a health risk considering the school activity of these students.

Vulnerability of healthy vertebrae in patients with and without previous vertebral fracture.

Vertebral deformities are associated with a marked increase in morbidity, mortality, and burden in terms of sanitary expenditures. Patients with vertebral fractures have a negative impact in their health, less quality of life, and loss of functional capacity and independence. The purpose of this study was to explore the vulnerability of healthy vertebrae in patients who have sustained already a compression fracture and in patients who do not have prevalent fractures in the thoracic spine; and to explore the association of the deformity in healthy vertebrae with different variables, such as bone mineral density (BMD), body mass index, age, loss of height, presence of clinical kyphosis, history of other osteoporotic fractures, and falls occurring during the last year. Clinical data and complementary studies from 175 postmenopausal outpatients were analyzed. These women (age: 69.7±11.1 years) had not received any treatment for osteoporosis. Anteroposterior and lateral radiographs of the thoracic spine and bone densitometry of the hip were obtained; morphometry was performed in 1575 thoracic vertebrae from T4 to T12. The angle of wedging of each vertebral body was calculated using a trigonometric formula. Then, the sum of wedge angles of vertebral bodies (SWA) was determined, and Cobb angle was measured. In patients with vertebral fractures, after excluding the angles of fractured vertebral bodies, the mean wedge angle of the remaining vertebrae (MWAhealthy) was calculated. The same procedure was followed in patients without vertebral fractures. MWAhealthy was considered as an indicator of the structural vulnerability of non-fractured vertebrae. Patients with prevalent fractures had lower BMD, wider Cobb angle, and higher sum of wedge angles than patients without vertebral fractures. The proportion of patients with accentuation of clinical kyphosis was higher in the group with prevalent vertebral fractures. A highly significant difference was found in the MWAhealthy, which was higher in patients with prevalent fractures (4.1±1.3° vs. 3.0±1.1°; p<0.001). Patients showing vertebral fractures had 7.1±4.2 cm height loss in average, significantly superior than that found among non-fractured women (3.6±3.2 cm; p<0.01). In multivariate analysis, the increase of MWAhealthy was associated with advancing age (p<0.02), lower femoral neck BMD (p<0.005), presence of clinical kyphosis (p<0.01) and vertebral fractures (p<0.02). This study presents evidence that a series of factors independently influence the increase in wedging deformity of vertebral bodies that are not fractured yet. These factors could contribute to an increased vulnerability of the vertebrae, making them more susceptible to fracture.

Medición comparada de procesos odontoblásticos y canalículos dentinarios / Comparative measurement of odontoblastic processes and dentinal tubules

El complejo dentinopulpar comparte el odontoblasto cuyo cuerpo está ubicado en la parte externa de la pulpa dentaria. De su polo apical se desprende el proceso odontoblástico que se introduce en el canalículo dentinal atravesando la dentina originando en su recorrido múltiples colaterales hasta su finalización. Describir el proceso fue ardua tarea de investigadores que combinaron técnicas histológicas para preservarlo en el interior de los canalículos utilizando microscopio electrónico de transmisión o scanning para visualizarlo. En un trabajo previo observamos ambos tejidos unidos por los odontoblastos y los procesos coloreados. El objetivo actual fue medir micrométricamente la longitud de procesos y canalículos para verificar si ambas son similares tanto en corona como en raíz. Se utilizaron treinta dientes sanos, extraídos por razones ortodóncicas de ambos sexos, cuyas edades oscilaron entre 6 y 18 años. Se descubrió la pulpa dental, se fijó y se dividieron en partes iguales. Las mitades sin pulpa se prepararon con técnica por desgaste. Las mitades que conservaron la pulpa se desmineralizaron aplicándoseles Colagenasa tipo II y coloreándolos con la técnica de Schmorl. Con microscopio óptico y una cuadrícula calibrada con micrómetro objetivo se midió primero el ancho de los campos histológicos y luego la longitud de procesos y canalículos dentinales. Los resultados fueron analizados con pruebas de chi2, t de Student y test exacto de Fischer con un nivel de significación del 5 por ciento. Observamos que el ancho de los campos histológicos coloreados tuvo una retracción del 92 por ciento respecto al mismo campo en el desgaste y que la longitud de canalículos siempre fue mayor que la de procesos, si bien se hallaron cuatro coincidencias de longitudes en corona y una en raíz. Estos resultados sugieren que la longitud del proceso aún sigue siendo tema controversial. La precausión profesional en los tratamientos odontológicos es el único medio para evitar...

The dentin-pulp complex shares the odontoblast, whose body is located in the external part of the dental pulp. The odontoblast process emerges from the apical pole and penetrates the dentinal canaliculus through the dentine producing multiple collaterals along the way. Descriibing the process was an arduous task for researchers, who combined histological techniques to preserve it in the interior of the canaliculi using transmission electron microscopy or scanning to visualize it. In a previous work we observed both tissues joined by the odontoblasts and the stained processes. The objective now was to micrometrically measure the length of the processes and canaliculi to verify if they are similar in the crown and in the root. Thirty healthy teeth were used, extracted for orthodontic reasons, from individuals of both sexes whose ages ranged from 6 to 18. The dental pulp was uncovered and attached, and they were divided in equal parts. The halves without pulp were prepared with the erosion technique. The halves that kept the pulp were demineralized with type II collagenase and stained with the Schmorl technique. With an optical microscope and a calibrated grid with a micrometric objective the width of the histological fields was first measured and then the length of the dentinal processes and canaliculi. The results were analyzed with chi2 test, Student t and Fischer's exact test with a 5 percent significance level. We observed that the width of the stained histological fields had a 92 percent retraction compared to the same field in the erosion and that the length of the canaliculi was always greater than the length of the processes, although four coincidences in length were found in the crown and one in the root. These results suggest that the length of the process is still a controversial topic. Professional precaution in odontological treatments is the safest prevention against injuries.

Gallbladder carcinoma: intraoperative imprint cytology, a helpful and valuable screening procedure.

BACKGROUND/PURPOSE: A major problem arises when a tumor is not readily recognized at the time of cholecystectomy. A carcinoma at early stages or one hidden by acute or chronic inflammation can be overlooked during surgery, and the diagnosis would then be made only after microscopic examination of paraffin-embedded tissue. The purpose of the present report is to communicate the results of 10 years' experience with the use of imprint cytology for the intraoperative diagnosis of gallbladder carcinoma. METHODS: During the period June 1994 to June 2004, 525 imprint cytologies of gallbladder mucosa were performed after 160 open cholecystectomies and 365 laparoscopic cholecystectomies. The patients had been operated on for acute or chronic cholecystitis due to lithiasis. Only 18 patients had a preoperative diagnosis of gallbladder carcinoma. The sensitivity, specificity, predictive values, accuracy, and their confidence intervals (95% CIs), of intraoperative imprint cytology for the diagnosis of carcinoma were analyzed. RESULTS: The average time employed for each procedure was 10 min. Patients' mean age was 69.2 years with a range of 24 to 92 years. Three hundred and forty-two patients (65.1%) were women and 183 (34.9%) were men. The imprint cytology method was positive in 44 of 58 gallbladder carcinomas diagnosed, with a sensitivity of 75.9% (44/58 patients) and a specificity of 99.8% (466/467). Only 1 case (1/525; 0.2%) was a false-positive; this was due to reactive changes. The positive predictive value was 97.8% (44/45; 95% CI = 86.8-99.9), negative predictive value was 97.1% (466/480; 95% CI = 95.0-98.3), and accuracy was 97.1% ([44 + 466]/525; 95% CI = 95.2-98.3). There was insufficient or inadequate material in 4 cases. CONCLUSIONS: Imprint cytology of the gallbladder mucosa is an easy, rapid, and high-quality method for detecting gallbladder carcinoma.

[Association between hip fractures and risk factors for osteoporosis. Multivariate analysis]. / Factores de riesgo para osteoporosis y fracturas de cadera. Análisis multivariado.

In this observational, case-control study, 376 inpatients were evaluated in order to determine the association of risk factors (RF) and hip fracture; 151 patients had osteoporotic hip fracture (cases); the remaining were controls. Data were obtained from medical charts, and through a standardized questionnaire about RF. Mean age of the sample (+/- SD) was 80.6 +/- 8.1 years, without statistically significant difference between cases and controls; the female:male ratio was 3:1 in both groups. Fractured women were older than men (82.5 +/- 8.1 vs. 79.7 +/- 7.2 years, respectively; p < 0.01). Physical activity, intake of alcohol and tobacco, and sun exposure were low in all patients. Falls among cases happened predominantly at home (p < 0.001). Among female cases, time spent in household duties was a RF (p = 0.007), which was absent in males. In multivariate analysis, the following RF were significantly more frequent: Cognitive impairment (p = 0.001), and previous falls (p < 0.0001); whereas the following protective factors were significantly different from controls: Calcium intake during youth (p < 0.0001), current calcium intake (p < 0.0001), and mechanical aid for walking (p < 0.0001). Evaluation of RF and protective factors may contribute to diminish the probability of hip fracture, through a modification of personal habits, and measures to prevent falls among elderly adults. Present information can help to develop local and national population-based strategies to diminish the burden of hip fractures for the health system.

Factores de riesgo para osteoporosis y fracturas de cadera: Análisis multivariado / Association between hip fractures and risk factors for osteoporosis: multivariate analysis

En este trabajo se analizó la asociación entre factores de riesgo (FR) y fracturas de cadera, se evaluó la influencia de FR relacionados con baja masa ósea o con traumatismos, y se exploró la existencia de factores protectores (FP). Se estudiaron datos de 376 pacientes hospitalizados, de los cuales 151 presentaban fracturas de cadera osteoporóticas (casos; el resto fueron controles), a partir de historias clínicas y un cuestionario sobre FR para osteoporosis. La edad promedio fue 80.6 más o menos 8.1 años, similar en casos y controles; la relación mujer/varón fue de 3:1 en ambos grupos. Las mujeres fracturadas eran mayores que los varones fracturados (82.5 más o menos 8.1 versus 79.7 más o menos 7.2 años; p menor que 0.01). La actividad física, el consumo de alcohol y tabaco, y la exposición solar de los pacientes fueron bajos. La proporción de pacientes con limitación funcional fue mayor en casos, sin diferencia significativa. La mayoría de caídas de los casos se produjo en domicilio (p menor que 0.001). En mujeres la actividad doméstica constituyó un FR (p = 0.007) no observado en varones. Las variables significativas en el análisis multivariado fueron los siguientes FR: deterioro cognitivo (p = 0.001) y antecedentes de caídas previas (p menor que 0.0001). Los FP fueron: ingesta cálcica en la juventud y actual, y asistencia mecánica para deambular (todos, p menor que 0.0001). La evaluación de FR y FP podría contribuir a disminuir la probabilidad de fracturas de cadera, modificando hábitos personales y previniendo las caídas en adultos mayores. Los datos podrían servir para elaborar estrategias locales y nacionales de prevención.

In this observational, case-control study, 376 inpatients were evaluated in order to determine the association of risk factors (RF) and hip fracture; 151 patients had osteoporotic hip fracture (cases); the remaining were controls. Data were obtained from medical charts, and through a standardized questionnaire about RF. Mean age of the sample (more or less SD) was 80.6 more or less 8.1 years, without statistically significant difference between cases and controls; the female:male ratio was 3:1 in both groups. Fractured women were older than men (82.5 more or less 8.1 vs. 79.7 more or less 7.2 years, respectively; p less than 0.01). Physical activity, intake of alcohol and tobacco, and sun exposure were low in all patients. Falls among cases happened predominantly at home (p less than 0.001). Among female cases, time spent in household duties was a RF (p = 0.007), which was absent in males. In multivariate analysis, the following RF were significantly more frequent: Cognitive impairment (p = 0.001), and previous falls (p less than 0.0001); whereas the following protective factors were significantly different from controls: Calcium intake during youth (p less than 0.0001), current calcium intake (p less than 0.0001), and mechanical aid for walking (p less than 0.0001). Evaluation of RF and protective factors may contribute to diminish the probability of hip fracture, through a modification of personal habits, and measures to prevent falls among elderly adults. Present information can help to develop local and national population-based strategies to diminish the burden of hip fractures for the health system.