RESUMEN
Increased risk of developing glaucoma has recently been associated with early age of menopause. Here, we examined how age and surgically-induced menopause via ovariectomy (OVX) impacted gene expression in gene pathways previously linked to glaucoma, such as extracellular matrix (ECM) remodeling and TGF-ß signaling. Using bulk RNA sequencing, we analyzed changes in young (3-4 months) and middle-aged (9-10 months) Long-Evans rats. We focused on posterior pole tissues (sclera and optic nerve head) but also examined the retina to compare observed changes across different tissue regions. Our results demonstrated that aging and OVX significantly alter gene expression in the sclera and optic nerve head. Generally, OVX triggered the enrichment of immune-related processes. However, OVX in young rats also led to significant enrichment of ECM and TGF-ß gene sets. At the same time, these effects were diminished in middle-aged rats, indicating an age dependency of the effects of OVX on matrix-related pathways. Notably, the transcriptional factor Fos was downregulated in the posterior eye and retina in aged and OVX animals. Fos is a major regulator of cell proliferation and survival, and its dysregulation may play an important role in aging and menopause for women. These findings underscore the important role of menopause timing in modulating molecular pathways associated with glaucoma, which is consistent with clinical studies showing that early menopause may heighten the risk of developing this condition. This study also highlights the importance of considering women's health factors, such as menopause, in understanding and managing glaucoma risk.
RESUMEN
The introduction of closed-loop systems in the pediatric population has been a revolution in the management and evolution of diabetes. However, there are not many published studies in situations in which the feeding, schedules, and activities of the children deviate from the routine for which the systems were programmed, as in the case of a summer camp for children and adolescents with diabetes, where the specific programming of this device is not well known. It was a single-center prospective preliminary study. A total of twenty-seven patients (mean age 11.9 ± 1.9 years, 40% male, duration of diabetes 6.44 ± 2.83 years) were included (twenty with Medtronic MiniMed 780G system and seven with Tandem Control-IQ). Glucometric variables and pump functionality were monitored during the 7-day camp and in the following 3 weeks. There was no decrease from the objective TIR 70% at any moment. The worst results in Time Below Range were at 72 h from starting the camp, and the worst results in Time Above Range were in the first 24 h, with a progressive improvement after that. No episodes of level 3 hypoglycemia or ketoacidosis occurred. The use of specific programming in two integrated systems, with complex blood glucose regulation algorithms and not-prepared-for situations with increased levels of physical activity or abrupt changes in feeding routines, did not result in an increased risk of level 3 hypoglycemia and ketoacidosis for our pediatric type 1 diabetes (T1D) patients, regardless of the closed-loop device.
Asunto(s)
Glucemia , Diabetes Mellitus Tipo 1 , Sistemas de Infusión de Insulina , Insulina , Humanos , Niño , Masculino , Adolescente , Femenino , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/sangre , Estudios Prospectivos , Insulina/administración & dosificación , Automonitorización de la Glucosa Sanguínea/instrumentación , Hipoglucemiantes/administración & dosificación , Acampada , Control Glucémico/métodos , Algoritmos , Hipoglucemia/prevención & controlRESUMEN
Background: Ischemic preconditioning (IP) is a powerful cellular protection mechanism. The cellular pathways underlying IP are extremely complex and involve the participation of cell triggers, intracellular signaling pathways, and end-effectors. Experimental studies have shown that sodium-glucose transport protein 2 (SGLT2) inhibitors promote activation of 5'-adenosine monophosphate (AMP)-activated protein kinase (AMPK), the main regulator of adenosine 5'-triphosphate homeostasis and energy metabolism in the body. Despite its cardioprotective profile demonstrated by numerous clinical trials, the results of studies on the action of SGLT2 inhibitors in IP are scarce. This study will investigate the effects of dapagliflozin on IP in patients with coronary artery disease (CAD). Methods: The study will include 50 patients with multivessel CAD, ischemia documented by stress testing, and preserved left ventricular ejection fraction (LVEF). Patients will undergo four exercise tests, the first two with a time interval of 30 min between them after washout of cardiovascular or hypoglycemic medications and the last two after 7 days of dapagliflozin 10 mg once a day, also with a time interval of 30 min between them. Discussion: The role of SGLT2 inhibitors on IP is not clearly established. Several clinical trials have shown that SGLT2 inhibitors reduce the occurrence cardiovascular events, notably heart failure. However, such studies have not shown beneficial metabolic effects of SGLT2 inhibitors, such as reducing myocardial infarction or stroke. On the other hand, experimental studies with animal models have shown the beneficial effects of SGLT2 inhibitors on IP, a mechanism that confers cardiac and vascular protection from subsequent ischemia-reperfusion (IR) injury. This is the first clinical study to evaluate the effects of SGLT2 inhibitors on IP, which could result in an important advance in the treatment of patients with stable CAD.
RESUMEN
The reproductive process in Octopus maya was analyzed to establish the amount of reactive oxygen species that the embryos inherit from females, during yolk synthesis. At the same time, respiratory metabolism, ROS production, and the expression of some genes of the antioxidant system were monitored to understand the ability of embryos to neutralize maternal ROS and those produced during development. The results indicate that carbonylated proteins and peroxidized lipids (LPO) were transferred from females to the embryos, presumably derived from the metabolic processes carried out during yolk synthesis in the ovary. Along with ROS, females also transferred to embryos glutathione (GSH), a key element of the antioxidant defense system, thus facilitating the neutralization of inherited ROS and those produced during development. Embryos are capable of neutralizing ROS thanks to the early expression of genes such as catalase (CAT) and superoxide dismutase (SOD), which give rise to the synthesis of enzymes when the circulatory system is activated. Also, it was observed that the levels of the routine metabolic rate of embryos are almost as high as those of the maximum activity metabolism, which leads, on the one hand, to the elevated production of ROS and suggests that, at this stage of the life cycle in octopuses, energy production is maximum and is physically limited by the biological properties inherent to the structure of embryonic life (oxygen transfer through the chorion, gill surface, pumping capacity, etc.). Due to its role in regulating vascularization, a high expression of HIf-1A during organogenesis suggests that circulatory system development has begun in this phase of embryo development. The results indicate that the routine metabolic rate and the ability of O. maya embryos to neutralize the ROS are probably the maximum possible. Under such circumstances, embryos cannot generate more energy to combat the free radicals produced by their metabolism, even when environmental factors such as high temperatures or contaminants could demand excess energy.
Asunto(s)
Embrión no Mamífero , Metabolismo Energético , Octopodiformes , Especies Reactivas de Oxígeno , Animales , Especies Reactivas de Oxígeno/metabolismo , Octopodiformes/metabolismo , Octopodiformes/genética , Embrión no Mamífero/metabolismo , Femenino , Regulación del Desarrollo de la Expresión Génica , Antioxidantes/metabolismo , Superóxido Dismutasa/metabolismo , Superóxido Dismutasa/genética , Catalasa/metabolismo , Catalasa/genética , Glutatión/metabolismoRESUMEN
Hot springs worldwide can be a source of extremophilic microorganisms of biotechnological interest. In this study, samplings of a hot spring in Hidalgo, Mexico, were conducted to isolate, identify, and characterize morphologically, biochemically, and molecularly those bacterial strains with potential industrial applications. In addition, a physicochemical and geochemical examination of the hot spring was conducted to fully understand the study region and its potential connection to the strains discovered. The hot spring was classified as sulfate-calcic according to the Piper Diagram; the hydrogeochemical analysis showed the possible interactions between minerals and water. Eighteen bacterial strains were isolated with optimal growth temperatures from 50 to 55 °C. All strains are Gram-positive, the majority having a rod shape, and one a round shape, and 17 produce endospores. Hydrolysis tests on cellulose, pectin, and xylan agar plates demonstrated enzymatic activity in some of the strains. Molecular identification through the 16S rDNA gene allowed classification of 17 strains within the Phylum Firmicutes and one within Deinococcus-Thermus. The bacterial strains were associated with the genera Anoxybacillus, Bacillus, Anerunibacillus, Paenibacillus, and Deinococcus, indicating a diversity of bacterial strains with potential industrial applications.
RESUMEN
Recognition of patients at high risk (HR) for breast cancer allows earlier screening and opportunities for risk reduction. We compare patients referred to our breast clinic as HR vs referrals for other reason (ROR) and found to be HR. We evaluate under-recognized factors and treatment differences. A retrospective chart review of patients found to be HR but referred for any reason to our breast clinic from July 2012 to December 2022 was performed. Referral reason, demographics, hormonal history, family history, and other risk factors were evaluated and compared (HR vs ROR). While other risk models were used for screening, Gail and Tyrer-Cuzick version 7 (TCv7) were used for comparison. Breast imaging received, hormonal therapy, and genetics referral evaluations were compared. 195 patients were referred to our breast team, 113 (58%) were referred as HR while 82 (42%) were ROR. Average age was 47 years old. 175 (91%) were Caucasian. 74 (65.5%) were referred for genetic testing, and 32 (26%) tested positive for a genetic mutation (n = 10, 12% ROR). 67 (35%) were recommended chemoprevention (n = 32, 16.4% took chemoprevention). 6 (3.1%) underwent prophylactic mastectomies and 163 (85%) had supplemental breast imaging. Comparison of HR vs ROR did not show significant differences in hormonal factors or treatments received; however, TCv7 was higher in the group referred as HR (P < .001). Our study showed that HR patients are more commonly referred secondary to family history but undergo similar treatments as those ROR. Accessibility to screening tools and education of risk factors, especially in minorities and those not otherwise being screened, may help better recognize HR.
Asunto(s)
Neoplasias de la Mama , Detección Precoz del Cáncer , Humanos , Neoplasias de la Mama/diagnóstico , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Adulto , Derivación y Consulta/estadística & datos numéricos , Medición de Riesgo , Pruebas Genéticas , Mamografía/estadística & datos numéricos , AncianoRESUMEN
Limb immobilization causes rapid declines in muscle strength and mass. Given the role of the nervous system in immobilization-induced weakness, targeted interventions may be able to preserve muscle strength, but not mass, and vice versa. The purpose of this study was to assess the effects of two distinct interventions during 1 week of knee joint immobilization on muscle strength (isometric and concentric isokinetic peak torque), mass (bioimpedance spectroscopy and ultrasonography), and neuromuscular function (transcranial magnetic stimulation and interpolated twitch technique). Thirty-nine healthy, college-aged adults (21 males, 18 females) were randomized into one of four groups: immobilization only (n = 9), immobilization + action observation/mental imagery (AOMI) (n = 10), immobilization + neuromuscular electrical stimulation (NMES) (n = 12), or control group (n = 8). The AOMI group performed daily video observation and mental imagery of knee extensions. The NMES group performed twice daily stimulation of the quadriceps femoris. Based on observed effect sizes, it appears that AOMI shows promise as a means of preserving voluntary strength, which may be modulated by neural adaptations. Strength increased from PRE to POST in the AOMI group, with +7.2% (Cohen's d = 1.018) increase in concentric isokinetic peak torque at 30°/s. However, NMES did not preserve muscle mass. Though preliminary, our findings highlight the specific nature of clinical interventions and suggest that muscle strength can be independently targeted during rehabilitation. This study was prospectively registered: ClinicalTrials.gov NCT05072652.
Asunto(s)
Articulación de la Rodilla , Fuerza Muscular , Humanos , Masculino , Femenino , Adulto Joven , Fuerza Muscular/fisiología , Articulación de la Rodilla/fisiología , Adulto , Inmovilización/métodos , Estimulación Eléctrica/métodos , Torque , Músculo Esquelético/fisiología , Músculo Cuádriceps/fisiología , Imaginación/fisiología , Rodilla/fisiología , Estimulación Magnética Transcraneal/métodosRESUMEN
Objective: We compared hair cortisol (HC) with classic tests of the hypothalamic-pituitary-adrenal (HPA) axis in chronic kidney disease (CKD) and assessed its association with kidney and cardiometabolic status. Design and methods: A cross-sectional study of 48 patients with CKD stages I-IV, matched by age, sex, and BMI with 24 healthy controls (CTR) was performed. Metabolic comorbidities, body composition, and HPA axis function were studied. Results: A total of 72 subjects (age 52.9 ± 12.2 years, 50% women, BMI 26.2 ± 4.1 kg/m2) were included. Metabolic syndrome features (hypertension, dyslipidaemia, glucose, HOMA-IR, triglycerides, waist circumference) and 24-h urinary proteins increased progressively with worsening kidney function (p < 0.05 for all). Reduced cortisol suppression after 1-mg dexamethasone suppression (DST) (p < 0.001), a higher noon (12:00 h pm) salivary cortisol (p = 0.042), and salivary cortisol AUC (p = 0.008) were seen in CKD. 24-h urinary-free cortisol (24-h UFC) decreased in CKD stages III-IV compared with I-II (p < 0.001); higher midnight salivary cortisol (p = 0.015) and lower suppressibility after 1-mg DST were observed with declining kidney function (p < 0.001). Cortisol-after-DST cortisol was >2 mcg/dL in 23% of CKD patients (12.5% in stage III and 56.3% in stage IV); 45% of them had cortisol >2 mcg/dL after low-dose 2-day DST, all in stage IV (p < 0.001 for all). Cortisol-after-DST was lineally inversely correlated with eGFR (p < 0.001). Cortisol-after-DST (OR 14.9, 95% CI 1.7-103, p = 0.015) and glucose (OR 1.3, 95% CI 1.1-1.5, p = 0.003) were independently associated with eGFR <30 mL/min/m2). HC was independently correlated with visceral adipose tissue (VAT) (p = 0.016). Cortisol-after-DST (p = 0.032) and VAT (p < 0.001) were independently correlated with BMI. Conclusion: Cortisol-after-DST and salivary cortisol rhythm present progressive alterations in CKD patients. Changes in cortisol excretion and HPA dynamics in CKD are not accompanied by significant changes in long-term exposure to cortisol evaluated by HC. The clinical significance and pathophysiological mechanisms explaining the associations between HPA parameters, body composition, and kidney damage warrant further study.
Asunto(s)
Cabello , Hidrocortisona , Insuficiencia Renal Crónica , Humanos , Estudios Transversales , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/tratamiento farmacológico , Cabello/metabolismo , Hidrocortisona/metabolismo , Estudios de Casos y Controles , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Dexametasona/uso terapéutico , Factores de Riesgo de Enfermedad Cardiaca , Estudios Prospectivos , Sistema Hipotálamo-HipofisarioRESUMEN
El riesgo de amputaciones en pacientes con diabetes es 10 a 20 veces más frecuente en comparación con no diabéticos. El equipo biotecnológico desarrollado por ROKIT Healthcare, Inc., de procedencia surcoreana: Dr. INVIVO, es un equipo de biotecnología que ofrece una terapia eficaz para el tratamiento del pie diabético, con una plataforma de regeneración de órganos hiperpersonalizados que mediante la inteligencia artificial, escanea la lesión para así, fabricar un parche que contiene células madres autólogas, matriz extracelular y materiales específicos de tejido, para posteriormente aplicarla a la herida, y con esto, lograr la cicatrización y regeneración completa. El propósito del presente reporte apunta a demostrar la efectividad del tratamiento en úlceras en pie diabético y exponer los resultados de 3 casos clínicos con extensas lesiones posteriores a amputaciones de miembros inferiores, atendidos en el Hospital Distrital de Ñemby, Paraguay, utilizando esta tecnología.
The risk of amputations in patients with diabetes is 10 to 20 times more frequent compared to non-diabetics. The biotechnological team developed by ROKIT Healthcare, Inc., of South Korean origin: Dr. INVIVO, is a biotechnology team that offers an effective therapy for the treatment of diabetic foot, with a hyper-personalized organ regeneration platform that, through artificial intelligence, scan the injury in order to manufacture a patch that contains autologous stem cells, extracellular matrix and specific tissue materials, to later apply it to the wound, and with this, achieve complete healing and regeneration. The purpose of this report aims to demonstrate the effectiveness of treatment in diabetic foot ulcers and present the results of 3 clinical cases with extensive injuries after lower limb amputations, treated at the District Hospital of Ñemby, Paraguay, using this technology.
RESUMEN
BACKGROUND: Triatoma garciabesi, a potential vector of the parasitic protozoan Trypanosoma cruzi, which is the causative agent of Chagas disease, is common in peridomestic and wild environments and found throughout northwestern and central Argentina, western Paraguay and the Bolivian Chaco. Genetic differentiation of a species across its range can help to understand dispersal patterns and connectivity between habitats. Dispersal by flight is considered to be the main active dispersal strategy used by triatomines. In particular, the morphological structure of the hemelytra is associated with their function. The aim of this study was to understand how genetic diversity is structured, how morphological variation of dispersal-related traits varies with genetic diversity and how the morphological characteristics of dispersal-related traits may explain the current distribution of genetic lineages in this species. METHODS: Males from 24 populations of T. garciabesi across its distribution range were examined. The cytochrome c oxidase I gene (coI) was used for genetic diversity analyses. A geometric morphometric method based on landmarks was used for morpho-functional analysis of the hemelytra. Centroid size (CS) and shape of the forewing, and contour of both parts of the forewing, the head and the pronotum were characterised. Length and area of the forewing were measured to estimate the aspect ratio. RESULTS: The morphometric and phylogenetic analysis identified two distinct lineages, namely the Eastern and Western lineages, which coincide with different ecological regions. The Eastern lineage is found exclusively in the eastern region of Argentina (Chaco and Formosa provinces), whereas the Western lineage is prevalent in the rest of the geographical range of the species. CS, shape and aspect ratio of the hemelytra differed between lineages. The stiff portion of the forewing was more developed in the Eastern lineage. The shape of both portions of the hemelytra were significantly different between lineages, and the shape of the head and pronotum differed between lineages. CONCLUSIONS: The results provide preliminary insights into the evolution and diversification of T. garciabesi. Variation in the forewing, pronotum and head is congruent with genetic divergence. Consistent with genetic divergence, morphometry variation was clustered according to lineages, with congruent variation in the size and shape of the forewing, pronotum and head.
Asunto(s)
Enfermedad de Chagas , Triatoma , Masculino , Animales , Filogenia , Insectos Vectores , Variación GenéticaRESUMEN
This manuscript represents the second phase of a clinical trial designed to examine the effects of knee joint immobilization and retraining on muscle strength and mass. In Phase 2, we examined sex differences in the recovery of multiple indices of muscle quality after a resistance training-based rehabilitation program. Following 1 week of immobilization, 27 participants (16 males, 11 females) exhibiting weakness underwent twice weekly resistance training sessions designed to re-strengthen their left knee. Unilateral retraining sessions utilizing leg press, extension, and curl exercises were conducted until participants could reproduce their pre-immobilization knee extension isometric maximal voluntary contraction (MVC) peak torque. Post-immobilization, both sexes demonstrated impaired MVC peak torque (males = -10.8%, females = -15.2%), specific torque (-9.8% vs. -13.1%), echo intensity of the vastus lateralis (+6.9% vs. +5.9%) and rectus femoris (+5.9% vs. +2.1), and extracellular water/intracellular water ratio (+7.8% vs. +9.0%). The number of retraining sessions for peak torque to return to baseline for males (median = 1, mean = 2.13) versus females (median = 2, mean = 2.91) was not significantly different, though the disparity in recovery times may be clinically relevant. Following retraining, specific torque was the only muscle-quality indicator that improved along with MVC peak torque (males = 20.1%, females = 22.4%). Our findings indicate that measures of muscle quality demonstrate divergent recovery rates following immobilization, with muscle mass lagging behind improvements in strength. Greater immobilization-induced strength loss among females suggests that sex-specific rehabilitation efforts may be justified.
Asunto(s)
Inmovilización , Articulación de la Rodilla , Fuerza Muscular , Músculo Esquelético , Entrenamiento de Fuerza , Torque , Humanos , Masculino , Femenino , Fuerza Muscular/fisiología , Entrenamiento de Fuerza/métodos , Articulación de la Rodilla/fisiología , Adulto , Músculo Esquelético/fisiología , Adulto Joven , Contracción Isométrica , Músculo Cuádriceps/fisiología , Recuperación de la Función , Factores Sexuales , Caracteres SexualesRESUMEN
Rates of youth behavioral health concerns have been steadily rising. Administrative data can be used to study behavioral health service utilization among youth, but current methods that rely on identifying an associated behavioral health diagnosis or provider specialty are limited. We reviewed all procedure codes billed to Medicaid for youth in one U.S. county over a 10-year period. We identified 158 outpatient behavioral health procedure codes and classified them according to service type. This classification system can be used by health services researchers to better characterize youth behavioral health service utilization.
RESUMEN
Epithelial ovarian cancer (EOC) is the gynaecological malignancy with highest mortality. Although adjuvant treatment with carboplatin and paclitaxel leads to an objective response in ~80% of these patients, a majority will relapse within two years. Better methods for assessing long-term treatment outcomes are needed. To address this, we established safe and efficacious doses of carboplatin and paclitaxel using IGROV-1 zebrafish-CDX models. Then fluorescently-labelled cell suspensions from 83 tumour biopsies collected at exploratory laparotomy of women with suspected EOC were generated and 37 (45%) were successfully implanted in zebrafish larvae. Among these 19 of 27 pathology-confirmed EOC samples (70%) engrafted. These zebrafish patient-derived tumour xenograft (ZTX) models were treated with carboplatin or paclitaxel and tumour growth/regression and metastatic dissemination were recorded. In a subgroup of nine patients, four ZTX models regressed during carboplatin treatment. All four corresponding patients had >24 months PFS. Furthermore, both ZTX models established from two patients having <24 months PFS failed to regress during carboplatin treatment. Seven of eight models seeding <6 metastatic cells were established from patients having >24 months PFS. In eleven of fourteen patients, FIGO stage I + II or III tumours gave rise to ZTX models seeding <4 or >4 metastatic cells, respectively. In conclusion, ZTX models predicted patients having >24 or <24 months PFS, based on response/no response to carboplatin. Furthermore, high metastatic dissemination in ZTX models correlated to shorter PFS and more advanced disease at diagnosis. These preliminary results suggest that ZTX models could become a useful prognostic tool in EOC treatment planning.
RESUMEN
The parDE family of toxin-antitoxin (TA) operons is ubiquitous in bacterial genomes and, in Vibrio cholerae, is an essential component to maintain the presence of chromosome II. Here, we show that transcription of the V. cholerae parDE2 (VcparDE) operon is regulated in a toxin:antitoxin ratio-dependent manner using a molecular mechanism distinct from other type II TA systems. The repressor of the operon is identified as an assembly with a 6:2 stoichiometry with three interacting ParD2 dimers bridged by two ParE2 monomers. This assembly docks to a three-site operator containing 5'- GGTA-3' motifs. Saturation of this TA complex with ParE2 toxin results in disruption of the interface between ParD2 dimers and the formation of a TA complex of 2:2 stoichiometry. The latter is operator binding-incompetent as it is incompatible with the required spacing of the ParD2 dimers on the operator.
Asunto(s)
Antitoxinas , Vibrio cholerae , Antitoxinas/genética , Homeostasis , Genoma Bacteriano , Operón , Polímeros , Vibrio cholerae/genéticaRESUMEN
The COVID-19 pandemic's early stages severely impacted global fisheries, particularly areas heavily reliant on imported food and tourism like the Galapagos Islands, Ecuador. To contain the spread of the virus, a full lockdown was implemented. However, the collapse of the tourism industry precipitated the worst economic crisis in the history of this multiple-use marine protected area. This paper examines the impact of the pandemic's early stages on consumption patterns and seafood security in the Galapagos from consumers' perspective, drawing on online surveys conducted during the lockdown. Our findings revealed pre-existing seafood insecurity across the archipelago, further exacerbated by the pandemic on the least-populated island. Nevertheless, the seafood system displayed moderated resilience to the pandemic's socioeconomic disruptions. A variety of adaptive responses were adopted by Galapagos residents to cope with the lockdown. Consumers modified their seafood consumption habits, while fishers adapted their harvesting and marketing strategies. Such adaptive responses were shaped by the unique socioeconomic characteristics of each inhabited island and the ability of seafood suppliers to shift from a tourism- and export-oriented to a resident- and domestic-oriented market. This transition has created novel opportunities to foster a systemic transformation of the Galapagos seafood system to enhance its resilience against future crises caused by new pandemics, climate change, or other natural and anthropogenic drivers of change.
Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Pandemias , Ecuador/epidemiología , Control de Enfermedades Transmisibles , Alimentos MarinosAsunto(s)
Narcolepsia , Oxibato de Sodio , Humanos , Oxibato de Sodio/efectos adversos , Manía , Método Doble CiegoRESUMEN
BACKGROUND: The detection of atrial electrical activity is extremely valuable in recognizing complex cardiac arrhythmias. However, P-wave detection on a surface electrocardiogram (S-ECG) can sometimes be challenging. The intracardiac electrocardiogram (IC-ECG), recorded by a central venous catheter loaded with saline solution, has proven to be a safe and effective method for amplifying atrial electrical activity. We aim to compare the P-wave amplitude recorded in the S-ECG and the IC-ECG in different venous accesses, catheters, heart rhythms, and atrial dimensions. METHODS: We compared the P wave amplitude obtained by the IC-ECG and the S-ECG recordings from cardiac intensive care unit patients. RESULTS: In 109 nonconsecutive patients, a total of 166 IC-ECG were collected. The median amplitude of the P wave was 0.1 (0.083-0.3) mV in the S-ECG and 0.4 (0.25-2.4) mV in the IC-ECG; p < 0.001. This difference remained significant regardless of the patient's heart rhythm, left atrial dimension, and catheter or vascular access used. CONCLUSION: The IC-ECG acquired using central venous catheters significantly increases atrial electrical activity signals. This technique might help identify complex cardiac arrhythmias.
Asunto(s)
Cateterismo Venoso Central , Catéteres Venosos Centrales , Humanos , Cateterismo Venoso Central/métodos , Electrocardiografía/métodos , Arritmias Cardíacas/diagnóstico , Atrios CardíacosRESUMEN
Aim: To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars. Materials and methods: Cross-sectional study consisting of 30 cone-beam computed tomography (CBCT) images of primary maxillary and mandibular first molars, with crown, and root integrity. The wall dentin thickness of each canal was measured in three axial views, divided into distal (D), mesial, lingual/palatine, and buccal surfaces. Results: The smallest dentin wall thickness of the maxillary molar was located on the mesial surface of the mesiobuccal (MB) canal apical third (mean 0.55 ± 0.04 mm). The buccal and palatal (P) surfaces of the distobuccal (DB) and P canals showed the smallest dentin thickness on the cervical third (0.62 ± 0.02 mm). On the mandibular molar, we found the smallest dentin thickness on the apical third [lingual surface of the MB canal and buccal surface of the mesiolingual (ML) canal] with a mean of 0.41 ± 0.07 mm. Additionally, the dentin thickness is average of the D canal was about 0.67 ± 0.11 mm. Conclusion: It is essential to understand the primary first molar's anatomy to reduce possible complications in pediatric patients from instrumentation during root canal treatments. Clinical significance: Pulpectomy is among the most challenging procedures in pediatric dentistry and the knowledge of the root anatomy of primary teeth allows the professional to make better clinical decisions and reduce possible risks during root canal treatment. How to cite this article: Justiniano-Navarro C, Caballero-García S, López-Rodriguez G, et al. Evaluating the Thickness of the Root Canal Dentin Wall in Primary First Molars using Cone-beam Computed Tomography. Int J Clin Pediatr Dent 2023;16(S-2):S122-S127.