Current Applications and Controversies in Preimplantation Genetic Testing for Aneuploidies (PGT-A) in In Vitro Fertilization.

Preimplantation genetic testing for aneuploidy (PGT-A) has evolved over recent years, including improvements in embryo culture, biopsy, transfer, and genetic testing. The application of new comprehensive chromosome screening analysis has improved the accuracy in determining the chromosomal status of the analyzed sample, but it has brought new challenges such as the management of partial aneuploidies and mosaicisms. For the past two decades, PGT-A has been involved in a controversy regarding its efficiency in improving IVF outcomes, despite its widespread worldwide implementation. Understanding the impact of embryo aneuploidy in IVF (in vitro fertilization) should theoretically allow improving reproductive outcomes. This review of the literature aims to describe the impact of aneuploidy in human reproduction and how PGT-A was introduced to overcome this obstacle in IVF (in vitro fertilization). The article will try to analyze and summarize the evolution of the PGT-A in the recent years, and its current applications and limitations, as well as the controversy it generates. Conflicting published data could indicate the lacking value of a single biopsied sample to determine embryo chromosomal status and/or the lack of standardized methods for embryo culture and management and genetic analysis among other factors. It has to be considered that PGT-A may not be a universal test to improve the reproductive potential in IVF patients, rather each clinic should evaluate the efficacy of PGT-A in their IVF program based on their population, skills, and limitations.

Net carbon balance study for selected roads in Tenerife, Canary Islands.

Carbon dioxide emissions linked to the transport sector are particularly relevant to islands. The Canary Islands have high level of tourism, with tourists who generally travel in rented vehicles on arrival in the archipelago. In addition, mobility of the local population in the islands is also always growing. Thus, transport is one of the sectors that emits the greatest amount of greenhouse gases. In this sense, the net carbon balance becomes a pioneering study in the framework of management of high-capacity road transport routes and will help plan new strategies, which pursue the neutrality and climate resilience of the road network. It will therefore be possible to design different future scenarios, according to traffic intensities detected, to mitigate their local effects by increasing green areas, which will contribute to greater absorption. This study calculated the carbon footprint linked to vehicles on the three high-capacity roads on the island of Tenerife, as well as the carbon footprint of the public lighting attached to these roads. The absorption of carbon by vegetation planted by the Road Service and the soil located on the margins of the road have also been calculated to explore the possibility of modifying the vegetation, using other types of local shrubs and trees that have a higher absorption factor. The results demonstrate that conifers have the highest absorption factor, the Canary Island pine being the best option in this case. However, it is not always possible to place trees on the roadside, and it is necessary to resort to smaller species. This study concludes that better mobility planning, an increase in electric vehicles, improved energy production from renewable sources, and the promotion and enhancement of absorption capacity of carbon sinks are key in the face of climate change. Integr Environ Assess Manag 2023;19:1023-1030. © 2022 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

An approximation to the identification of contexts, experiences, and profiles of victims of drug-facilitated sexual assaults.

This study advances on overcoming a bias limiting the forensic cases studies of drug-facilitated sexual assaults: a narrow study focus, restricted to assaults affecting young women in leisure contexts related to nightlife, party culture, and dating. A new working framework is applied to analyse data from cases received in the National Institute of Toxicology and Forensic Sciences (Madrid, Spain) over the six years between 2012 and 2017. The work throws light on non-previously described contexts, experiences, and profiles of victims, including domestic cohabitation, labour, education, healthcare, women trafficking, and the daily life of people with intellectual disabilities.

Activities of Daily Living and Categorization Skills of Elderly with Cognitive Deficit: A Preliminary Study.

Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.

Usability Evaluation of a Distributed User Interface Application for Visuomotor Organization Assessment.

BACKGROUND: This article describes the development and evaluation of a distributed user interface (DUI) application to assess visuomotor organization ability. This application enables therapists to evaluate the acquired brain injury (ABI) on patients, and patients, to perform the assessment on a touch screen while therapists can observe the assessment process in real time on a separated monitor without interfering patients during the process as in traditional methodologies employing physical elements. OBJECTIVES: The main goal of this research is the evaluation of the quality in use of DUIs in the Pegboard Construction assessment with patients with ABI from the therapist perspective in the area of occupational therapy. METHODS: To evaluate our system, we have performed a usability evaluation following the ISO/IEC 25010 and ISO/IEC 25062 standards to evaluate software usability and quality and it was conducted in collaboration with therapists and psychologists that have previously worked with people with ABI in diagnostic and assessment tasks. RESULTS: We show the results of the evaluation collected in a table that shows the completeness rate for each user for both, assisted (i.e., the percentage of tasks where participants performed with test director assistance) and unassisted tasks (i.e., the percentage of tasks where participants completed tasks autonomously), the total time participants required to complete proposed tasks, the number of mistakes participants performed during the session, and the number of assists they required to finish proposed tasks. In addition, we also evaluated the user satisfaction regarding our application using the system usability scale. CONCLUSION: The use of information technologies in this field enables therapists to perform these evaluations in a simpler, efficient, and automated way. This proposal enables patients to perform the assessment as it is performed traditionally using paper providing them with a touch screen in which they can easily insert a set of pins into the holes. The usability evaluation of the proposal meets the appropriate design standards for applications of this type, and this is demonstrated by the high degree of satisfaction of the participants.

Performance of a new star-bar phantom designed for MTF calculations in x-ray imaging systems.

PURPOSE: A new phantom, designed and manufactured for modulation transfer function (MTF) calculations is presented in this work. The phantom has a star-bar pattern and is manufactured in stainless steel. Modulation transfer function determinations are carried out with the new phantom and with an edge phantom to compare their performance and to compare them with previous theoretical predictions. METHODS: The phantoms are imaged in an x-ray imaging system using different beam qualities and different entrance air KERMA. Methods, previously developed for synthetic images and simulations, are adapted to real measurements, solving practical implementation issues. RESULTS: In the case of the star-bar, in order to obtain optimal MTF determinations it is necessary to accurately determine the center of the pattern. Also, to avoid underestimates in MTF calculations, the length in pixels of each of the scanning circumferences must be an integer multiple of the number of cycles in the pattern. Both methods, star-bar and edge, give similar mean values of the MTF in all cases analyzed. Also, the dependence with frequency of the experimental MTF standard deviation (SD) agrees with the theoretical expressions presented in previous works. In this regard, the precision is better for the star-bar method than for the edge and differences in precision between both methods are higher for the lowest beam quality. CONCLUSIONS: The star-bar phantom can be used for MTF determinations with the advantage of having an improved precision. However, precision is reduced when the radiation quality increases. This fact suggests that, for the highest beam qualities, materials with an attenuation coefficient greater than that of steel should be used to manufacture the phantom.

PDS5 proteins are required for proper cohesin dynamics and participate in replication fork protection.

Cohesin is a chromatin-bound complex that mediates sister chromatid cohesion and facilitates long-range interactions through DNA looping. How the transcription and replication machineries deal with the presence of cohesin on chromatin remains unclear. The dynamic association of cohesin with chromatin depends on WAPL cohesin release factor (WAPL) and on PDS5 cohesin-associated factor (PDS5), which exists in two versions in vertebrate cells, PDS5A and PDS5B. Using genetic deletion in mouse embryo fibroblasts and a combination of CRISPR-mediated gene editing and RNAi-mediated gene silencing in human cells, here we analyzed the consequences of PDS5 depletion for DNA replication. We found that either PDS5A or PDS5B is sufficient for proper cohesin dynamics and that their simultaneous removal increases cohesin's residence time on chromatin and slows down DNA replication. A similar phenotype was observed in WAPL-depleted cells. Cohesin down-regulation restored normal replication fork rates in PDS5-deficient cells, suggesting that chromatin-bound cohesin hinders the advance of the replisome. We further show that PDS5 proteins are required to recruit WRN helicase-interacting protein 1 (WRNIP1), RAD51 recombinase (RAD51), and BRCA2 DNA repair associated (BRCA2) to stalled forks and that in their absence, nascent DNA strands at unprotected forks are degraded by MRE11 homolog double-strand break repair nuclease (MRE11). These findings indicate that PDS5 proteins participate in replication fork protection and also provide insights into how cohesin and its regulators contribute to the response to replication stress, a common feature of cancer cells.

Optimizing the recalibration process in radiochromic film dosimetry.

Intra-lot, inter-scan and other variabilities in radiochromic film dosimetry may have a severe impact on absolute dosimetry with this dosimeter. In the literature, several dosimetry protocols may be found characterized by different calibration functions and different film response variables. Also, the re-calibration methods found in the literature correct and minimize the impact of the variabilities in the absolute dose estimates. In this work, several recalibration methods and dosimetry protocols are evaluated. In order to find optimal configurations, their accuracy is compared, and the accuracy level that can be reached in each case is discussed. The efficient protocol and the parameter escalation are used to recalibrate EBT3 films from two different film batches. The mean absolute deviations between known doses and estimated doses for eight dose levels are obtained and compared with the self calibration of each reading, named intrinsic film calibration. Eight film sheets from two different lots and two digitizers are used. The parameter escalation method with a four-level recalibration using net optical density (NOD) and a power law as dosimetry protocol obtains the highest accuracy. Regarding the number of control strips, increasing the number from two to three makes the parameter escalation protocol to come close to intrinsic film calibration in all cases, but has a less important effect on the efficient protocol. Regardless the choice of the sensitometric variables, using the appropriate recalibration method results in accuracy levels typical of self calibration of the film. In addition, the parameter escalation method provides better results than the efficient protocol with three calibration strips.

Successful treatment against American cutaneous leishmaniasis by intralesional infiltration of a generic antimonial compound-lidocaine combination. A follow up study.

One hundred and twenty-two lesions caused by Leishmania braziliensis in 92 patients were treated using weekly intralesional (IL) infiltrations of a generic pentavalent antimonial compound, combined with local anesthetics. The topical therapy produced satisfactory healing in all the included patients, bearing from single-small ulcers to multiple or big lesions, after receiving an average 6 ±â€¯3 IL infiltrations (90 mgSb5+each). The rapid effect of this compound was demonstrated by the observed decrease of the Leishmania-amastigote population following microscopical grading in complicated ulcers after receiving two infiltrations. Neither discomfort nor side effects after infiltrations were recorded from the treated patients at any time. In addition, no signs of cutaneous relapse or mucosal lesion were detected during follow up after a decade clinical healing in 22% of the treated patients. Investment to produce the generic antimonial-IL treatment resulted significantly lower than the standard antimonial systemic therapy, and its cost/risk is discussed. The minimal dose of Sb5+ causing non-side effects or patient discomfort, the low production cost and the here demonstrated successful results, lead us to propose this generic antimonial compound as an alternative therapy for leishmanial-control in areas where American cutaneous leishmaniasis is endemic.

Monitoring of early humoral immunity to identify lung recipients at risk for development of serious infections: A multicenter prospective study.

BACKGROUND: Infection is still a leading cause of death during the first year after lung transplantation. We performed a multicenter study among teaching hospitals to assess monitoring of early humoral immunity as a means of identifying lung recipients at risk of serious infections. METHODS: We prospectively analyzed 82 adult lung recipients at 5 centers in Spain. Data were collected before transplantation and at 7 and 30 days after transplantation. Biomarkers included IgG, IgM, IgA, complement factors C3 and C4, titers of antibodies to pneumococcal polysaccharide antigens (IgG, IgA, IgM) and antibodies to cytomegalovirus (IgG), and serum B-cell activating factor (BAFF) levels. The clinical follow-up period lasted 6 months. Clinical outcomes were bacterial infections requiring intravenous anti-microbial agents, cytomegalovirus (CMV) disease, and fungal infections requiring therapy. RESULTS: We found that 33 patients (40.2%) developed at least 1 serious bacterial infection, 8 patients (9.8%) had CMV disease, and 10 patients (12.2%) had fungal infections. Lower IgM antibody levels against pneumococcal polysaccharide antigens at Day 7 (defined as <5 mg/dl) were a risk factor for serious bacterial infection (adjusted odds ratio [OR] 3.96; 95% confidence interval [CI] 1.39 to 11.26; p = 0.0099). At Day 7 after transplantation, IgG hypogammaglobulinemia (defined as IgG <600 mg/dl) was associated with a higher risk of CMV disease (after adjustment for CMV mismatch: OR 8.15; 95% CI 1.27 to 52.55; p = 0.028) and fungal infection (adjusted OR 8.03, 95% CI 1.51 to 42.72; p = 0.015). Higher BAFF levels before transplantation were associated with a higher rate of development of serious bacterial infection and acute cellular rejection. CONCLUSION: Early monitoring of specific humoral immunity parameters proved useful for the identification of lung recipients who are at risk of serious infections.

Growth Hormone Secretagogue (A233) Improves Growth and Changes the Tissue Fatty Acid Profile in Juvenile Tilapia (Oreochromis niloticus).

Growth hormone (GH) release is a process that is well regulated by several factors, including GH secretagogues. GH can mediate the regulation of the fatty acid level and composition. The aim of this study was to determine the effect of a synthetic GH secretagogue peptide (A233) on the growth and fatty acid composition in tilapia (Oreochromis niloticus). To address this objective, we administrated a diet supplemented with A233 to juvenile tilapia for 60 days. The group fed with a diet supplemented with 600 µg of A233 per kg of feed increased in weight (4.81 ± 0.09 g) and specific growth rate (2.49 ± 0.03%/day) compared to the control diet group (3.63 ± 0.08 g, 2.07 ± 0.04%/day; respectively) (p < 0.001). In the muscle, the total lipids for the control diet group were higher than that in the group fed with 600 µg of A233 per kg feed; however, no differences were detected in the liver. In both tissues, the patterns of fatty acid composition and content were generally similar, with some exceptions. Tilapia fed with 600 µg of A233 per kg of feed showed, in liver and muscle, a significantly higher composition and content of n-3 polyunsaturated fatty acids (such as 20:5n-3, 22:5n-3, 22:6n-3) and n-3/n-6 PUFA than animals fed with the control diet. To our knowledge, this is the first report on the the effects of natural or synthetic GH secretagogues (GHS) on fatty acid composition, implying an increase in the nutritional quality of the tilapia.

Monte Carlo uncertainty analysis of dose estimates in radiochromic film dosimetry with single-channel and multichannel algorithms.

PURPOSE: To provide a multi-stage model to calculate uncertainty in radiochromic film dosimetry with Monte-Carlo techniques. This new approach is applied to single-channel and multichannel algorithms. MATERIAL AND METHODS: Two lots of Gafchromic EBT3 are exposed in two different Varian linacs. They are read with an EPSON V800 flatbed scanner. The Monte-Carlo techniques in uncertainty analysis provide a numerical representation of the probability density functions of the output magnitudes. From this numerical representation, traditional parameters of uncertainty analysis as the standard deviations and bias are calculated. Moreover, these numerical representations are used to investigate the shape of the probability density functions of the output magnitudes. Also, another calibration film is read in four EPSON scanners (two V800 and two 10000XL) and the uncertainty analysis is carried out with the four images. RESULTS: The dose estimates of single-channel and multichannel algorithms show a Gaussian behavior and low bias. The multichannel algorithms lead to less uncertainty in the final dose estimates when the EPSON V800 is employed as reading device. In the case of the EPSON 10000XL, the single-channel algorithms provide less uncertainty in the dose estimates for doses higher than four Gy. CONCLUSION: A multi-stage model has been presented. With the aid of this model and the use of the Monte-Carlo techniques, the uncertainty of dose estimates for single-channel and multichannel algorithms are estimated. The application of the model together with Monte-Carlo techniques leads to a complete characterization of the uncertainties in radiochromic film dosimetry.

Establishing and dissolving cohesion during the vertebrate cell cycle.

Replicated chromatids are held together from the time they emerge from the replication fork until their separation in anaphase. This process, known as cohesion, promotes faithful DNA repair by homologous recombination in interphase and ensures accurate chromosome segregation in mitosis. Identification of cohesin thirty years ago solved a long-standing question about the nature of the linkage keeping together the sister chromatids. Cohesin is an evolutionarily conserved complex composed of a heterodimer of the Structural Maintenance of Chromosomes (SMC) family of ATPases, Smc1 and Smc3, the kleisin subunit Rad21 and a Huntingtin/EF3/PP2A/Tor1 (HEAT) repeat domain-containing subunit named SA/STAG. In addition to mediating cohesion, cohesin plays a major role in genome organization. Cohesin functions rely on the ability of the complex to entrap DNA topologically and in a dynamic manner. Establishment of cohesion during S phase requires coordination with the DNA replication machinery and restricts the dynamic behaviour of at least a fraction of cohesin. Dissolution of cohesion in subsequent mitosis is regulated by multiple mechanisms that ensure that daughter cells receive the correct number of intact chromosomes. We here review recent progress on our understanding of how these processes are regulated in somatic vertebrate cells.

Usefulness of Ct value in acute respiratory infections caused by respiratory syncytial virus A and B and influenza virus A (H1N1)pdm09, A (H3N2) and B. / Utilidad del valor Ct en las infecciones respiratorias agudas causadas por el virus respiratorio sincitial A y B y los virus gripales A (H1N1)pdm09, A (H3N2) y B.

INTRODUCTION: Acute respiratory infections of viral cause are very frequent entities. The difficulty in evaluating the detection of a virus in these entities could be solved by determining the viral load. METHODS: A prospective study on the mean Ct value (cycle threshold value) detected against RSV-A, RSV-B and influenza A (H1N1)pdm09, A (H3N2) and B viruses in patients of different origin and age was performed. Detection was performed using a commercial molecular amplification (RT-PCR) technique. RESULTS: Different mean Ct values were detected for each virus. In RSV infections, no differences were observed between those caused by RSV-A or RSV-B in children. Depending on the patient's age, the only statistical significance was observed in those included in the 0-4 month groups for RSV-A and this group and the 5-12 months group for RSV-B (higher values). A lower viral load was detected in adult patients than in paediatric patients. In influenza infections, no statistical significance was observed in the mean values detected in patients from the Red Centinela («sentinel network¼, a Spanish network of doctors aimed at research and surveillance of diseases), those diagnosed in the adult emergency room or in hospital admissions. In the adult patients admitted to the ICU, only a slightly lower mean value was observed in those infected with influenza A (H1N1)pdm09, but without statistical significance. There were no patients admitted to the ICU with influenza B infection. CONCLUSION: The detection of viral load could be a good tool for the evaluation, monitoring and prognosis of acute viral respiratory infections. With the exception of those caused by RSV, no significant differences were observed in influenza infections except in younger paediatric patients.

On the re-calibration process in radiochromic film dosimetry.

PURPOSE: The accuracy and precision of the dose estimates obtained with radiochromic film dosimetry are investigated in a clinical environment. The improvement in the accuracy of dose estimates reached with corrective methods is analyzed. Two novel re-calibration algorithms for radiochromic film dosimetry are presented. METHODS: Two different EBT3 lots are evaluated in two different centres. They are calibrated in Varian linacs and read in two different EPSON scaners. Once the lots are calibrated, three films per lot are considered and divided into stripes that are exposed to known doses. Several dosimetry protocols usually employed in radiochromic film dosimetry are used to convert film responses to absorbed doses. These protocols are characterized by different choices of the film responses or different sensitometric curves. Finally, the accuracy and reproducibility of the dose estimates is investigated with and without the corrective methods. RESULTS AND CONCLUSIONS: The variabilities that affect radiochromic film dosimetry, such as intra-lot variability, inter-scan variability, post-exposure time and film autodevelopment may give rise to inaccuracies in the dose estimates. However, the implementation of re-calibration methods leads to more accurate dose estimates. All the investigated protocols showed more accurate and reproducible results when the re-calibrated methods were employed. So, the novel re-calibration methods may be applied in order to improve the accuracy and reproducibility of radiochromic film dosimetry.

The incidence of the different sources of noise on the uncertainty in radiochromic film dosimetry using single channel and multichannel methods.

The influence of the various sources of noise on the uncertainty in radiochromic film (RCF) dosimetry using single channel and multichannel methods is investigated in this work. These sources of noise are extracted from pixel value (PV) readings and dose maps. Pieces of an RCF were each irradiated to different uniform doses, ranging from 0 to 1092 cGy. Then, the pieces were read at two resolutions (72 and 150 ppp) with two flatbed scanners: Epson 10000XL and Epson V800, representing two states of technology. Noise was extracted as described in ISO 15739 (2013), separating its distinct constituents: random noise and fixed pattern (FP) noise. Regarding the PV maps, FP noise is the main source of noise for both models of digitizer. Also, the standard deviation of the random noise in the 10000XL model is almost twice that of the V800 model. In the dose maps, the FP noise is smaller in the multichannel method than in the single channel ones. However, random noise is higher in this method, throughout the dose range. In the multichannel method, FP noise is reduced, as a consequence of this method's ability to eliminate channel independent perturbations. However, the random noise increases, because the dose is calculated as a linear combination of the doses obtained by the single channel methods. The values of the coefficients of this linear combination are obtained in the present study, and the root of the sum of their squares is shown to range between [Formula: see text] and [Formula: see text] over the dose range studied. These results indicate the random noise to play a fundamental role in the uncertainty of RCF dosimetry: low levels of random noise are required in the digitizer to fully exploit the advantages of the multichannel dosimetry method. This is particularly important for measuring high doses at high spatial resolutions.

In-vitro evaluation of bond strength of four self-etching cements.

Indirect restorations need to be attached with adhesive luting agents to prevent them from becoming dislodged and provide adequate marginal sealing. The aim of this study was to evaluate bond strength to dentin of self-etching resin cements. MATERIALS AND METHODS: 75 flat dentin surfaces were randomly distributed among 5 groups, according to cements used; Group 1: RelyxU100 (3M/ESPE), Group 2: Bis Cem (Bisco), Group 3: Max Cem (Kerr), Group 4: SeT PP (SDI) and Group 5: Relyx ARC (3M/ESPE), control. Ceramic test cylinders (IPS Empress 2 / Ivoclar-Vivadent) 4.1 mm across were prepared and attached to the dentin surfaces using the different cements. A constant 25N load was applied for 1 minute and they were light-polymerized. Following storage for 24 hours at 100% humidity and 37 °C, the specimens were tested for bond strength under shear strain in an Instron testing machine at a crosshead speed of 1 mm/minute; at 7, 14 and 21 days. Data were analyzed by ANOVA and Tukey's test. There were significant differences between materials (p < 0.0001), but not between times or material/time interaction. RelyXARC (Control Group) had the highest bond strength (15.52 MPa). Among the self-etching cements, the best behavior was found for Relyx U100 (10.80MPa), followed by BisCem (6.36 MPa), MaxCem (5.45 MPa) and SeTPP (3.17 MPa). The bond strength of the self-adhesive cements evaluated was lower than that for resin cements which require previous treatment of the dental substrate (control group). This should be taken into account during clinical selection, in particular for tooth preparations with poor retention.

Las restauraciones indirectas deben ser fijadas por medio de agentes cementantes, para evitar su desprendimiento y mantener un adecuado sellado marginal. El objetivo de este trabajo fue evaluar la resistencia adhesiva a dentina de los cementos resinosos de autograbado. Materiales y métodos: Se utilizaron 75 superficies planas de dentina, distribuidos aleatoriamente en 5 grupos, según los medios cementantes; GRUPO 1: RelyxU100 (3M/ESPE), GRUPO 2: Bis Cem (Bisco), GRUPO 3: Max Cem (Kerr), GRUPO 4: SeT PP (SDI) y GRUPO 5: Relyx ARC (3M/ESPE), control. Se confeccionaros probetas cilindricas de cerámica (IPS Empress 2 / Ivoclar-Vivadent) de 4,1 mm de diámetro, las que fueron fijadas a las superficies de dentina mediante los distintos cementos. Se aplicó una carga constante de 25N durante 1 minuto y se realizó la fotopolimerización. Después de 24 horas de almacenamiento en un medio con 100 % de humedad a 37° C, las probetas fueron sometidas a ensayo de resistencia adhesiva bajo tensiones de corte en máquina Instron, con una velocidad del cabezal de 1 mm/minuto; a los 7, 14 y 21 dias. Los datos fueron analizados mediante ANOVA y test de Tukey, mostrando diferencias significativas entre los materiales (p < 0,0001), no asi respecto al factor tiempo ni a su interacción. El mayor valor de resistencia adhesiva lo presentó RelyX ARC (Grupo control) (15,52MPa), De los cementos autograbantes, el mejor comportamiento se obtuvo en Relyx U100 (10,80MPa), seguido por BisCem (6,36MPa), MaxCem (5,45MPa) y SeTPP (3,17MPa): Los cementos autoadhesivos evaluados presentaron menor resistencia adhesiva que los cementos resinosos que requieren tratamiento previo del sustrato dentario (grupo control). Esto deberia ser considerado cuando se realiza su selección clinica, sobre todo en preparaciones dentarias poco retentivas.

Four Lymphomas in 1 Patient: A Unique Case of Triple Composite Non-Hodgkin Lymphoma Followed by Classical Hodgkin Lymphoma.

Composite lymphomas consist of 2 or more distinct lymphomas occurring in a single anatomical site or simultaneously in different sites and can be composed of any combination of B-cell non-Hodgkin lymphoma (NHL), T-cell NHL, or Hodgkin lymphoma (HL). Cases of composite lymphomas with more than 2 lymphomas are extremely rare, with only 4 reports in the literature. We report the case of a 49-year-old man with a triple composite lymphoma in a single lymph node, consisting of small lymphocytic lymphoma, follicular lymphoma, and mantle cell lymphoma in situ. The patient received multiple courses of chemotherapy and an autologous stem cell transplant, which resulted in complete remission. Then, 6 years after the stem cell transplant, he developed classical HL. This unique case is, to our knowledge, the first report of a patient with triple composite lymphoma consisting of 3 small mature B-cell NHLs, who subsequently developed a fourth lymphoma.