Predictors of surgical difficulty in upper third molar removal: a prospective cohort study.

BACKGROUND: Upper third molar (U3M) removal is a common surgical procedure. The aims of this study were to assess the patient-specific, radiological and surgical factors related to the difficulty of U3M removal, and to determine the incidence of intraoperative and postoperative complications. MATERIAL AND METHODS: A prospective cohort study was carried out in adult patients undergoing U3M removal. Operative time, surgeon-reported difficulty and the Parant classification were used to assess extraction difficulty. Clinical, radiological and surgical factors were recorded to determine their relationship with surgical difficulty. A descriptive, bivariate and multivariate statistical analysis was carried out. RESULTS: A total of 250 patients were included. The mean operative time was 10.4 (±12.3) minutes, mean surgeon-reported difficulty was 3.2/10 (±2.3). The multivariate analysis showed greater impaction against the second molar and greater soft tissue and bony impaction to significantly increase operative time and surgeon-perceived difficulty. Additionally, surgeon experience was related to perceived difficulty. The overall incidence of intraoperative complications was 0.8%, and no postoperative events were recorded. CONCLUSIONS: Upper third molars in close relation with the roots of the adjacent second molar and with soft tissue and bony impaction are significantly more difficult to extract. Perceived difficulty was related to surgeon experience. This procedure appears to produce few intra- and postoperative complications.

Diagnosis and indications for the extraction of third molars - The SECIB clinical practice guideline.

BACKGROUND: The removal of third molars (3Ms) is the most frequent surgical procedure in the field of Oral Surgery. As a result, the Spanish Society of Oral Surgery (SECIB) aims to create a Clinical Practice Guideline (CPG) that offers evidence-based recommendations for optimal clinical practice. Specifically, the CPG will focus on providing guidance regarding the indications and criteria for clinical and radiological diagnosis of patients with 3Ms. MATERIAL AND METHODS: This CPG was developed by the SECIB, following the methodological guidelines described in the methodological manual for the "Development of Clinical Practice Guidelines in the National Health System". Several PICO questions related to the diagnosis and indications for the extraction of 3Ms were formulated. The leading experts carried out the evaluation of the evidence and the formulation of specific recommendations. RESULTS: A total of 17 PICO questions were evaluated, addressing the indications, prognosis, diagnosis, and cost-benefit relationship of 3M extraction. CONCLUSIONS: The present Clinical Practice Guideline provides evidence-based recommendations on the diagnosis and indications for 3M extraction. These evidence-based recommendations can assist healthcare professionals and the general population in making informed decisions regarding the management of 3Ms.

Is measurement of the gingival biotype reliable? Agreement among different assessment methods

BACKGROUND: To determine agreement among the most commonly used methods for assessing the gingival biotype. MATERIAL AND METHODS: An electronic survey was sent to a sample of dentists practicing in Spain. The question-naire was based on the evaluation of 5 cases involving different gingival biotype assessment methods. Dentists were required to classify the cases as having a "thin", "thick" or "not able to classify" biotype. Each case was as-sessed using a frontal intraoral photo of the anterior teeth; an enlarged photo of the buccal aspect of the tooth with a periodontal probe inserted inside the sulcus; and the real thickness measured in mm with a calibrated needle. Agreement among the classifications was assessed using Cohen's kappa coefficient. RESULTS: A total of 104 surveys were analyzed. The most commonly used assessment method was visual evaluation of the morphology of the gingiva and the teeth (62.5%). Concordance among the three different methods was weak (kappa = 0.278). Agreement among the classification methods was greater in extreme cases (thinner and thicker gingival thickness). CONCLUSIONS: The most commonly used methods for assessing gingival biotype are not reliable. The three tested methods show poor to weak agreement, which leads to non-reliable estimation of the gingival biotype

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Modulación del metabolismo de esfingolípidos en cáncer de vejiga como una potencial estrategia para optimizar resultados de terapias intravesicales para tumores de vejiga no musculoinvasores / Modulation of sphingolipid metabolism in bladder cancer as a potential strategy to optimize outcomes of intravesical therapies for non-muscle invasive bladder cancers

El cáncer de vejiga representa un problema de salud pública importante a nivel mundial. En Chile su relevancia es aún mayor en la región de Antofagasta. Este cáncer se caracteriza por una alta tasa de recurrencia, por lo que los pacientes requieren un seguimiento estricto que afecta su calidad de vida e implica elevados costos para los sistemas de salud. Esto explica la necesidad de optimizar los tratamientos actuales (quimioterapia e inmunoterapia con BCG intravesical) para reducir las tasas de recurrencia y progresión. Los esfingolípidos son lípidos bioactivos que a nivel celular cumplen funciones relacionadas con la regulación del crecimiento, proliferación, migración, invasión, resistencia a drogas y apoptosis. La evidencia disponible a la fecha sobre el rol de los esfingolípidos en cáncer de vejiga es escasa, pero sugiere que en este cáncer existe un metabolismo esfingolipídico desplazado hacia la reducción de los niveles intracelulares de ceramida y esfingosina (esfingolípidos pro-apoptóticos) y aumento de esfingosina 1-fosfato (esfingolípido anti-apoptótico). La manipulación del metabolismo esfingolipídico para invertir esta relación se propone en esta revisión como una estrategia que podría ayudar a optimizar el efecto de las terapias disponibles actualmente para reducir las recurrencias y progresiones de los tumores de vejiga no músculo-invasores...

Bladder cancer is an important health problem worldwide. In Chile it has particular relevance in the region of Antofagasta. This cancer is characterized by a high recurrence rate, for which patients need a strict follow up that impairs their quality of life and determines increased costs for health care systems. These facts explain the necessity of optimizing the actual treatments (chemotherapy and BCG immunotherapy) for reducing the rates of recurrence and progression. Sphingolipids are bioactive lipids that at a cellular level have roles related to the regulation of growth, proliferation, migration, invasiveness, drug resistance and apoptosis. To date, the available evidence about the role of sphingolipids in bladder cancer is scarce, but suggests that in this cancer there is a sphingolipid metabolism shifted towards a reduction of the intracellular levels of ceramide and sphingosine (pro-apoptotic sphingolipids) and an increase of sphingosine 1-phosphate (anti-apoptotic sphingolipid). In this review we propose that the manipulation of the sphingolipid metabolism to invert this balance can contribute to optimize the effect of the actual therapies to reduce the rates of recurrence and progression of non-muscle invasive bladder cancers...

Esfingosina-1-fosfato y cánceres urológicos: identificando potenciales blancos terapéuticos en su etabolismo y señalización / Sphingosine-1-phosphate and urological cancers: identifying potential therapeutic targets in its metabolism and signalling

Los lípidos no sólo son moléculas estructurales de las membranas. Hay numerosos ejemplos de lípidos que median acciones fisiológicas dentro de las células. Específicamente, esfingolípidos como ceramida, esfingosina y esfingosina-1-fosfato (S1P) han sido involucrados en el control del crecimiento celular, la proliferación y la migración, todo lo cual se ha relacionado con el cáncer.Los efectos pro-apoptóticos de la ceramida y la esfingosina son revertidos por S1P. Por lo tanto, el destino de la célula puede ser modulada mediante el cambio de la proporción de estos esfingolípidos (el modelo reóstato). S1P promueve la proliferación celular, el crecimiento, la supervivencia, la migración, invasión y resistencia fármacos y radiación, en parte a través de receptores de membrana (S1PR1-5). La sobreexpresión de enzimas productoras de S1P y el aumento de los niveles de S1P se ha descrito en muchos tipos de cáncer, incluyendo cánceres urológicos. Por lo tanto, se pueden identificar posibles objetivos terapéuticos en el metabolismo y las vías de señalización de los esfingolípidos, cuya relevancia clínica debe ser determinada en futuros estudios.

Lipids are not only structural molecules of the membranes. There are numerous examples of lipids mediating physiologic actions within the cells. Specifically, sphingolipids like ceramide, sphingosine and sphingosine-1-phosphate (S1P) have been described to be involved in the control of cell growth, proliferation and migration, all of which has been linked to cancer. The pro-apoptotic effects of ceramide and sphingosine are opposed by S1P. Therefore, the fate of the cell can be modulated by changing the ratio of these sphingolipids (the rheostat model). S1P promotes cell proliferation, growth, survival, migration, invasion and resistance to drugs and radiation, in part mediated by S1P membrane receptors (S1PR1-5). Overexpression of S1P producing enzymes and increased S1P levels has been described in many cancers, including urological cancers. Therefore, potential therapeutic targets can be recognized in the metabolism and signaling pathways of sphingolipids and their clinical relevance have to be determined in future studies.

Alarma e defesa no ninho de Synoeca surinama (L) (Hymenoptera: Vespidae) ()

Summary This study concerns to the social communication of S. surinama during alarm and nest defense. Visual and pheromone responses are Incriminated as stimulants of excitation and attack, and are related to the factors necessary to produce general alarm in the nest, as are: rate of wings vibration of nest guards and blows to the involucre.

Resumo Relaciona-se neste estudo o comportamento social da comunicação durante o alarma e defesa do ninho de S. surinama na presença de vespas S. surinama de colônias diferentes e vespas Polistes canadensis. Incriminam-se aspectos visuais e feromônios como estímulos de excitação e ataque, e relacionam-se os fatores necessários para produzir alarma geral no ninho, como são: golpes sobre o invólucro e tempo de vibração das asas das guardiãs dos ninhos.

Culicoides (Diptera: Ceratopogonidae) na Amazônia Brasileira. II. Espécies coletadas na Reserva Florestal Ducke, aspectos ecológicos e distribuição geográfica

Six species of Anthropophilic midges Culicoides: C. debilipalpis, C. foxi, C. lutzi, C. paraensis, C. pseudodiabolicus e C. todatangae, have been collected, in three different areas, of the Ducke Forest Reserve. Geographical distribution, ecological and taxonomics aspects were studied.

Seis espécies de Culicoides latreille, antropófilos: C. debilipalpis, C. foxi, C. lutzi, C. paraensis, C. pseudodiabolicus e C. todatangae, foram capturados com isca humana em três distintas áreas, na Reserva Florstal Ducke. A distribição geográfica, aspectos ecológicos e taxonômicos foram abordados.

Culicoídes (Diptera: Ceratopogonídae) na Amazônia Brasileira. I. Coletas na Usina Hidrelétrica (UHE) de Balbina, Usina Hidrelétrica (UHE) Cachoeira Porteira e Cachoeira dos Espelhos (Rio Xingú)

Working in tree different areas in the Brazilian Amazon , was catched twenty two species of Culicoides, which four species yet not have been collected in the Amazon Region: C. efferus Fox, C. lahillei Wirth & Blanton, C. spurius Wirth & Blanton an C. verecundus Macfie. Biting midges were distributed for areas and according to hight of collected with CDC light traps; are relationed the names of 63 species at now reported in the brazilian Amazon basin.

Trabalhando em três áreas da Amazônia Brasileira, capturamos 22 espécies de Culicoides, dos quais quatros deles não haviam sido encontradas, na região: C. efferus Fox, C. lahillei Wirth & Blanton, C. spurius Wirth & Blanton e C. verecundus Macfie. Distribuimos os insetos por área e conforme a altura em que foram capturados com armadilhas CDC; e apresentamos os nomes das 63 espécies até agora assinaladas na parte brasileira da bacia Amazônica.

Flebotomíneos (Diptera: Psychodidae) no Estado de Roraima, Brasil. II. Espécies coletadas na Região Norte

In this, paper. are reported by the first time, the species of sand flies founded at north of the state of Roraima, Brasil, colected with CDC - light traps, and malaise thapis. Twenty seven species in the region have been reported increasing the number, of known species for. the state to fifty five.

Neste trabalho são reportadas pela primeira vez, as espécies de flebotomíneos acha dos no norte do Estado de Roraima, Brasil; coletadas com armadilhas CDC e Malaise. São reportadas vinte, e oito espécies na região elevando o total para cinquenta e seis conhe cidas para o Estado.