BLK and BANK1 variants and interactions are associated with susceptibility for primary Sjögren's syndrome and with some clinical features.

BLK and BANK1 in primary Sjögren's syndrome (pSS) have scarcely been evaluated and the results are inconclusive. The aim of our study was to determine whether single nucleotide variants (SNVs) located within BLK or BANK1 are associated with susceptibility, clinical and serological features, and smoking in pSS. BLK rs13277113A/G, BANK1 rs10516487G/A and rs3733197G/A were genotyped in 203 cases and 424 controls using a TaqMan® SNP genotyping assay. The BLK rs13277113A allele showed association with pSS under the allelic (OR 1.35, p = 0.02), and recessive (OR 1.83, p = 0.003) model, while, BANK1 rs3733197G/A showed association under the dominant model (OR 2.90, p = 0.043). Interactions between BANK1 and BLK genotypes also showed association (OR 2.36, p < 0.0001). In addition, BLK rs13277113A/G was associated with protection against arthritis and BANK1 rs10516487G/A with both arthritis and keratoconjunctivitis sicca, meanwhile, BANK1 rs3733197G/A was associated with smoking in patients with pSS. This is the first study to describe an association between BLK and susceptibility to pSS in a Latin-American population. Our data also shows a first evidence of association between interactions of BLK and BANK1 in pSS, and association of BLK and BANK1with arthritis, keratoconjunctivitis sicca and smoking in patients with pSS.

Three-dimensional analysis of the root canal preparation with Reciproc Blue®, WaveOne Gold® and XP EndoShaper®: a new method in vivo.

BACKGROUND: The purpose of this study was to evaluate the changes in canal volume after root canal preparation in vivo with 3 different single-file techniques (Reciproc-Blue®, WaveOne-Gold® and XP-EndoShaper®), with a new method using CBCT and 3D reconstruction. METHODS: In this prospective study, thirty human lower premolars from healthy patients were used, in which extraction was indicated for orthodontic reasons. All the teeth used were caries- and restoration-free with complete root development, without signs of periodontal disease or traumatic occlusion, and with only one straight canal (up to 25º curvature). Teeth were randomly divided into three different groups: Reciproc-Blue, WaveOne-Gold and XP-EndoShaper. CBCT scans before root canal preparation were used to create a 3D reconstruction with RHINOCEROS 5.0 software to assess the initial canal volume, and then compared with 3D reconstructions after canal preparation to measure the increase in canal volume. Student's t test for paired data were used to determine statistically significant differences between the before and after canal volumes. Anova test was used to determine statistically significant differences in the percentage of canal volume increase between the groups and Tukey's post-hoc test were used to paired comparison. RESULTS: Reciproc-Blue showed the higher increase in canal volume, followed by WaveOne-Gold and XP-EndoShaper (p = 0.003). XP-EndoShaper did not show a statistically significant increase in canal volume after root canal preparation (p = 0.06). CONCLUSION: With this model, Reciproc-Blue showed higher increase in root canal volume, followed by WaveOne-Gold, while XP-EndoShaper did not significantly increase root canal volume during preparation.

Thermophysical characterisation of VO2 thin films hysteresis and its application in thermal rectification.

Hysteresis loops exhibited by the thermophysical properties of VO2 thin films deposited on either a sapphire or silicon substrate have been experimentally measured using a high frequency photothermal radiometry technique. This is achieved by directly measuring the thermal diffusivity and thermal effusivity of the VO2 films during their heating and cooling across their phase transitions, along with the film-substrate interface thermal boundary resistance. These thermal properties are then used to determine the thermal conductivity and volumetric heat capacity of the VO2 films. A 2.5 enhancement of the VO2 thermal conductivity is observed during the heating process, while its volumetric heat capacity does not show major changes. This sizeable thermal conductivity variation is used to model the operation of a conductive thermal diode, which exhibits a rectification factor about 30% for small temperature differences (≈70 °C) on its terminals. The obtained results grasp thus new insights on the control of heat currents.

Tumor necrosis factor gene polymorphisms are associated with systemic lupus erythematosus susceptibility or lupus nephritis in Mexican patients.

The TNF -238G/A (rs361525) and -308G/A (rs1800629) polymorphisms have consistently been associated with systemic lupus erythematosus (SLE) in several populations; however, these findings have not been verified in all populations. Here, we aimed to examine whether the TNF -238G/A, -308G/A, -376G/A (rs1800750), and -1031T/C (rs1799964) polymorphisms confer SLE or lupus nephritis (LN) susceptibility in a Mexican population. Our study included 442 patients with SLE and 495 controls. For genotyping, we used the TaqMan 5' allele discrimination assay. The TNF -238G/A and -1031T/C polymorphisms were associated with SLE susceptibility (odds ratio (OR) 2.1, p = 0.0005 and OR 1.4, p = 0.003, respectively). Gender stratification showed a strong association between TNF -238G/A and SLE in women (OR 2.2, p = 0.00006), while TNF -1031T/C had an OR of 1.5 (p = 0.007). With regard to the TNF -376G/A polymorphism, this also showed association with SLE susceptibility (OR 1.95, p = 0.036) and LN (OR 3.5, p = 0.01). In conclusion, our study provides the first demonstration of association between the TNF -376G/A polymorphism and SLE and LN susceptibility. In addition, our study is the second documenting an association of TNF -1031T/C with SLE susceptibility. We also observed a strong association between TNF -238G/A and SLE susceptibility. The TNF 308G/A polymorphism was not associated with SLE or LN.

Expression of MICA, MICB and NKG2D in human leukemic myelomonocytic and cervical cancer cells.

BACKGROUND: Cancer cells are known to secrete the stress molecules MICA and MICB that activate cytotoxicity by lymphocytes and NK cells through their NKG2D receptor as a mechanism of immunological defense. This work was undertaken to evaluate if cancer cells can also express this receptor as a possible mechanisms of depletion of MIC molecules and thus interfere with their immune recognition. METHODS: Myelomonocytic leukemic (TPH-1 and U-937) and cervical cancer (CALO and INBL) cell lines were evaluated by Western Blot, ELISA, flow cytometry and immunocytochemistry to evaluate their capacity to express and secrete MICA and MICB and to be induced to proliferate by these molecules as well as to express their receptor NKG2D. Statistical analysis was performed by two-way ANOVA for time course analysis and Student's t-test for comparison between groups. Values were considered significantly different if p < 0.05. RESULTS: THP-1 and U-937 produce and secrete the stress MICA and MICB as shown by Western Blot of lysed cells and by ELISA of their conditioned media. By Western Blot and flow cytometry we found that these cells also express the receptor NKG2D. When THP-1 and U-937 were cultured with recombinant MICA and MICB they exhibited a dose dependent induction for their proliferation. CALO and INBL also produce MICA and MICB and were induced to proliferate by these stress molecules. By Western Blot, flow cytometry and immunocytochemistry we also found that these cells express NKG2D. CONCLUSIONS: Our novel results that tumor cells can simultaneously secrete MIC molecules and express their receptor, and to be induced for proliferation by these stress molecules, and that tumor epithelial cells can also express the NKG2D receptor that was thought to be exclusive of NK and cytotoxic lymphocytes is discussed as a possible mechanism of immunological escape and of tumor growth induction.

Infección relacionada con los dispositivos cardiovasculares / Cardiovascular device-related infections

Resumen Objetivo: Describir las características demográficas y clínicas de los pacientes que presentaron infecciones relacionadas con los dispositivos cardiovasculares electrónicos implantables. Métodos: Se revisaron las historias clínicas de los pacientes que ingresaron por infecciones de los dispositivos cardiovasculares implantables entre enero de 2006 y septiembre de 2015. Se describieron las características relacionadas con el paciente, el procedimiento, el dispositivo y el microorganismo aislado. Resultados: 22 pacientes fueron admitidos por infecciones relacionadas con los dispositivos electrónicos cardiovasculares implantables. El promedio de edad fue 63 años (DE 13,7) y 86% fueron del sexo masculino. La mitad de los pacientes tenían enfermedad renal crónica y solo el 27% diabetes mellitus. Todos los casos tenían al menos 2 electrodos intracardiacos y el 40,91% refirieron el antecedente de recambio del dispositivo. El germen más frecuentemente aislado fue el Staphylococcus epidermidis. La mortalidad fue del 22,73%. Conclusiones: Las infecciones por los dispositivos cardiovasculares son cada vez más frecuentes. Se debe identificar la presencia de infección local o sistémica con o sin compromiso intracardiaco. Los objetivos del tratamiento van dirigidos a la remoción del dispositivo cardiovascular y el tratamiento antibiótico dirigido.

Abstract Motivation: To describe demographic and clinical characteristics of patients who developed infections related to cardiovascular implantable electronic devices. Methods: Medical records of patients who were admitted for infections of cardiovascular implantable devices between January 2006 and September 2015 were reviewed. Characteristics related to the patient, the procedure, the device and the isolated microorganism were described. Results: 22 patients were admitted for infections related to cardiovascular implantable Electronic devices Average age was 63 years (SD 13.7) and 86% were male. Half of the patients suffered from chronic renal disease and only 27% diabetes mellitus. All cases had at least 2 intracardiac electrodes and 40.91% had required a previous replacement of the device. The most frequently isolated germ was Staphylococcus epidermidis. Mortality rate was 22.73%. Conclusions: Cardiovascular device-related infections are more and more frequent. The presence of a local or systemic infection with or without intracardiac involvement must be identified. The goals of the treatment are oriented towards the removal of the cardiovascular device and empirical antibiotic therapy.

El receptor NKG2D en la frontera de la inmunovigilancia y la carcinogénesis / The NKG2D receptor in the border of immune surveillance and carcinogenesis

El sistema inmune es capaz de realizar la detección y eliminación de células transformadas por un mecanismo fisiológico conocido como inmunovigilancia. En este proceso participa el receptor activador NKG2D presente en linfocitos T y células NK, ambos de suma relevancia en la inmunovigilancia contra el cáncer. Al reconocer el receptor NKG2D a sus ligandos (NKG2DLs) en las células que experimentan neotransformación se desencadena la respuesta lítica específica de las células linfoides citotóxicas. Asimismo, se ha descrito en diversos tipos de cáncer formas solubles de NKG2DLs que se ha demostrado son utilizadas para la evasión tumoral al saturar los receptores NKG2D presentes en las células efectoras linfoides evitando de esta manera ser reconocidas y eliminadas y, con ello escapando de la inmunovigilancia. Aunque este fenómeno de evasión inmune, donde participan algunos NKG2DLs, ha sido ya descrito y corroborado clínicamente no se ha estudiado si el receptor NKG2D está presente en las células tumorales per se ya que también podría estar implicado en subvertir la inmunovigilancia. En este trabajo se analizan evidencias recientes de que la expresión del receptor NKG2D no es exclusiva de linfocitos T y NK ya es expresado por células epiteliales tumorales tanto in vitro como in vivo. Las consecuencias de esta anómala expresión en células no linfoides tiene amplias implicaciones en la carcinogénesis que serán revisadas. También se analizan estudios clínicos recientes donde se comprueba la participación del receptor NKG2D en diferentes patologías tumorales.

The immune system is able to perform the detection and elimination of transformed cells by a mechanism known as physiological immune surveillance. This process involves the NKG2D receptor activator present in T lymphocytes and NK cells, both of paramount importance in the immune surveillance against cancer. To recognize the receptor NKG2D ligands (NKG2DLs) in cells that experience retransformation triggers the specific lithic response of the cytotoxic lymphoid cells. Also, soluble forms of NKG2DLs have been described in various types of cancer that have proven to be used for tumor evasion by saturating the NKG2D receptors present in the effector lymphoid cells thus avoiding their recognition and elimination, which makes them escape immune surveillance. Although this phenomenon of immune evasion, where some NKG2DLs participate, has already been described and corroborated, clinically, it has not been studied whether the receptor NKG2DL is present in the tumor cells per se because it could also be involved in reversing immune surveillance. This paper analyzes recent evidence that the expression of the NKG2D receptor is not lymphocyte T and NK exclusive it is already expressed by tumor epithelial cells in vitro and in vivo. Consequences of this anomalous expression in non-lymphoid cells have widespread implications in carcinogenesis, which will be revised. Recent clinical studies to prove the participation of NKG2D receptor in several tumor pathologies are analyzed.

Recomendaciones para la sedación y la analgesia por médicos no anestesiólogos y odontólogos de pacientes mayores de 12 años / Sedation and analgesia recommendations for non-anesthesiologist physicians and dentists in patients over 12 years old

Las complicaciones relacionadas con la sedación son, en su enorme mayoría, prevenibles. El presente documento establece unas recomendaciones para que los no anestesiólogos puedan realizar sedaciones nivel I y II con un buen nivel de seguridad. Sus aspectos másimportantes son: administración de la sedación por una persona diferente del operador; recomendaciones en cuanto a la capacitación, la monitorización, el uso de un solo medicamento para la sedación y la disponibilidad de medicamentos y equipos de respaldo;la necesidad de realizar una evaluación previa a la sedación, así como el consentimiento informado y el registro durante el procedimiento; y recomendaciones para considerar un bajo umbral con el fin de solicitar el apoyo de un anestesiólogo.

Most of the complications related to sedation are preventable. This document defines some recommendations for non-anesthesiologists so that they can provide sedation level I and II with adequate safety. The most important recommendations are: that the sedation be provided by someone different from the person who performs the surgical procedure; designation of the training and monitoring of thje person who sedates; the use of only one medication for sedation, and the availability of medications and equipment to manage complications; the mandatory need of an assessment prior to the sedation, as well as informed consent and record of events during the procedure; and the recommendation of having a low threshold to request the support of an anesthesiologist.

Adenoma pleomorfo de la cavidad nasal: presentación de un caso / Pleomorphic adenoma in the nasal cavity: presentation of a case

Se presenta un caso extremadamente raro de adenoma pleomorfo de la cavidad nasal, en una paciente del sexo femenino de 31 años, de edad, que acudió a consulta por obstrucción nasal derecha. Los hallazgos radiológicos en una tomografía computada evidenciaron neoformación en fosa nasal derecha con lisis septal. Se realizó una biopsia incisional con reporte histopatológico de adenoma pleomorfo; posteriormente se resecó en su totalidad a través de la técnica quirúrgica de desguante facial y el diagnóstico posquirúrgico confirmó el reporte de adenoma pleoformo de la cavidad nasal, mediante el análisis histopatológico del tumor

Ruptura espontanea del esofago por vomitos síndrome de Boerhaave: presentación / Spontaneous rupture the esophogus for vomiting Boerhaave's syndrome: presentation of 2 cases with complication

Se presentan dos casos de ruptura del esófago por vómitos (Síndrome de Boerhaave) que fueron tratados por complicaciones severas en el curso de los últimos tres años. Se destacan, la causa de la ruptura, su mecanismo y el manejo quirúrgico de acuerdo a las condiciones clínicas y patológicas de cada paciente. Se señala el beneficio de la nutrición enteral y parenteral. Se hace conocer el hallazgo de osificación de la cicatriz abdominal en ambos pacientes planteándose la posible relación con la nutrición enteral a largo plazo