Odontogenic tumours in a Chilean population: a retrospective study of 544 cases based on 2022 WHO classification.

BACKGROUND: Odontogenic tumours are infrequent lesions. Studies on the frequency of odontogenic tumours from Latin America are scarce. This work aimed to determine the relative frequency of odontogenic tumours in a Chilean population using the 2022 World Health Organization classification. MATERIAL AND METHODS: This is a case series retrospective study. We reviewed 35,530 samples from 1975 to 2022 from the Oral Pathology Referral Institute and the Pathological Anatomy Service, Faculty of Dentistry, University of Chile. We utilized the 2022 World Health Organization classification for histological typification. RESULTS: According to 2022 World Health Organization classification, 544 odontogenic tumours were confirmed. The most frequent odontogenic tumours were: odontoma (n=241; 44.3%), ameloblastoma (n=109; 20.0%) and cemento-ossifying fibroma (n=71; 13.1%). Benign odontogenic tumours corresponded to 538 cases (98.9%) and malignant tumours were only six cases (1.1%). CONCLUSIONS: In our population, odontoma was the most frequent odontogenic tumour followed by ameloblastoma and cemento-ossifying fibroma. Malignant odontogenic tumours were very rare. The results of this study are similar to reports from America, but there are some differences concerning the data from Africa and Asia.

The use of readily available laboratory tests for the identification of the emerging yeast Candida auris in Mexico.

Identification of the emerging multidrug-resistant yeast Candida auris is challenging. Here, we describe the role of the Mexico national reference laboratory Instituto de Diagnóstico y Referencia Epidemiológicos Dr. Manuel Martínez Báez (InDRE) and the Mexican national laboratory network in the identification of C. auris. Reference identification of six suspected isolates was done based on phenotypic and molecular laboratory methods, including growth in special media, evaluation of isolate micromorphology, and species-specific PCR and pan-fungal PCR and sequencing. The four C. auris isolates identified were able to grow on modified Sabouraud agar with 10% NaCl incubated at 42 °C. With one exception, isolates of C. auris were spherical to ovoid yeast-like cells and blastoconidia, with no hyphae or pseudohyphae on cornmeal agar. C. auris isolates were resistant to fluconazole. Species-specific and pan-fungal PCR confirmed isolates as C. auris. Sequence analysis revealed the presence of two different C. auris clades in Mexico, clade I (South Asia) and clade IV (South America).

Growth and viability of Streptococcus mutans in sucrose with different concentrations of Stevia rebaudiana Bertoni.

OBJECTIVE: To evaluate total absorbance, planktonic growth, biofilm formation, viability, metabolic activity, and pH of Streptococcus mutans UA159 cultures when different dilutions of Stevia rebaudiana Bertoni were applied and to determine the minimum inhibitory concentration (MIC) and the minimum biofilm inhibitory concentration (MBIC) of Stevia on S. mutans. MATERIALS AND METHODS: The effects of different dilutions of Stevia (0-400 mg/ml) on S. mutans total growth, planktonic growth, biofilm formation, viability, metabolic activity, and pH during a 72-h growth period were evaluated in this in vitro study. A stock solution was prepared by mixing 10 ml of tryptic soy broth (TSB) supplemented with 1% sucrose (TSBS) and 4 g of Stevia. RESULTS: S. mutans total growth and biofilm formation decreased with reduced concentrations of Stevia. Furthermore, the MIC was 25 mg/ml and the MBIC was 6.25 mg/ml. Complete eradication of S. mutans was not observed with any of the Stevia concentrations. Planktonic growth of S. mutans was not repressed by high concentrations of Stevia and most of the Stevia concentrations generated an increased pH. CONCLUSION: Because Stevia reduces biofilm and acid production, Stevia can be considered a non-cariogenic sweetener. CLINICAL RELEVANCE: This study confirms the anticariogenic effect of Stevia, like it has been previously reported, but more studies on the most effective concentration are needed, and in the present study, the minimum inhibitory concentration (MIC) and the minimum biofilm inhibitory concentration (MBIC) was determined in the presence of sucrose. Additionally, this is the first study to evaluate the effect of Stevia on S. mutans metabolic activity.

Experimental study of an in-fiber acousto-optic tunable bandpass filter for single- and dual-wavelength operation in a thulium-doped fiber laser.

A tunable single- and dual-wavelength thulium-doped all-fiber laser is demonstrated based on the implementation of an in-fiber acousto-optic tunable bandpass filter (AOTBF). The AOTBF is fabricated to be operated in the 1.9 µm region, and takes advantage of the intermodal coupling effect produced by traveling flexural acoustic waves in an optical fiber. It exhibits a 3-dB bandwidth of 2.04 nm with an insertion loss of 4.75 dB. The tuning properties of the AO device allows a continuous-wave operation with characteristics of wide tuning range (211.5 nm), narrow linewidth (50 pm) and high signal-to-noise ratio (60 dB). In the dual-wavelength regime, the laser is capable of independent tuning of each of the laser lines, achieving a tunable dual-wavelength emission that extends from 1802.67 to 1932.75 nm. A controllable wavelength spacing with minimum and maximum separations of 1.04 and 130.08 nm is obtained.

Broadband tuning of a long-cavity all-fiber mode-locked thulium-doped fiber laser using an acousto-optic bandpass filter.

A long-cavity passively mode-locked thulium-doped all-fiber laser is reported incorporating a tapered acousto-optic tunable bandpass filter (AOTBF). The operation of the AOTBF relies on the intermodal coupling between core and cladding modes when a flexural acoustic wave propagates along an 80 µm tapered fiber. The filter works in transmission and exhibits a 3 dB bandwidth of 9.02 nm with an insertion loss of 3.4 dB. The laser supports ultrashort pulse generation at a low repetition rate of 784.93 kHz. Optical pulses with 2.43 nm of optical bandwidth and 2.1 ps pulse duration were obtained in a broad tuning range from 1824.77 to 1905.16 nm.

Growth hormone-releasing hormone is produced by adipocytes and regulates lipolysis through growth hormone receptor.

BACKGROUND: Growth hormone-releasing hormone (GHRH) has a crucial role in growth hormone (GH) secretion, but little is known about its production by adipocytes and its involvement in adipocyte metabolism. OBJECTIVES: To determine whether GHRH and its receptor (GHRH-R) are present in human adipocytes and to study their levels in obesity. Also, to analyze the effects of GHRH on human adipocyte differentiation and lipolysis. METHODS: GHRH/GHRH-R and GH/GH-R mRNA expression levels were analyzed in human mature adipocytes from non-obese and morbidly obese subjects. Human mesenchymal stem cells (HMSC) were differentiated to adipocytes with GHRH (10-14-10-8 M). Adipocyte differentiation, lipolysis and gene expression were measured and the effect of GH-R silencing was determined. RESULTS: Mature adipocytes from morbidly obese subjects showed a higher expression of GHRH and GH-R, and a lower expression of GHRH-R and GH than non-obese subjects (P<0.05). A total of 10-14-10-10 M GHRH induced an inhibition of lipid accumulation and PPAR-γ expression (P<0.05), and an increase in glycerol release and HSL expression (P<0.05) in human differentiated adipocytes. A total of 10-12-10-8 M GHRH decreased GHRH-R expression in human differentiated adipocytes (P<0.05). A total of 10-10-10-8 M GHRH increased GH and GH-R expression in human differentiated adipocytes (P<0.05). The effects of GHRH at 10-10 M on adipocyte differentiation and lipolysis were blocked when GH-R expression was silenced. CONCLUSIONS: GHRH and GHRH-R are expressed in human adipocytes and are negatively associated. GHRH at low doses may exert an anti-obesity effect by inhibiting HMSC differentiation in adipocytes and by increasing adipocyte lipolysis in an autocrine or paracrine pathway. These effects are mediated by GH and GH-R.

Diagnosis and quantification of fibrosis, steatosis, and hepatic siderosis through multiparametric magnetic resonance imaging. / Diagnóstico y cuantificación de fibrosis, esteatosis y hepatosiderosis por medio de resonancia magnética multiparamétrica.

BACKGROUND: The presence of liver fibrosis is the common denominator in numerous chronic liver diseases that can progress to fibrosis and hepatocellular carcinoma. Most important, with respect to frequency, are viral hepatitis and non-alcoholic fatty liver disease, the prevalence of which is increasing in epidemic proportions. Liver biopsy, albeit imperfect, continues to be the criterion standard, but in many clinical situations tends to be replaced with noninvasive imaging methods. OBJECTIVES: The aim of the present article was to describe our imaging department experience with magnetic resonance elastography and to analyze and discuss recently published results in gastroenterology, hepatology, and radiology from other authors in the literature, complemented with a PubMed search covering the last 10 years. RESULTS AND CONCLUSIONS: Magnetic resonance elastography is an efficacious, noninvasive method with results that are concordant with liver biopsy. It is superior to ultrasound elastography because it evaluates a much greater volume of hepatic tissue and shows the often heterogeneous lesion distribution. The greatest advantage of the magnetic resonance protocol described is the fact that it quantifies fibrosis, fat content, and iron content in the same 25min examination specifically directed for that purpose, resulting in a favorable cost-benefit ratio for the patient and/or institution.

Urotensinergic system genes in experimental subarachnoid hemorrhage.

OBJECTIVE: Cerebral vasospasm, one of the main complications of subarachnoid hemorrhage (SAH), is characterized by arterial constriction and mainly occurs from day 4 until the second week after the event. Urotensin-II (U-II) has been described as the most potent vasoconstrictor peptide in mammals. An analysis is made of the serum U-II concentrations and mRNA expression levels of U-II, urotensin related peptide (URP) and urotensin receptor (UT) genes in an experimental murine model of SAH. DESIGN: An experimental study was carried out. SETTING: Experimental operating room of the Biomedicine Institute of Seville (IBiS), Virgen del Rocío University Hospital (Seville, Spain). PARTICIPANTS: 96 Wistar rats: 74 SAH and 22 sham intervention animals. INTERVENTIONS: Day 1: blood sampling, followed by the percutaneous injection of 100µl saline (sham) or blood (SAH) into the subarachnoid space. Day 5: blood sampling, followed by sacrifice of the animals. MAIN VARIABLES OF INTEREST: Weight, early mortality, serum U-II levels, mRNA values for U-II, URP and UT. RESULTS: Serum U-II levels increased in the SAH group from day 1 (0.62pg/mL [IQR 0.36-1.08]) to day 5 (0.74pg/mL [IQR 0.39-1.43]) (p<0.05), though not in the sham group (0.56pg/mL [IQR 0.06-0.83] day 1; 0.37pg/mL [IQR 0.23-0.62] day 5; p=0.959). Between-group differences were found on day 5 (p<0.05). The ROC analysis showed that the day 5 serum U-II levels (AUC=0.691), URP mRNA (AUC=0.706) and UT mRNA (AUC=0.713) could discriminate between sham and SAH rats. The normal serum U-II concentration range in rats was 0.56pg/mL (IQR 0.06-0.83). CONCLUSION: The urotensinergic system is upregulated on day 5 in an experimental model of SAH.

Acute pain trajectories and the persistence of post-surgical pain: a longitudinal study after total hip arthroplasty.

PURPOSE: The aim of this study was to explore acute movement-evoked postoperative pain intensity trajectories over the first 5 days after total hip arthroplasty (THA) and to examine how these pain trajectories are associated with pain-related outcomes 6 weeks and 6 months later. METHODS: A total of 150 adult patients [72 women (48.0 %); mean age 60.0 ± 9.2 (standard deviation) years] completed pain questionnaires preoperatively, several times daily postoperatively until hospital discharge, and 6 weeks and 6 months after surgery. RESULTS: Results showed that the best model had four different acute postoperative pain trajectories and a significant quadratic term. The trajectories varied in terms of initial pain intensity levels and rates of decline/increase in pain over the first 4 postoperative days. Significant predictors of pain trajectory membership were preoperative pain disability and anxiety as well as cumulative morphine consumption 24 h following surgery. Pain trajectories were significantly associated with levels of pain intensity and anxiety at 6 weeks but not at 6 months postoperatively. CONCLUSION: This study showed that during the postoperative period patients differed in terms of pain intensity profiles and that these differences were associated with outcomes for up to 6 weeks following surgery. Pain trajectories were not predictive of persistent postoperative pain status at 6 months. Nonetheless, these results highlight the importance of patient heterogeneity in acute postoperative pain and pain-related outcomes months after THA.

[Usefulness of biomarkers in the prognosis of severe head injuries]. / Utilidad de los biomarcadores en el pronóstico del traumatismo craneoencefálico grave.

Severe head injuries have a great socioeconomic and public health impact. Despite progress in diagnosis and treatment, no sufficiently reliable predictive models have been established for developing clinical trials and promoting effective therapeutic strategies capable of improving the prognosis. In the last decades, several brain damage biomarkers have been studied as potential diagnostic and prognostic tools in traumatic brain injury. However, all of them have limitations that preclude their universalized application. The properties of the known biomarkers -both those traditionally shown to correlate with severity and prognosis, and those recently announced as promising options- should be analyzed. New studies are needed to define their properties, both isolatedly and in combined use.

[An experimental model of mass-type brain damage in the rat: expression of brain damage based on neurospecific enolase and protein S100B]. / Modelo experimental de lesión cerebral tipo masa en rata: expresión del daño cerebral mediante enolasa neuroespecífica y proteína S100B.

OBJECTIVE: To determine whether a model of transient mass-type brain damage (MTBD) in the rat produces early release of neurospecific enolase (NSE) and protein S100B in peripheral blood, as an expression of the induced brain injury. DESIGN: An experimental study with a control group. SETTING: Experimental operating room of the Institute of Biomedicine (IBiS) of Virgen del Rocío University Hospital (Seville, Spain). PARTICIPANTS: Fourteen adult Wistar rats. INTERVENTIONS: Blood was sampled at baseline, followed by: MTBD group, a trephine perforation was used to insert and inflate the balloon of a catheter at a rate of 500 µl/20 sec, followed by 4 blood extractions every 20 min. Control group, the same procedure as before was carried out, though without trephine perforation. PRIMARY STUDY VARIABLES: Weight, early mortality, serum NSE and S100B concentration. RESULTS: Differences in NSE and S100B concentration were observed over time within the MTBD group (P<.001), though not so in the control group. With the exception of the baseline determination, differences were observed between the two groups in terms of the mean NSE and S100B values. Following MTBD, NSE and S100B progressively increased at all measurement timepoints, with r=0.765; P=.001 and r=0.628; P=.001, respectively. In contrast, the control group showed no such correlation for either biomarker. CONCLUSIONS: Serum NSE and S100B concentrations offer an early indication of brain injury affecting the gray and white matter in an experimental model of mass-type MTBD in the rat.

Resistin regulates pituitary lipid metabolism and inflammation in vivo and in vitro.

The adipokine resistin is an insulin-antagonizing factor that also plays a regulatory role in inflammation, immunity, food intake, and gonadal function and also regulates growth hormone (GH) secretion in rat adenopituitary cells cultures with the adipokine. Although adipose tissue is the primary source of resistin, it is also expressed in other tissues, including the pituitary. The aim of this study is to investigate the possible action of resistin on the lipid metabolism in the pituitary gland in vivo (rats in two different nutritional status, fed and fast, treated with resistin on acute and a chronic way) and in vitro (adenopituitary cell cultures treated with the adipokine). Here, by a combination of in vivo and in vitro experimental models, we demonstrated that central acute and chronic administration of resistin enhance mRNA levels of the lipid metabolic enzymes which participated on lipolysis and moreover inhibiting mRNA levels of the lipid metabolic enzymes involved in lipogenesis. Taken together, our results demonstrate for the first time that resistin has a regulatory role on lipid metabolism in the pituitary gland providing a novel insight in relation to the mechanism by which this adipokine can participate in the integrated control of lipid metabolism.

Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury.

OBJECTIVE: To determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI). DESIGN: Cross-sectional telephone survey. SETTING: Rehabilitation institute. PARTICIPANTS: Community-dwelling adult men and women (N=617) with SCI who were at least 1 year postinjury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: RNL Index and Satisfaction With Life Scale (SWLS). RESULTS: Reliability of the RNL Index was determined by using Cronbach α, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (α=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R(2)=.26 (P<.001). CONCLUSIONS: The RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause.

Water stable isotopes reveal a complex rainfall to groundwater connectivity in central Honduras.

The inter-mountainous region of central Honduras has been experiencing abrupt urban drinking water shortages during the last decade. Land use fragmentation and rainfall deficits have rapidly reduced surface water quality and quantity in this region. Here we present a 3-yr (2018-2020) tracer study within the headwaters of the Choluteca River basin (2949 km2). We sampled rainfall (weekly N = 156; daily N = 270), drilled wells (N = 166; up to ~300 m depth), boreholes (N = 70; ~4-12 m depth), and springs (N = 128) to assess the spatiotemporal connectivity between rainfall and mean groundwater recharge elevations (MREs). Clear W-shaped incursions characterized rainfall isotopic seasonality from the dry to the wet season. Air mass back trajectory analysis revealed three primary moisture sources: 73 % (east, Caribbean Sea), 17 % (southwest, Pacific Ocean), and 10 % (north; Gulf of Mexico). Groundwater sources exhibited a strong meteoric origin with evidence of secondary evaporation evolution, characterized by low d-excess values. MREs for the drilled wells ranged from 821 to 2018 m asl with a mean value of 1570 ± 150 m asl. Seasonal isotopic variability during dry-wet transitions and the influence of rapid infiltration limited the performance of the MRE method in springs and boreholes. MREs coincided primarily with coniferous forests, pasture, and crop areas, within regions of moderate to high transmissivity. These results are intended to guide the mapping and delineation of critical recharge areas in central Honduras to enhance municipal water regulations, effective environmental protection, and long-term conservation practices.

Evaluation of a heart failure knowledge questionnaire and its use in guiding the educational intervention.

INTRODUCTION AND OBJECTIVE: Patient education by nurses is a cornerstone of any heart failure (HF) program, but the models are widely heterogeneous and few specific instruments exist. Our objective is to evaluate our own questionnaire and its utility as a guide for educational intervention. METHODS: This work is a prospective cohort study of patients followed-up on in a specialized unit after diagnosis of HF. The intervention group received educational sessions guided according to their knowledge using the questionnaire and was compared to a group which received standard education. The validity and reliability of the questionnaire was evaluated. The utility of the educational model was determined by the primary composite endpoint of death and/or hospital admission or emergency care for HF. RESULTS: A total of 152 patients were included, 88 which received guided education and 64 which received standard education, with a mean follow-up time of 16±4 months. In the guided education group, the evaluation questionnaire score (qs) rose from 59% to 78.5% (p=0.018), which was associated with greater self-care (28.5-0.6*qs, p=0.04), a tendency toward better quality of life (51.1-1.1*qs, p=0.09), and adherence (5.02+0.04*qs, p=0.06), with acceptable reliability (Cronbach's alpha 0.75). The primary composite endpoint was met in 12 patients (13.6%) in the intervention group compared to 19 (29.7%) in the control group (hazard ratio: 0.46; 95% confidence interval: 0.24-0.88; p=0.019). Only educational level, age, NT-proBNP, and atrial fibrillation were predictors in the multivariate analysis. CONCLUSION: The HF knowledge questionnaire proposed is a valid, reliable tool and allows for quantifying learning. Its utility in guiding education requires a certain degree of skill from the patient that determines a group with better prognosis.

Stereotactic body radiotherapy for early-stage non-small cell lung cancer: a multicentre study by the Oncologic Group for the Study of Lung Cancer (Spanish Radiation Oncology Society).

PURPOSE/OBJECTIVE(S): Stereotactic body radiotherapy (SBRT) has become the standard of care for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) and for patients who refuse surgery. The aim of this study was to evaluate the effectiveness and safety of primary SBRT in patients with early-stage NSCLC. MATERIALS/METHODS: Retrospective multicenter study of 397 patients (416 primary lung tumours) treated with SBRT at 18 centres in Spain. 83.2% were men. The median age was 74.4 years. In 94.4% of cases, the tumour was inoperable. The pathological report was available in 54.6% of cases. SPSS vs 22.0. was used to perform all statistical analyses. RESULTS: Complete response was obtained in 53.6% of cases. Significant prognostic factors were standard CT planning (p = 0.014) and 4D cone beam CT (p = 0.000). Acute and chronic toxicity ≥ grade 3 was observed in 1.2% of cases. At a median follow-up of 30 months, local relapse was 9.6%, lymph node relapse 12.8%, distant metastasis 16.6%, and another lung tumour 11.5%. Complete response was the only significant prognostic factor for local relapse (p = 0.012) and distant metastasis (p = 0.001). The local relapse-free survival was 88.7%. The overall survival was 75.7%. The cancer-specific survival was 92.7%. The disease-free survival was 78.7%. CONCLUSION: SBRT is an effective and well-tolerated treatment option for patients with early-stage lung cancer who are not suitable for surgery. The most important prognostic factor for local and distant recurrence was complete response, which in our sample depended on the type of CT planning and the IGRT technique.

Fatty liver index as a predictor for type 2 diabetes in subjects with normoglycemia in a nationwide cohort study.

Our aim was to evaluate whether fatty liver index (FLI) is associated with the risk of type 2 diabetes (T2DM) development within the Spanish adult population and according to their prediabetes status; additionally, to examine its incremental predictive value regarding traditional risk factors. A total of 2260 subjects (Prediabetes: 641 subjects, normoglycemia: 1619 subjects) from the Di@bet.es cohort study were studied. Socio-demographic, anthropometric, clinical data and survey on habits were recorded. An oral glucose tolerance test was performed and fasting determinations of glucose, lipids and insulin were made. FLI was calculated and classified into three categories: Low (< 30), intermediate (30-60) and high (> 60). In total, 143 people developed diabetes at follow-up. The presence of a high FLI category was in all cases a significant independent risk factor for the development of diabetes. The inclusion of FLI categories in prediction models based on different conventional T2DM risk factors significantly increase the prediction power of the models when all the population was considered. According to our results, FLI might be considered an early indicator of T2DM development even under normoglycemic condition. The data also suggest that FLI could provide additional information for the prediction of T2DM in models based on conventional risk factors.

Jejunal wall triglyceride concentration of morbidly obese persons is lower in those with type 2 diabetes mellitus.

The overproduction of intestinal lipoproteins may contribute to the dyslipidemia found in diabetes. We studied the influence of diabetes on the fasting jejunal lipid content and its association with plasma lipids and the expression of genes involved in the synthesis and secretion of these lipoproteins. The study was undertaken in 27 morbidly obese persons, 12 of whom had type 2 diabetes mellitus (T2DM). The morbidly obese persons with diabetes had higher levels of chylomicron (CM) triglycerides (P < 0.001) and apolipoprotein (apo)B48 (P = 0.012). The jejunum samples obtained from the subjects with diabetes had a lower jejunal triglyceride content (P = 0.012) and angiopoietin-like protein 4 (ANGPTL4) mRNA expression (P = 0.043). However, the apoA-IV mRNA expression was significantly greater (P = 0.036). The jejunal triglyceride content correlated negatively with apoA-IV mRNA expression (r = -0.587, P = 0.027). The variables that explained the jejunal triglyceride content in a multiple linear regression model were the insulin resistance state and the apoA-IV mRNA expression. Our results show that the morbidly obese subjects with diabetes had lower jejunal lipid content and that this correlated negatively with apoA-IV mRNA expression. These findings show that the jejunum appears to play an active role in lipid homeostasis in the fasting state.