Shift from Pro- to Anti-Inflammatory Phase in Pelvic Floor Muscles at Postpartum Matches Histological Signs of Regeneration in Multiparous Rabbits.

Background and Objectives: Pelvic floor muscles (PFM) play a core role in defecation and micturition. Weakening of PFM underlies urogynecological disorders such as pelvic organ prolapse and stress urinary incontinence. Vaginal delivery damages PFM. Muscle trauma implies an inflammatory response mediated by myeloid cells, essential for subsequent recovery. Molecular signaling characterizing the pro-inflammatory phase shifts M1 macrophages to M2 macrophages, which modulate muscle repair. The present study aimed to evaluate histological characteristics and the presence of M1 and M2 macrophages in bulbospongiosus (Bsm) and pubococcygeus muscles (Pcm). Materials and Methods: Muscles from young nulliparous (N) and multiparous rabbits on postpartum days three (M3) and twenty (M20) were excised and histologically processed to measure the myofiber cross-sectional area (CSA) and count the centralized myonuclei in hematoxylin-eosinstained sections. Using immunohistochemistry, M1 and M2 macrophages were estimated in muscle sections. Kruskal-Wallis or one-way ANOVA testing, followed by post hoc tests, were conducted to identify significant differences (p < 0.05). Results: The myofiber CSA of both the Bsm and Pcm of the M3 group were more extensive than those of the N and M20 groups. Centralized myonuclei estimated in sections from both muscles of M20 rabbits were higher than those of N rabbits. Such histological outcomes matched significant increases in HLA-DR immunostaining in M3 rabbits with the CD206 immunostaining in muscle sections from M20 rabbits. Conclusions: A shift from the pro- to anti-inflammatory phase in the bulbospongiosus and pubococcygeus muscles of multiparous rabbits matches with centralized myonuclei, suggesting the ongoing regeneration of muscles.

Safety of oil from Schizochytrium limacinum (strain TKD-1) for use in infant and follow-on formula as a novel food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the safety of Schizochytrium sp. (TKD-1) oil as a novel food (NF) pursuant to Regulation (EU) 2015/2283. Schizochytrium sp. is a single-cell microalga. The strain TKD-1, used by the applicant (ATK Biotech Co. Ltd.), belongs to the species Schizochytrium limacinum. The NF is a mixture of triglycerides in which docosahexaenoic acid (DHA) represents 53%-61% of fatty acids. The applicant proposed to use the NF in infant formulae (IF) and follow-on formulae (FOF). The use levels proposed by the applicant were derived from Regulation (EU) 2016/127, which states the mandatory addition of DHA to IF and FOF at the level of 20-50 mg/100 kcal. S. limacinum was attributed the qualified presumption of safety (QPS) status with the qualification 'for production purposes only'. Data provided by the applicant demonstrated the absence of viable cells in the NF. No toxicological studies were performed with the NF. However, based on the available toxicological data on oils derived from Schizochytrium sp., the QPS status of the source of the NF, the production process, the composition of the NF and the absence of marine biotoxins and viable cells in the NF, the Panel considers there are no concerns with regard to toxicity of the NF. The Panel concludes that the NF is safe under the proposed conditions of use.

Safety of oil from Schizochytrium sp. (strain CABIO-A-2) for use in infant and follow-on formula as a novel food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the safety of Schizochytrium sp. (strain CABIO-A-2) oil as a novel food (NF) pursuant to Regulation (EU) 2015/2283. S. sp. is a single-cell microalga. The NF is a mixture of triglycerides in which docosahexaenoic acid (DHA) represents 38%-44% of fatty acids. The applicant proposed to use the NF in infant formulae (IF) and follow-on formulae (FOF). The use levels proposed by the applicant were derived from Regulation (EU) 2016/127, which states the mandatory addition of DHA to IF and FOF at the level of 20-50 mg/100 kcal. The evidence provided demonstrated that the strain S. sp. CABIO-A-2 is phylogenetically closely related to the strain S. sp. ATCC 20888. The assessment of some already authorised S. sp. oils in the Union list were also based on similarities with the strain ATCC 20888. The applicant provided a 90-day repeated dose toxicity study in rats with the NF. No adverse effects were observed up to the highest dose tested, i.e. 10.2 g/kg body weight (bw) per day. Taking into account the toxicity studies performed with the NF and with DHA-oils derived from strains belonging to the genus Schizochytrium, its phylogenetical profile, the production process, the composition of the NF and the absence of marine biotoxins and viable cells in the NF, the Panel considers that there are no concerns with regard to the toxicity of the NF. The Panel concludes that the NF is safe under the proposed conditions of use.

Comunicación interpersonal de médicos-docentes en las prácticas formativas de un pregrado de medicina

Introducción: La comunicación es una competencia esencial en los currículos médicos, y es fundamental en modelos de atención centrados en el paciente. Las prácticas clínicas, eje en la formación médica, son escenarios de interacciones docente-estudiantes-pacientes; en ellas, los estudiantes aprenden a comunicarse con el paciente de la mano de sus profesores. El objetivo del estudio fue comprender la comunicación de médicos-docentes en prácticas clínicas de un pregrado de medicina. Metodología: Investigación cualitativa desde el marco interpretativo del interaccionismo simbólico y el análisis bajo los lineamientos de la teoría fundamentada. Se entrevistaron quince médicos docentes de cursos clínicos. Las entrevistas se grabaron, transcribieron y codificaron por unidades de sentido. Resultados: Del análisis emergen diferentes visiones del estudiante e interés por los elementos comunicativos con este y el paciente y la reflexión de la práctica docente. Los docentes son conscientes del rol de modelaje para el aprendizaje de los estudiantes; consideran a los pacientes como seres vulnerables, generosos, agradecidos, que representan el recurso más valioso para la enseñanza; con ellos desarrollan su doble misión de resolver problemas de salud y enseñar. Conclusiones: Los docentes, en la interacción con los estudiantes y pacientes, transforman una práctica más instruccional y disciplinar a una centrada en los sujetos y sus necesidades. La regulación del currículo y la normativa de las instituciones de salud genera tensiones a los docentes entre el quehacer médico y el deseo de enseñar.

Introduction: Communication is an essential skill in medical curricula and crucial in patient-centered care models. Resident experience is fundamental in medical training. These experiences offer teacher-student-patient interactions where students learn about doctor-patient communication directly from their preceptors. The objective of the study was to understand doctor-teacher communication during clinical practices in an undergraduate medical program. Methodology: Qualitative research undertaken from the interpretive framework of Symbolic Interactionism andanalysis under Grounded Theory guidelines. Fifteen (15) clinical-course medical doctors were interviewed. The interviews were recorded, transcribed, and coded by meaning units. Results: Different student views emerged, including student interest in student-patient communicative aspects as well as their own thoughts on teaching. Teachers are aware of their role as models in student learning; they see patients as vulnerable, generous, grateful people that represent the most valuable asset in their teaching endeavor; with them, teachers develop their dual mission, that is, solving health-related problems and teaching. Discussion and conclusions: During their interaction with students and patients, teachers transform an essentially instructional and disciplined practice into one centered on the patient and their needs. The stress doctors face when addressing the medical task itself versus their desire to teach is compounded by curriculum guidelines and health agency norms. This is, in fact, part of the hidden curriculum that influences student learning

Safety of a change in specifications of the novel food oleoresin from Haematococcus pluvialis containing astaxanthin pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on the safety of a change of specifications of the novel food (NF) oleoresin from Haematococcus pluvialis containing astaxanthin (ATX) pursuant to Regulation (EU) 2015/2283. The NF is already authorised as ingredient for the use in food supplements as defined in Directive 2002/46EC in accordance to Regulation (EU) 2017/2470. The NF concerns an oleoresin which contains ~ 10% ATX, obtained by supercritical CO2 extraction of the homogenised and dried biomass of cultivated H. pluvialis. This NF has been assessed by the Panel in 2014. With the present dossier, the applicant proposed to lower the minimum specification limits for protein and ATX monoesters for the NF, and to increase the maximum specification limit for the relative amount of ATX diesters in total ATX. An increase of the maximum specification limit for the 9-cis isomer is also applied for. Although the data are limited regarding bioavailability and distribution in humans of these three naturally occurring ATX isomers, the available in vitro and in vivo data suggest that the 13-cis rather than the 9-cis ATX is selectively absorbed, i.e. has a higher bioavailability and/or possibly emerges from isomerisation of all-trans ATX. The Panel notes that the toxicity of the individual ATX isomers has not been studied individually. However, the ADI of 0.2 mg/kg, which was established for synthetic ATX and ATX from H. pluvialis, applies also for ATX in the oleoresin from H. pluvialis with the proposed changes of specifications. The Panel concludes that the NF, oleoresin from H. pluvialis containing ATX, is safe with the proposed specification limits.

Ser adolescente y las relaciones mediadas por las redes sociales en Internet

Objetivo: indagar sobre la relación entre la apropiación y uso de las redes sociales virtuales y la construcción del sí mismo en adolescentes escolares. Metodología: estudio de corte cualitativo guiado por los lineamientos de la teoría fundamentada y el enfoque del interaccionismo simbólico. Se realizó en los años 2016 y 2017 con 19 escolares del grado décimo de un municipio del oriente cercano a Medellín, Colombia. La recolección de los datos se hizo mediante entrevistas semiestructuradas y grupos focales. Resultados: la construcción de identidad en estos adolescentes se da en las interacciones con sus familias, amigos y grupos de interés, y está mediada por las redes sociales virtuales. Estas redes sociales satisfacen sus necesidades de información, conocimiento, comunicación y entretenimiento, y reflexionan acerca de las oportunidades y amenazas que conlleva su uso. Conclusiones: los adolescentes tienen una actitud activa frente a la vida y la apropiación y uso de las redes sociales virtuales para las interacciones con los otros y la búsqueda de información que satisfaga sus intereses les abre a los adolescentes una ventana al mundo.

Objective: To inquire about the relationship between the appropriation and use of virtual social networks and the construction of self in school teenagers. Materials and methods: Qualitative study led by the guidelines of the grounded theory and the approach of symbolic interactionism. The study was carried out in the years 2016-2017 with 19 tenth grade students of a municipality in the east near Medellin, Colombia. Data collection was carried out through semi-structured interviews and focus groups. Results: The construction of identity in these adolescents occurs in interactions with their families, friends and interest groups, and mediated by virtual social networks. These social networks satisfy their information, knowledge, communication and entertainment needs, and reflect on the opportunities and threats associated with their use. Conclusion: Teenagers have an active attitude towards life and the appropriation and use of virtual social networks for interactions with others and, the search for information that satisfies their interests, opens a window to the world for them.

Objetivo: indagar sobre a relação entre a apropriação e uso das redes sociais virtuais e a construção do si mesmo em adolescentes escolares. Metodologia: estudo de corte qualitativo guiado pelos lineamentos da teoria fundamentada e o enfoque do interacionismo simbólico. Realizou-se nos anos 2016 e 2017 com 19 estudantes do ensino médio dum município do oriente perto a Medellín, Colômbia. A coleta dos dados se fez mediante entrevistas semiestruturadas e grupos focais. Resultados: a construção de identidade nestes adolescentes se dá nas interações com suas famílias, amigos e grupos de interesse, e está mediada pelas redes sociais virtuais. Estas redes socias satisfazem suas necessidades de informação, conhecimento, comunicação e entretenimento, e reflexionam acerca das oportunidades e ameaças que envolve seu uso. Conclusões: os adolescentes tem uma atitude ativa frente à vida e a apropriação e uso das redes sociais virtuais para as interações com os outros e a busca de informação que satisfaça seus interesses lhes abre aos adolescentes uma janela ao mundo.

Teaching Health Sciences at the Universidad de Antioquia, Colombia

Introduction: Studying the identity of university teachers contributes to the understanding of their professional career, since their personal and professional development is projected in their work, as well as in their commitment to educational change or improvement on the basis of the concept they have of themselves and their profession. Objective: To recognize the meanings of being a health science professor at the Universidad of Antioquia, Colombia. Materials and methods: Qualitative study, based on symbolic interactionism, carried out between 2016 and 2019. Semi-structured interviews were administered to 73 teachers who had been working for more than five years in the health sciences programs offered by the Universidad de Antioquia. Data were analyzed inductively and compared with each other until achieving the creation of an explanatory table that would allow addressing the objective of the work. Results: The meaning of being a health sciences professor at the Universidad de Antioquia was expressed as follows: 1) being a trainer: since professors conceived themselves as academics and educators; 2) having ethical behaviors: being a critical and caring counselor-companion for students who generates bonds with social responsibility; and 3) being someone welcoming: being a role model in terms of social relationships and demonstrating fulfillment with their performance in their teaching practice. Conclusion: Participants conceive teaching as a way to contribute to the development of critical thinking in students and define their role as facilitators of the students' learning process. Furthermore, they have a common interest, namely, to guide, support and facilitate such process, so that students acquire tools that allow them to achieve an appropriate personal and professional development in the affective, social, and life project dimensions.

Introducción. Estudiar la identidad de los docentes universitarios contribuye a la comprensión de su vida profesional, ya que estos proyectan su desarrollo personal y profesional en su labor, así como su compromiso con el cambio o mejoramiento educativo sobre la base del concepto que construyen de sí mismos y de su profesión. Objetivo. Reconocer los significados de ser docente de ciencias de la salud de la Universidad de Antioquia, Colombia. Materiales y métodos. Estudio cualitativo, basado en el interaccionismo simbólico, llevado a cabo entre 2016 y 2019. Se realizaron entrevistas semiestructuradas a 73 docentes vinculados por más de 5 años a los programas de ciencias de la salud de la Universidad de Antioquia. Los datos se analizaron de forma inductiva y fueron comparados entre sí hasta lograr un cuadro explicativo que permitiera abordar el objetivo del trabajo. Resultados. El significado de ser docente de ciencias de la salud en la Universidad de Antioquia quedó expresado así: 1) ser un formador, al concebirse como académicos y pedagogos; 2) ser ético: ser un orientador-acompañante crítico y amoroso que genera vínculos con responsabilidad social, y 3) ser acogedor: ser un modelo a seguir en lo que respecta a relaciones sociales, y demostrar satisfacción con su ejercicio docente. Conclusión. Los participantes conciben la enseñanza como una forma de contribuir al desarrollo del pensamiento crítico de los estudiantes y se definen como facilitadores de su proceso de aprendizaje; además, tienen un interés común: ser orientadores, acompañadores y facilitadores en dicho proceso para que los estudiantes adquieran herramientas que les permitan lograr un apropiado desarrollo personal y profesional en las dimensiones afectiva, social y de proyecto de vida.

Evidence on port-locking with heparin versus saline in patients with cancer not receiving chemotherapy: A randomized clinical trial.

Objective: To assess the safety and efficacy of port-locking with heparin every 2 months vs. every 4 months and vs. saline solution every 2 months in patients with cancer not receiving active chemotherapy. The hypothesis stated that locking with heparin at four-month intervals and saline at two-month intervals would not increment > 10% of port obstructions. Methods: Multicentre, phase IV parallel, post-test control group study took place at the two chemotherapy units of oncology hospitals. Included patients with cancer with ports that completed the chemotherapy treatment but still having port maintenance care or blood samples taken up to four months. A sample of 126 patients with cancer in three arms was needed to detect a maximum difference of 10% for bioequivalence on the locking methods. Consecutive cases non-probabilistic sampling and randomized to one of the three groups; group A: received heparin 60 IU/mL every two months (control) vs. group B heparin every four months and vs. saline every two months in group C. Primary variables were the type of locking regimen, port obstruction, and absence of blood return, port-related infection, or venous thrombosis during the study period. Clinical and sociodemographic variables were also collected. Results: A total of 143 patients were randomly assigned; group A, 47 patients with heparin every 2 months, group B, 51 patients with heparin 4 months, and group C, 45 patients with saline every 2 months. All participants presented an adequate blood return and no obstructions, until the month of the 10th, when one participant in the group A receiving was withdrawn due to an absence of blood flow (P â€‹= â€‹0.587). Conclusions: Port locks with heparin every 4 months or saline every 2 months did not show differences in safety maintenance, infection, or thrombosis compared to heparin every 2 months.

G protein-coupled estrogen receptor (GPER/GPR30) levels in pelvic floor muscles and its association with estrogen status in female rabbits.

Objective: To assess the relative expression of the G-protein coupled estrogen receptor (GPER) in the bulbospongiosus (Bsm) and pubococcygeus (Pcm) muscles in control, ovariectomized (OVX), and OVX with estradiol benzoate supplementation (OVX + EB) rabbits.Methods: We used tissues from C, 1-month OVX, and OVX plus 15-day EB implanted (OVX + EB) groups. The GPER expression was evaluated by Western blot and immunohistochemistry for both Bsm and Pcm. Results: Both muscles showed a GPER immunoreactivity in blood vessels, inside myofibers next to myonuclei, and in polymorphonuclear cells. Four-week ovariectomy did not modify the GPER expression in the Bsm and Pcm, but two-week estradiol benzoate increased it in the latter muscle alone.Conclusions: We demonstrated that the Bsm and Pcm of female rabbits express GPER. High serum estradiol levels elevate GPER relative expression in the Pcm alone. The present study supports the remarkable estrogen sensitivity of the Pcm.

Estrogens influence differentially on the pelvic floor muscles activation at somatovisceral reflexes involved in micturition of rabbits.

OBJECTIVE: To determine the estrogen-dependency of the bladder and urethral function and the coordinated activation of pelvic floor muscles (PFM) during micturition. METHODS: We allocated age-matched female rabbits to control, 1-month ovariectomized (OVX), and OVX plus 2-week estradiol benzoate (EB) groups to record cystometry, urethral pressure, and electromyograms of bulbospongiosus (Bsm), and pubococcygeus muscles (Pcm) simultaneously. We also measured serum estradiol levels and myofiber cross-sectional area. We assessed urodynamic and urethral variables, categorized the Bsm-Pcm activation patterns at storage and voiding phases, and obtained the power spectrum density of muscle activation around the voiding phase. We investigated the influence of ovarian hormones, in general, and the contribution of estrogen, particularly on the functions of the bladder, urethra, and PFM. Statistical significance was set at P < 0.05. RESULTS: Ovarian hormones influence the bladder, urethral, and PFM functions. The urodynamics analyses indicated estrogens contribute to voiding duration and, to a lesser extent, to the time between bladder contractions. Urethral pressure at closure (maximal pressure-to-maximal urethral pressure ratio) improved partially (8%, P < 0.05) in the OVX plus 2-week estradiol benzoate compared with OVX, but urethral resistance increased (∼1.9-fold, P < 0.05) compared with control rabbits. Our findings support that Pcm activity at voiding is estrogen-sensitive, albeit EB administration reduced it at storage resume, which relates to high urethral resistance. CONCLUSIONS: Ovariectomy impairs bladder and urethral pressures and Bsm and Pcm activation at micturition in anesthetized rabbits. Estrogen administration partially reverts some of these effects and influences Pcm activation.

Differential estrogen-related responses in myofiber cross-sectional area of pelvic floor muscles in female rats.

OBJECTIVE: To determine the role of estrogens in myofiber cross-sectional area (CSA) of the pubococcyegeus (Pcm) and iliococcygeus muscles (Icm). METHODS: In Experiment 1, we excised the Pcm and Icm during the metestrus and proestrus stages of the estrous cycle to measure the myofiber CSA. In Experiment 2, we allocated other rats into the following groups: sham (Sh), ovariectomized (OVX), OVX plus 1,4,6-androstatriene-3,17-dione (ATD; OVX + ATD), an aromatase inhibitor, and OVX plus estradiol benzoate (OVX + EB). We carried out appropriate statistical tests to determine significant differences (p ≤ 0.05) in variables measured for both Experiments. RESULTS: The Pcm myofiber CSA at proestrus was higher than at metestrus, while the Icm myofiber CSA did not change. Ovariectomy increased the Pcm myofiber CSA, which was exacerbated with the ATD administration. The EB supplementation successfully reversed the ovariectomy-induced enlargement of the CSA. No significant changes were detected for the Icm myofiber CSA. CONCLUSIONS: Fluctuating ovarian steroid levels at the estrus cycle significantly influence the CSA myofiber of the Pcm but not that of the Icm. Estrogen actions, having a gonadal or extragonadal origin, influence importantly the CSA of the Pcm.

When Is Sentinel Node Biopsy Indicated in High-Risk Ductal Carcinoma in situ? Four Hundred Sixty-Eight Cases from Three Institutions.

INTRODUCTION: Sentinel lymph node biopsy (SLNB) in ductal carcinoma in situ (DCIS) is not indicated. However, in certain cases (size >3 cm, high grade, mass effect on mammography, or palpable mass), it may be possible to find incidental invasive carcinoma (IC) that requires an SLNB. We studied the correlation of the aforesaid factors with the probability of finding IC in the surgical specimen. METHODS: Data was collected from 3 different institutions between 2010 and 2016, recording characteristics such as, but not limited to: high grade, size >3 cm, mass effect on mammography, and palpable mass. RESULTS: On the whole, 468 "high-risk" DCIS cases were identified, 139 (29%) of which had IC. When the DCIS was high grade or the size was >3 cm, there was no significant difference in the probability of finding IC in the surgical specimen (OR = 1.13; 95% CI 0.84-1.51; OR = 1.2; 95% CI 0.85-1.40). Nevertheless, when a high grade and size (>3 cm) were combined, IC was more likely to exist (72.7 vs. 27.3%; p = 0.001). In addition, mass effect and palpation were independently associated with a significantly greater degree of IC (OR = 12.76; 95% CI 6.93-23.52). CONCLUSIONS: The results suggest that high-grade DCIS or DCIS with a size >3 cm, independently, does not require SLNB. Nonetheless, in the event that both factors are found in the same case, SLNB may be indicated. Additionally, SLNB is advisable for DCIS cases that are palpable or show a mass effect on mammography.

La visita domiciliara familiar: estrategia educativa en salud de niños y sus familias / A visita domiciliar familiar: estratégia educativa em saúde de crianças e suas famílias / The family home visit: educational strategy in health of children and their families

La estrategia didáctica de la visita domiciliaria familiar se incluyó, desde el año 2001, en el curso Niñez I, ofrecido por la Sección de Pediatría Social, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia. Este estudio indagó por el significado que, las familias participantes del programa, dan a sus interacciones con docentes y estudiantes que asisten a la visita. Estudio cualitativo con enfoque desde el interaccionismo simbólico, llevado a cabo entre 2017 y 2019. Emergieron tres categorías: 1) emociones de la familia al momento del anunció de visita; 2) relaciona los significados de la visita, y 3) aprendizajes que la familia cree adquieren los estudiantes. Las familias expresaron satisfacción por interactuar con este equipo de salud en su propio espacio y manifestaron que interactuar les ayuda a constituirse en protagonistas de la crianza y en el acompañamiento del proceso salud-enfermedad. (AU)

A estratégia didática da visita domiciliar familiar foi incluída, desde o ano 2001, no curso Criança 1, oferecido pela Sessão de Pediatria Social da Faculdade de Medicina da Universidade de Antioquia, Medellin, Colômbia. Este estudo investigou o significado que as famílias participantes do programa atribuem às suas interações com doentes e estudantes que assistem a visita. Estudo qualitativo com enfoque desde o interacionismo simbólico, levado a cabo entre 2017 e 2019. Emergiram três categorias: 1) Emoções da família no momento do anúncio da visita; 2) Relaciona os significados da visita; 3) Aprendizagens que a familia acredita que vão adquirir os estudantes. As familias expressaram satisfação pelo fato de interagir com a equipe de saúde em seu próprio espaço e manifestaram que interagir lhes ajuda a se construir em protagonistas da criança e no acompanhamento do processo saúde-doença. (AU)

The family home visit was introduced to the Child 1 course offered by the Social Pediatrics Department at the Faculty of Medicine, University of Antioquia, Colombia in 2001. This study investigated the meanings that participating families assign to their engagement with the professors and students involved in the visits. We conducted a qualitative study between 2017 and 2019 drawing on the theory of symbolic interactionism. Three categories emerged: 1) Family emotions at the time of the announcement of the visit; 2) Meanings assigned the visits; 3) Lessons that the families believe the students learn. The families reported that they were satisfied with the engagement with the health team in their own space, suggesting that the interactions help them to play a more active role in theirs children's health care. (AU)

Relationship between Implant Length and Implant Stability of Single-Implant Restorations: A 12-Month Follow-Up Clinical Study.

Background and Objectives: Implant stability in vivo is contingent on multiple factors, such as bone structure, instrument positioning and implant surface modifications, implant diameter, and implant length. Resonance-frequency analysis is considered a non-invasive, reliable, predictable, and objective method by which to evaluate implant stability, due to its correlation with bone-to-implant contact. The purpose of this study was to evaluate the effect of implant length on the primary and secondary stability of single-implant crown rehabilitations, as measured by resonance-frequency analysis at different times. Materials and Methods: Implants of 10 and 11.5 mm were placed, and the resonance frequency was measured at the time of surgery (T0), as well as at 3 (T1), 6 (T2), and 12 (T3) months post-surgery. Results: A total of 559 implants were placed in 195 patients. Significant differences were observed when comparing the implant stability quotient (ISQ) values at T1, with values for 10-mm implants being greater than those for 11.5-mm implants (p = 0.035). These differences were also observed when comparing ISQ values for buccal and lingual areas. At T0, T2, and T3, no significant differences in ISQ values were observed. The use of 10-mm implants in the anterior maxilla yielded significantly greater values at T0 (p = 0.018) and T1 (p = 0.031) when compared with 11.5-mm implants. Significant differences in measurements were observed only for buccal areas (p = 0.005; p = 0.018). When comparing the sample lengths and sex, women with 11.5-mm implants showed significantly lower results than those with 10-mm implants (p < 0.001). Conclusions: There is a direct relationship between implants of a smaller length and greater ISQ values, with this relationship being most evident in the maxilla and in women.

Lumbosacral ventral root avulsion alters reflex activation of bladder, urethra, and perineal muscles during micturition in female rabbits.

AIM: To determine the effect of the lumbosacral ventral root avulsion (VRA) on the reflex activation of bladder, urethra, and activation of perineal muscles during micturition in female rabbits. METHODS: We allocated 14 virgin female rabbits to evaluate, first, the gross anatomy of lumbosacral spinal cord root (n = 5) and, second, to determine the effect of VRA on perineal muscles during micturition (n = 9). We recorded cystometrograms, urethral pressure, and electromyograms of the bulbospongiosus (Bsm) and ischiocavernosus (Ism) muscles before and after the L6-S2 VRA. Standard variables were measured from each recording and analyzed to identify significant differences (P < .05). RESULTS: We found that the L6-S2 VRA affected directly the bladder and urethral function and reduced the duration and the frequency of the bursting of Ism and Bsm muscles during voiding. The Ism and Bsm showed a phasic activation, of different frequencies, during the voiding phase and the L6-S2 VRA inhibited the co-contraction of the Ism and Bsm-bladder-urethra. CONCLUSIONS: The Ism and Bsm are activated at different frequencies to trigger the voiding phase. The L6-S2 VRA affected the activity pattern of both perineal muscles. These modifications affected the bladder and urethra function. It is possible that the restoration of the activation frequency of perineal muscles contributed for an efficient bladder contraction.

The Expression of Hormone Receptors as a Gateway toward Understanding Endocrine Actions in Female Pelvic Floor Muscles.

OBJECTIVE: To provide an overview of the hormone actions and receptors expressed in the female pelvic floor muscles, relevant for understanding the pelvic floor disorders. METHODS: We performed a literature review focused on the expression of hormone receptors mainly in the pelvic floor muscles of women and female rats and rabbits. RESULTS: The impairment of the pelvic floor muscles can lead to the onset of pelvic floor dysfunctions, including stress urinary incontinence in women. Hormone milieu is associated with the structure and function alterations of pelvic floor muscles, a notion supported by the fact that these muscles express different hormone receptors. Nuclear receptors, such as steroid receptors, are up till now the most investigated. The present review accounts for the limited studies conducted to elucidate the expression of hormone receptors in pelvic floor muscles in females. CONCLUSION: Hormone receptor expression is the cornerstone in some hormone-based therapies, which require further detailed studies on the distribution of receptors in particular pelvic floor muscles, as well as their association with muscle effectors, involved in the alterations relevant for understanding pelvic floor disorders.

Bladder and urethral dysfunction in multiparous and mature rabbits correlates with abnormal activity of pubococcygeus and bulbospongiosus muscles.

AIMS: To evaluate the combined effect of age and multiparity on the micturition reflex, including pelvic floor muscle activation. METHODS: Young and mature nulliparous rabbits were compared to young and mature multiparas (n = 6 per group). Cystometrograms and urethral pressure (UP) were performed while simultaneously recording the electromyogram (EMG) activity of the pubococcygeus and bulbospongiosus muscles to establish their functional correlation to urological function. RESULTS: Multiparity and age significantly influence the bladder and UP affecting the voiding efficiency and intercontraction interval. Such interaction also reduced the UP threshold, timing, and duration. Other bladder and urethral variables were predominantly affected only by age. Urodynamic alterations correlated with abnormal patterns or absent EMG activity of the pubococcygeus and bulbospongiosus muscles. CONCLUSIONS: The present findings strongly suggest that multiparity and age affects specific pelvic floor muscle reflex activation during micturition, and may contribute to alterations in bladder and urethral function. This data broadens our understanding of the critical role of the appropriate activity of the individual pelvic floor muscles in micturition.

Frequency Values and Their Relationship With the Diameter of Dental Implants. Prospective Study of 559 Implants.

PURPOSE: The purpose of this prospective study is to evaluate the relationship between implant diameter, and primary and secondary stability. MATERIALS AND METHODS: Five hundred fifty-nine implants with diameters of 3.7, 4.0, and 4.3 mm and lengths of 10 and 11.5 mm were placed in 195 patients. The resonance frequency was measured during surgery and at 3, 6, and 12 months. RESULTS: Related average implant stability quotient (ISQ) values were 69.62 for 3.7-mm implants, 72.02 for 4.0-mm implants, and 69.67 for 4.3-mm implants. Values in men were greater than values in women. Values were greater for the mandible than for the maxilla. There are significant differences between 4.0-mm implants, and 3.7 anterior maxilla and 4.3 posterior maxilla. CONCLUSIONS: There is no relationship between increased ISQ values and increased diameters. We observed a preference regarding sex, with men having significantly greater values for 3.7- and 4.3-mm diameters. The mandible obtained the greatest ISQ values, with significant differences for diameters 3.7 and 4.3 mm.

Significado de la sexualidad y el orgasmo en un grupo de mujeres profesionales / Meaning of Sexuality and Orgasm in Professional Women

Introducción La salud sexual se considera uno de los elementos de bienestar y salud general en el ser humano. Múltiples estudios asocian calidad de vida y salud corporal con la actividad sexual. Objetivo Comprender el significado de la sexualidad y el orgasmo en un grupo de mujeres profesionales. Materiales y Métodos Se realizó una investigación cualitativa con enfoque etnográfico, en la que participaron 15 mujeres profesionales con vínculo a la vida universitaria. La edad del grupo fue entre 26­58 años. Se utilizó una entrevista estructurada que permitió conocer y describir sus prácticas de sexualidad. La investigación está inscrita y aprobada en el Sistema Universitario de la Universidad de Antioquia. Resultados Las 15 entrevistadas manifestaron tener vida sexual activa y expresaron los siguientes ejes temáticos: La sexualidad significó la construcción y el reconocimiento del sí mismo para refinar el encuentro con el otro; es un espacio de relacionamiento que requiere del entendimiento mutuo, no limitado a lo coital; compartir las creencias, valores y rituales con sus parejas da una estabilidad que se traduce en una sexualidad sana. El sexo en pareja es un ejercicio de relación que genera alegría, placer y ganas de vivir. La sexualidad significa un encuentro permanente con el otro, donde la convivencia, la armonía, la posibilidad de crecer, es lo que se prodiga, como deseo y pasión; ese vínculo de pareja es un tipo de conexión que no se equipara con otras relaciones. La sexualidad es parte de la salud, es algo natural e indispensable en la vida de las personas. El orgasmo es definido como un momento de supremo placer liberador de energía, que produce éxtasis, un momento culmen donde parece juntarse la vida y la muerte. No es el fin último, ni es tan satisfactorio como el vínculo que se genera en los encuentros; el orgasmo no lo es todo y no siempre se vive con la misma intensidad. Conclusión Para las mujeres entrevistadas sexualidad implica salud, bienestar y encuentro con el otro. El orgasmo no es una condición indispensable para gozar la actividad sexual.

Introduction Sexual health is considered one of the elements of wellbeing and general health in the human being. Multiple studies associate quality of life and bodily health with sexual activity. Objective Understand the meaning of sexuality and orgasm in professional women. Materials and Methods A qualitative research with ethnographic approach was designed, in which 15 professional women with links to university life participated. The age of the group was between 26­58 years. A structured interview was used which enabled them to know and describe their sexuality practices.. The research is registered and approved in the University System of the University of Antioquia. Results The 15 interviewees had active sex life and expressed the following thematic axes: Sexuality meant the construction and recognition of the self to refine the encounter with the other; is a space of relationship that requires mutual understanding, which is not limited to the coital; sharing beliefs, values and rituals with their partners gives stability that translates into a healthy sexuality. Sex as a couple is an exercise in relationship that generates joy, pleasure, energy and the desire to live. Sexuality means a permanent encounter with the other, where coexistence, harmony, the possibility of growing, is what is lavished, as desire and passion; this link is a type of connection that is not equated with other relationships. Sexuality is part of health, is something natural and indispensable in the lives of people, which is altered by desires and concerns. Eroticism has an emotional and emotional component that makes pleasure possible. The orgasm is defined by the participants as a moment of supreme energy-releasing pleasure, which produces ecstasy, a culminating moment where life and death seem to gather together, a sensation of maximum fullness, of climax. Orgasm is not the ultimate goal, nor is it as satisfying as the bond generated in encounters; orgasm is not everything and not always lived with the same intensity. Conclusion For women interviewed sexuality implies health, well-being and encounter with the other. Orgasm is not an indispensable condition to enjoy sexual activity.

CURVAS DE ABSORCIÓN DE MACRONUTRIENTES EN TRES VARIEDADES DE CAÑA DE AZÚCAR (Saccharum officinarum L.) PARA PANELA, EN LA HOYA DEL RÍO SUÁREZ / MACRONUTRIENT ABSORPTION CURVES IN THREE VARIETIES OF SUGARCANE (Saccharum officinarum L.) FOR PANELA IN THE HOYA DEL RÍO SUÁREZ

RESUMEN La caña de azúcar (Saccharum officinarum L.) es una fuente importante de carbohidratos para la panela. En Colombia, la principal región panelera está ubicada en la Hoya del Río Suarez; sin embargo, falta aún consolidar una producción suficientemente rentable, competitiva y amigable con el ambiente. Uno de los aspectos más determinante en la producción de panela es la nutrición mineral, debido a que, actualmente, se hace de forma convencional, desconociendo los niveles de extracción de los materiales genéticos utilizados. El objetivo fue determinar el requerimiento nutricional, producción de biomasa y productividad en segundo corte, en el municipio de Suaita (Santander). El diseño empleado fue bloques al azar (BCA), con 3 tratamientos (las variedades CC 93-7711, CC 93-7510 y RD 75-11) y 5 repeticiones. Se realizaron 4 muestreos, a los 118, 252, 335 y 392 días después de corte (ddc). Se observó que la mayor absorción de N, Ca y Mg ocurrió a los 335 ddc, mientras que para P y K, aconteció a los 392. Los nutrientes se acumularon, especialmente, en los tallos; la CC 93-7711 superó a las otras variedades, con una absorción total en kilogramos por hectárea, de 448 N, 296 K, 85 Ca, 43 P y 40 Mg, seguida por RD 75-11, que presentó, aproximadamente, 16% menos en N-K-Ca-P-Mg. El patrón de absorción de los nutrientes fue N>K>Ca>P>Mg y, referente a la productividad, se destacó RD 75-11, luego CC 93-7711 y CC 93-7510, con 172,6, 171,1 y 159,9 toneladas de caña por hectárea, respetivamente.

ABSTRACT Sugarcane (Saccharum officinarum L.) is a primary carbohydrates source for panela; in Colombia the main panela region is located in the Hoya del Rio Suarez, however, it has not been consolidated a production sufficiently profitable, competitive and environmentally friendly production. One of the most decisive aspects in the production of panela is mineral nutrition, due to the fact that it is currently done in a conventional way without knowing the levels of extraction of the genetic materials used. The objective was to determine the nutritional requirement, production of biomass and productivity in second cut in the municipality of Suaita (Santander), the design used was blocks at random, with 3 treatments (the varieties CC 93-7711, CC 93-7510 and RD 75-11) and 5 repetitions, 4 samplings were made at 118, 252, 335 and 392 days after cutting (ddc). It was observed that the highest absorption of N, Ca and Mg occurred at 335 ddc, while for P and K, occurred at 392 ddc; nutrients accumulated especially in the stems; CC 93-7711 outperformed the other varieties with a total absorption in kilograms per hectare of 448 N, 296 K, 85 Ca, 43 P and 40 Mg, followed by RD 75-11 that presented approximately 16% less in N-K-Ca-P-Mg, the nutrient absorption pattern was N>K>Ca>P>Mg and as for productivity, RD 75-11 stood out, then CC 93-7711 and CC 93-7510 with 172.6, 171,1 and 159.9 tons of cane per hectare, respectively.