Hiperostosis cortical congénita: una causa infrecuente de llanto inconsolable del lactante. Presentación de caso clínico / Congenital cortical hyperostosis: a rare cause of inconsolable crying in a baby. Clinical case report

Se presenta el caso de un lactante de 2 meses que fue llevado a consulta varias veces por llanto problemático, inicialmente interpretado como de causa gastrointestinal. Dado que el síntoma persistía, se sospechó de una fractura debido a su asociación con la movilización de los miembros y la palpación de una tumoración en la cara anterior de la tibia derecha. Las radiografías mostraron compromiso poliostótico diafisario y lesiones compatibles con compromiso cortical de huesos largos. Se realizó el diagnóstico operativo de síndrome de Caffey-De Toni-Silverman y se inició el tratamiento con antiinflamatorios no esteroideos, lo que resultó en una remisión sintomática. Posteriormente, se confirmó el diagnóstico mediante la identificación de la variante patogénica COL1A1 en estado heterocigota. Se trata de una patología rara de la cual se estima una incidencia de 48/100 000 y hay menos de 150 casos descritos al momento.

Here we describe the case of a 2-month-old infant who consulted several times due to excessive crying, initially interpreted as having a gastrointestinal cause. Since the symptom persisted, a fracture was suspected due to its association with mobilization of the limbs and palpation of a mass on the anterior aspect of the right tibia. X-rays showed diaphyseal polyostotic involvement and lesions compatible with cortical involvement of long bones. Caffey-De Toni-Silverman syndrome was diagnosed and treatment with nonsteroidal anti-inflammatory drugs was initiated, resulting in symptom remission. Subsequently, the diagnosis was confirmed by the identification of the pathogenic heterozygous variant COL1A1. This is a rare condition with an estimated incidence of 48/100 000 individuals, and less than 150 cases have been described to date.

Adolescentes con trastornos de la conducta alimentaria durante la pandemia por COVID-19: cambios en vínculos sociales y modalidades de atención / Adolescents with eating disorders during the COVID-19 pandemic: Changes in social ties and healthcare modalities

Introducción. La pandemia por COVID-19 ha tenido un impacto profundo en la salud de la población joven de todo el mundo y especialmente en personas con trastornos de la conducta alimentaria (TCA) por situaciones de estrés, ansiedad y cambios en el acceso a la atención médica. Objetivo. Explorar las percepciones de adolescentes sobre los cambios en sus vínculos sociales y modalidades de atención en pacientes con TCA. Población y métodos. Se realizó un estudio cualitativo a través de entrevistas en profundidad a adolescentes con TCA en un hospital universitario durante la pandemia por COVID-19. Resultados. Se entrevistó a 15 adolescentes; el 93 % fueron mujeres y la mediana de edad fue 18 años. El 86,6 % tuvo anorexia nerviosa. Los aspectos negativos percibidos más importantes fueron los malestares en la convivencia familiar (80 %) y la disconformidad con los contenidos de las redes sociales sobre la imagen corporal y dietas (73 %). Los aspectos percibidos positivos fueron la ayuda de los pares (66 %) y mejoras en relación con la alimentación (66 %). El principal cambio identificado en comparación con el tratamiento recibido previo a la pandemia por COVID-19 fue el seguimiento virtual por salud mental (73 %). Conclusión. La población adolescente con TCA durante el ASPO manifestó malestar en la convivencia familiar y disconformidad en los contenidos en redes sociales sobre imagen corporal y dietas. Aunque resaltaron como aspectos positivos la ayuda de los pares y mejoras en su alimentación

Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects.

Congenital cortical hyperostosis: a rare cause of inconsolable crying in a baby. Clinical case report. / Hiperostosis cortical congénita: una causa infrecuente de llanto inconsolable del lactante. Presentación de caso clínico.

Here we describe the case of a 2-month-old infant who consulted several times due to excessive crying, initially interpreted as having a gastrointestinal cause. Since the symptom persisted, a fracture was suspected due to its association with mobilization of the limbs and palpation of a mass on the anterior aspect of the right tibia. X-rays showed diaphyseal polyostotic involvement and lesions compatible with cortical involvement of long bones. Caffey-De Toni-Silverman syndrome was diagnosed and treatment with nonsteroidal anti-inflammatory drugs was initiated, resulting in symptom remission. Subsequently, the diagnosis was confirmed by the identification of the pathogenic heterozygous variant COL1A1. This is a rare condition with an estimated incidence of 48/100 000 individuals, and less than 150 cases have been described to date.

Se presenta el caso de un lactante de 2 meses que fue llevado a consulta varias veces por llanto problemático, inicialmente interpretado como de causa gastrointestinal. Dado que el síntoma persistía, se sospechó de una fractura debido a su asociación con la movilización de los miembros y la palpación de una tumoración en la cara anterior de la tibia derecha. Las radiografías mostraron compromiso poliostótico diafisario y lesiones compatibles con compromiso cortical de huesos largos. Se realizó el diagnóstico operativo de síndrome de Caffey-De Toni-Silverman y se inició el tratamiento con antiinflamatorios no esteroideos, lo que resultó en una remisión sintomática. Posteriormente, se confirmó el diagnóstico mediante la identificación de la variante patogénica COL1A1 en estado heterocigota. Se trata de una patología rara de la cual se estima una incidencia de 48/100 000 y hay menos de 150 casos descritos al momento.

Lesiones ocasionadas por mordeduras de perros en niños atendidos en un hospital de tercer nivel de Bolivia / Dog bite injuries in children seen at a tertiary care hospital in Bolivia

Introducción. Este estudio pretende caracterizar las lesiones provocadas por perros en niños de un hospital pediátrico de Bolivia. Población y métodos. Se realizó un estudio observacional, retrospectivo, en pacientes atendidos del 2017 al 2021. Resultados. Se estudiaron 769 pacientes. Las lesiones representaron el 5,6 % de las emergencias y el 0,8 % de las internaciones. Fueron más frecuentes en niños de hasta 5 años (55,1 %), en quienes se observó mayor gravedad de las lesiones (p = 0,008), antecedente de provocación al animal (p = 0,048), un animal agresor conocido (p <0,036), el contexto doméstico del accidente (p = 0,021), mayor frecuencia de profilaxis con suero luego de la exposición (p = 0,005) y regiones afectadas principalmente maxilofaciales (p <0,001). Observamos 3 casos de mortalidad por rabia humana y 1 por shock hipovolémico. Conclusión. Las lesiones producidas por perros son causas frecuentes de visita a emergencia y hospitalización en pediatría, y tienen características particulares en niños de hasta 5 años de edad.

Introduction. The objective of this study is to describe the characteristics of dog bite injuries in children seen at a children's hospital in Bolivia. Population and methods. This was an observational, retrospective study in patients seen between 2017 and 2021. Results. A total of 769 patients were studied. Dog bite injuries accounted for 5.6% of emergency visits and 0.8% of hospitalizations. They were more frequent in children younger than 5 years (55.1%), in whom the following were observed: greater injury severity (p = 0.008), history of animal provocation (p = 0.048), known attacking animal (p < 0.036), domestic accident (p = 0.021), greater frequency of post-exposure prophylaxis with anti-rabies serum (p = 0.005), and maxillofacial area as the main region involved (p < 0.001). There were 3 deaths due to human rabies and 1 due to hypovolemic shock. Conclusion. Dog bite injuries are a frequent cause of visit to the emergency department and hospitalization in pediatrics and have specific characteristics in children younger than 5 years.

Seguridad y eficacia de la bioprótesis de válvula cardiaca INC en humanos / Safety and efficacy of the INC bioprosthetic heart valve in humans

Resumen Introducción: Las bioprótesis de válvulas cardiacas son el estándar de oro para el reemplazo quirúrgico de la válvula aórtica en pacientes seleccionados. Objetivo: Evaluar la seguridad y eficacia de la válvula cardiaca bioprotésica del Instituto Nacional de Cardiología (INC) en humanos. Métodos: Estudio unicéntrico que incluyó 341 pacientes que se sometieron a reemplazo valvular quirúrgico único de válvula aórtica con válvula INC. Resultados: Se realizaron 318 implantes de novo (93 %) y 23 como segunda cirugía (7 %); las puntuaciones STS fueron de 1.4 y 1.8 % y el seguimiento de 42 y 46 meses, respectivamente. No existieron diferencias en las complicaciones ni en la tasa de implantación de marcapasos. Ambos grupos mantuvieron una FEVI normal. Se observó mejoría global en la clase funcional con empeoramiento solo en dos pacientes del grupo de novo. La disfunción de la prótesis INC que ameritó reintervención quirúrgica se observó en ocho pacientes (4.65 %) del grupo de novo versus un paciente (7.69 %) con segunda cirugía. Conclusiones: La válvula cardiaca INC es eficaz y segura, se asocia a baja tasa de complicaciones y mejoría de la clase funcional durante el seguimiento a largo plazo. Se necesitan estudios prospectivos comparativos de esta válvula.

Abstract Introduction: Heart valve bioprostheses are the gold standard for aortic valve surgical replacement in selected patients. Objective: To evaluate the safety and efficacy of the of the National Institute of Cardiology (INC) bioprosthetic heart alve of the National Institute of Cardiology (INC) bioprosthetic heart valve in humans. Methods: Single-center study that ncluded 341 patients who underwent single surgical aortic valve replacement with INC heart valve. Results: 318 implants were performed de novo (93%) and 23 as redo surgery (7%); STS scores were 1.4 and 1.8%, and follow-up was for 42 and 46 months, respectively. There were no differences in clinical complications or pacemaker implantation rate. Both groups maintained a normal LVEF. Overall improvement in functional class was observed, with worsening only in two patients of the de novo group. INC prosthesis dysfunction requiring surgical reintervention was observed in eight patients (4.65%) of the de novo group vs. one patient in the redo group. Conclusions: The INC heart valve is efficacious and safe, and is associated with a The INC heart valve is efficacious and safe, and is associated with a low rate of complications and functional class improvement during long-term follow-up. Prospective, comparative studies of this valve are required.

Melatonin protects gingival mesenchymal stem cells and promotes differentiation into osteoblasts.

Melatonin (MEL) has antioxidant properties and participates in osteogenic differentiation. In periodontitis, in which increased oxidative stress and bone resorption are involved, mesenchymal stem cells derived from the gingiva (GMSCs) combined with MEL could be relevant for osteogenic regeneration. In this study, we studied the antioxidant and differentiating effect of MEL on an in vitro system of GMSCs. Primary culture of GMSCs from Wistar rats was developed to evaluate differentiation into osteoblasts with an appropriate medium with or without MEL. Marker genes of mesenchymal stem cells by real time-polymerase chain reaction, clonogenic capacity, and cell migration after wound assay were used to characterize GMSCs as mesenchymal stem cells. Alkaline phosphatase activity and the alizarin red technique were used to evaluate osteogenic activity and differentiation. MEL increased alkaline phosphatase activity and alizarin red values, promoting osteogenic differentiation. Besides this, MEL protected GMSCs in a model of cellular damage related to oxidative stress, returning viability to baseline. MEL was more effective in promoting and protecting GMSCs by the production of osteogenic cells when oxidative stress is present. This evidence supports the use of MEL as a novel bone-regenerative therapy in periodontal diseases.

Safety and efficacy of the INC bioprosthetic heart valve in humans.

INTRODUCTION: Heart valve bioprostheses are the gold standard for aortic valve surgical replacement in selected patients. OBJECTIVE: To evaluate the safety and efficacy of the National Institute of Cardiology (INC) bioprosthetic heart valve in humans. METHODS: Single-center study that included 341 patients who underwent single surgical aortic valve replacement with INC heart valve. RESULTS: 318 implants were performed de novo (93%) and 23 as redo surgery (7%); STS scores were 1.4 and 1.8%, and follow-up was for 42 and 46 months, respectively. There were no differences in clinical complications or pacemaker implantation rate. Both groups maintained a normal LVEF. Overall improvement in functional class was observed, with worsening only in two patients of the de novo group. INC prosthesis dysfunction requiring surgical reintervention was observed in eight patients (4.65%) of the de novo group vs. one patient in the redo group. CONCLUSIONS: The INC heart valve is efficacious and safe, and is associated with a low rate of complications and functional class improvement during long-term follow-up. Prospective, comparative studies of this valve are required.

INTRODUCCIÓN: Las bioprótesis de válvulas cardiacas son el estándar de oro para el reemplazo quirúrgico de la válvula aórtica en pacientes seleccionados. OBJETIVO: Evaluar la seguridad y eficacia de la válvula cardiaca bioprotésica del Instituto Nacional de Cardiología (INC) en humanos. MÉTODOS: Estudio unicéntrico que incluyó 341 pacientes que se sometieron a reemplazo valvular quirúrgico único de válvula aórtica con válvula INC. RESULTADOS: Se realizaron 318 implantes de novo (93 %) y 23 como segunda cirugía (7 %); las puntuaciones STS fueron de 1.4 y 1.8 % y el seguimiento de 42 y 46 meses, respectivamente. No existieron diferencias en las complicaciones ni en la tasa de implantación de marcapasos. Ambos grupos mantuvieron una FEVI normal. Se observó mejoría global en la clase funcional con empeoramiento solo en dos pacientes del grupo de novo. La disfunción de la prótesis INC que ameritó reintervención quirúrgica se observó en ocho pacientes (4.65 %) del grupo de novo versus un paciente (7.69 %) con segunda cirugía. CONCLUSIONES: La válvula cardiaca INC es eficaz y segura, se asocia a baja tasa de complicaciones y mejoría de la clase funcional durante el seguimiento a largo plazo. Se necesitan estudios prospectivos comparativos de esta válvula.

[Comportamiento y decisión cardiovascular en el síndrome de MASS. Reporte de un caso y revisión de la literatura]. / Cardiovascular behavior and decision in MASS syndrome. A case report and literature review

MASS syndrome (disorder of connective tissue characterized by involvement of the mitral valve, aorta, skeleton, and skin) is a rare genetic disease with a phenotype similar to that of Marfan syndrome, but with important cardiovascular differences like the absence of aortic root aneurysm and marked mitral affection. We present a case of a patient with MASS syndrome and review the limited literature addressing these differences, and we discuss the impact this information may have in decisions regarding cardiovascular surgery.

El síndrome de MASS (que afecta a: válvula mitral [M], aorta [A], piel [S, skin], sistema musculoesquelético [S, skeletal]) es una rara enfermedad genética con un fenotipo similar al del síndrome de Marfan, pero con diferencias cardiovasculares importantes, como ausencia de afección de la raíz aórtica y marcada afectación mitral. Presentamos el caso de una paciente con síndrome de MASS y revisamos la limitada literatura con respecto a estas diferencias; finalmente discutimos acerca del impacto que pudiera tener esta información con respecto a las decisiones desde el punto de vista de la cirugía cardiovascular.

Oral methylmercury intoxication aggravates cardiovascular risk factors and accelerates atherosclerosis lesion development in ApoE knockout and C57BL/6 mice.

Methylmercury (MeHg) intoxication is associated with hypertension, hypercholesterolemia, and atherosclerosis by mechanisms that are not yet fully understood. We investigated the effects of MeHg intoxication in atherosclerosis-prone (ApoE-KO) and resistant C57BL/6 mice. Mice were submitted to carotid stenosis surgery (to induce atherosclerosis faster) and received water or MeHg solution (20 mg/L) for 15 days. Tail plethysmography was performed before and after MeHg exposure. Food and MeHg solution intakes were monitored weekly. On the 15th day, mice were submitted to intravital fluorescence microscopy of mesenteric vasculature to observe in vivo leukocyte rolling and adhesion. Results showed that despite the high hair and liver Hg concentrations in the MeHg group, food and water (or MeHg solution) consumption and liver function marker levels were similar to those in controls. MeHg exposure increased total cholesterol, the atherogenic (non-HDL) fraction and systolic and diastolic blood pressure. MeHg exposure also induced inflammation, as seen by the increased rolling and adhered leukocytes in the mesenteric vasculature. Atherosclerosis lesions were more extensive in the aorta and carotid sites of MeHg-ApoE knockout mice. Surprisingly, MeHg exposure also induced atherosclerosis lesions in C57BL/6 mice, which are resistant to atherosclerosis formation. We concluded that MeHg intoxication might represent a risk for cardiovascular diseases since it accelerates atherogenesis by exacerbating several independent risk factors.

How to Build a Functional Connectomic Biomarker for Mild Cognitive Impairment From Source Reconstructed MEG Resting-State Activity: The Combination of ROI Representation and Connectivity Estimator Matters.

Our work aimed to demonstrate the combination of machine learning and graph theory for the designing of a connectomic biomarker for mild cognitive impairment (MCI) subjects using eyes-closed neuromagnetic recordings. The whole analysis based on source-reconstructed neuromagnetic activity. As ROI representation, we employed the principal component analysis (PCA) and centroid approaches. As representative bi-variate connectivity estimators for the estimation of intra and cross-frequency interactions, we adopted the phase locking value (PLV), the imaginary part (iPLV) and the correlation of the envelope (CorrEnv). Both intra and cross-frequency interactions (CFC) have been estimated with the three connectivity estimators within the seven frequency bands (intra-frequency) and in pairs (CFC), correspondingly. We demonstrated how different versions of functional connectivity graphs single-layer (SL-FCG) and multi-layer (ML-FCG) can give us a different view of the functional interactions across the brain areas. Finally, we applied machine learning techniques with main scope to build a reliable connectomic biomarker by analyzing both SL-FCG and ML-FCG in two different options: as a whole unit using a tensorial extraction algorithm and as single pair-wise coupling estimations. We concluded that edge-weighed feature selection strategy outperformed the tensorial treatment of SL-FCG and ML-FCG. The highest classification performance was obtained with the centroid ROI representation and edge-weighted analysis of the SL-FCG reaching the 98% for the CorrEnv in α1:α2 and 94% for the iPLV in α2. Classification performance based on the multi-layer participation coefficient, a multiplexity index reached 52% for iPLV and 52% for CorrEnv. Selected functional connections that build the multivariate connectomic biomarker in the edge-weighted scenario are located in default-mode, fronto-parietal, and cingulo-opercular network. Our analysis supports the notion of analyzing FCG simultaneously in intra and cross-frequency whole brain interactions with various connectivity estimators in beamformed recordings.

Early pregnancy protein multiplex screening reflects circulating and urinary divergences associated with the development of preeclampsia.

BACKGROUND: Preeclampsia, a pregnancy disorder characterized by hypertension and proteinuria, represents the leading cause of fetal and maternal morbidity and mortality in developing countries. The identification of novel and accurate biomarkers that are predictive of preeclampsia is necessary to improve the prognosis of patients with preeclampsia. OBJECTIVE: To evaluate the preeclampsia predictive value of 34 angiogenic-related proteins. METHODS: We performed a nested cohort case-control study of pregnant women. The profile of the 34 proteins was evaluated at 12, 16, and 20 gestational weeks (GWs), using urine/plasma from 16 women who developed preeclampsia and 20 normotensive pregnant controls by Bio-Plex ProTM Human Cancer Biomarker Panels 1 and 2. RESULTS: The urine concentration of soluble epidermal growth factor receptor (sEGFR), hepatocyte growth factor (HGF), angiopoietin-2 (ANG-2), endoglin (ENG), soluble fas ligand (sFASL), interleukin 6 (IL-6), placental growth factor (PLGF), and vascular endothelial growth factor A (VEGF-A) at 12 GW, prolactin (PRL), ANG-2, transforming growth factor alpha (TGF-α), and VEGF-A at 16 GW, and soluble IL-6 receptor alpha (sIL-6Rα), ANG-2 and sFASL at 20 GW, were different between groups (p < 0.05). The concentration cut-off values calculated in this study for the mentioned proteins, predicted an increased risk to developing preeclampsia in a range of 3.8-29.8 times in the study population. CONCLUSION: The proteins sEGFR, HGF, ANG-2, sFASL, IL-6, PLGF, VEGF-A, PRL, TGF-α FGF-b, sHER2/Neu sIL-6Rα, ENG, uPA, and insulin-like growth factor binding protein 1 (IGFBP-1), were predictive of the development of preeclampsia and their use as markers for this disease should be considered.

Acción Inmediata de los Enjuagues Orales en la Saliva / Immediate Action of Mouthwashes on Whole Saliva

RESUMEN: Numerosos estudios confirman la efectividad de los enjuagatorios orales sobre la viabilidad de los microorganismos que producen gingivitis y halitosis, pero poco se conoce sobre la influencia de los mismos en el medio ambiente oral. El objetivo del siguiente trabajo fue analizar In vivo e In vitro el efecto de enjuagatorios orales sobre la saliva total no estimulada. Se trabajó con saliva de individuos sanos. Para el estudio in vivo se recogieron las muestras antes y después del enjuague oral a diferentes tiempos (1, 5, 10, 15, 30, 45 y 60 minutos). Para el ensayo in vitro, se incubó la saliva con igual volumen de la solución enjuagatoria a 37 ºC con agitación a diferentes tiempos (1, 5, 10 y 15 minutos). Se determinó pH inmediatamente recogidas las muestras. Posteriormente fueron centrifugadas y determinados flujo salival y proteínas totales. La separación de proteínas por electroforesis en SDS-PAGE se realizó solo en el ensayo in vivo. Los resultados mostraron que los enjuagatorios fluorurados poco alteran la fisiología oral a través de flujo salival, pH y proteínas totales. La combinación fluoruro de sodio/xilitol produjo mayor estimulación del flujo salival. La mezcla de aceites esenciales provocó un incremento del flujo salival y de pH, redujo el contenido de proteínas totales, evidenciando por SDS-PAGE que las comprometidas fueron particularmente las de mediano y bajo peso molecular. Clorhexidina debido a su elevada sustantividad, incrementó significativamente flujo salival y pH in vivo. In vitro, fuera del medioambiente oral, los enjuagatorios estudiados ejercieron un efecto similar sobre proteínas totales. Los enjuagatorios de uso frecuente alteraron parámetros salivales, por lo que podría estudiarse la acción que ejercen sobre otros componentes de la saliva con actividad biológica importante en cavidad oral.

ABSTRACT: Numerous studies confirm the effectiveness of mouthwashes on the viability of microorganisms that produce gingivitis and halitosis, but little is known about their influence on the oral environment. The objective of the following work was to analyze In vivo and In vitro the effect of mouthwashes on total non-stimulated saliva. We worked with saliva from healthy individuals. For In vivo study, samples were collected before and after oral rinsing at different times (1, 5, 10, 15, 30, 45 and 60 minutes). For the In vitro assay, the saliva was incubated with equal volume of the rinse solution at 37 ° C with shaking at different times (1, 5, 10 and 15 minutes). PH was determined immediately collected samples. Subsequently they were centrifuged and determined salivary flow and total proteins. Separation of proteins by SDS-PAGE electrophoresis was performed only in the In vivo assay. The results showed that fluoridated rinses hardly alter oral physiology through salivary flow, pH and total proteins. The combination of sodium fluoride / xylitol produced greater stimulation of salivary flow. The mixture of essential oils caused an increase in salivary flow and pH, reduced the total protein content, evidencing by SDS-PAGE that those involved were particularly those of medium and low molecular weight. Chlorhexidine due to its high substantivity, significantly increased salivary flow and pH In vivo. In vitro, outside the oral environment, the rinses studied had a similar effect on total proteins. Rinses used frequently altered salivary parameters, so that the action they exert on other components of saliva with important biological activity in the oral cavity could be studied.

sIgA, peroxidase and collagenase in saliva of smokers aggressive periodontal patients.

BACKGROUND: Tobacco smoking is strongly associated with destructive periodontal disease, alveolar bone loss and poor response to periodontal therapy. The aim of this study was to investigate the effect of smoking on antimicrobials and destructive proteins in the saliva of patients with generalized aggressive periodontal disease. MATERIAL AND METHODS: The study group consisted of 55 adult subjects. They were classified according to their clinical diagnoses either as having generalized aggressive periodontitis (n = 27; 13 smokers and 14 non-smokers) or as periodontitis-free control group (n = 28; 14 smokers and 14 non-smokers). Total proteins, sIgA, peroxidase and collagenase were quantified in whole saliva. Data were analyzed using one-way ANOVA and Tukey tests. RESULTS: Statistical differences were found between smokers with periodontal disease and healthy control subjects for sIgA, and between non-smokers with periodontal disease and healthy control subjects for peroxidase. Collagenase activity was higher in smokers and non-smokers with periodontal disease, and tobacco use was found to increase collagenase activity in healthy subjects. CONCLUSION: Whole saliva from all patients with periodontal disease had higher sIgA and lower peroxidase content. Smokers with periodontitis had higher sIgA than smokers without periodontitis. Smokers with and without periodontitis had higher collagenase activity than non-smokers (with and without periodontitis).

Changes in pH of irrigating solutions after contact with human root dentin / Variaciones del ph de soluciones de irrigación endodónticas en contacto con dentina radicular humana

El objetivo de este trabajo fue estudiar in vitro el comportamiento del pH de diferentes soluciones de irrigación endodónticas, usadas solas o en forma consecutiva, después del contacto con dientes humanos extraídos. Se seleccionaron premolares inferiores. El tercio medio radicular se dividió en 6 partes. Los especímenes obtenidos se dividieron en 6 grupos,de acuerdo a la solución de irrigación empleada: 1) agua destilada; 2) NaClO 1 por ciento; 3) Ácido Cítrico 1 por ciento (AC); 4) EDTA 17 por ciento; 5) AC 1 por ciento + NaClO 1 por ciento ; 6) EDTA 17 por ciento + NaClO 1 por ciento. Los especímenes fueron sumergidos en 1 mL de cada solucióna 37°C. Aquellos del grupo 1, 2 y 3 durante 5 minutos, y el resto, consecutivamente 2,5 minutos. Se determinaron pH inicial y final para cada solución. Los datos fueron analizados utilizando Test T, ANOVA y Test de comparaciones múltiples de Tukey. A los 2,5 y 5 minutos de exposición hubo diferencias estadísticamente significativas entre el pH inicial y final en todas las soluciones. El pH disminuyó en el caso de agua destilada e NaClO, mientras que aumentó en AC y EDTA. In vitro, el pH de todas las soluciones se modificó después del contacto con dentina radicular humana en ambos períodos de tiempo (2,5 y 5 minutos).

The aim of this study was to analyze the in vitro behavior of the pH of different irrigating solutions, used alone or consecutively, after contact with extracted human teeth. Mandibular human premolars were selected. The middle thirds were divided into 6 parts. The specimens obtained were divided into 6 groups and treated with irrigating solutions: 1) distilled water; 2) 1% NaOCl; 3) 1% Citric Acid (CA); 4) 17% EDTA; 5) 1% CA + 1% NaOCl; 6) 17% EDTA + 1% NaOCl. Specimens were immersed in 1 mL of each solution at 37ºC, those of groups 1, 2, 3 and 4, for 5 minutes, and the rest, consecutively for 2.5 minutes in each solution. Initial and final pH of the solutions were determined. Data were analyzed by the T Test, one-way analysis of variance (ANOVA) and Tukey multiple comparison Test. At 2.5 and 5 minutes there were significant differences between the initial and final pH for all solutions. The pH values decreased for distilled water and NaOCl, while they increased for CA and EDTA. In vitro, the pH of all solutions was modified after contact with root dentin at both test times (2.5 and 5 min).

Doença periodontal: associação com hábitos tabagísticos e doenças sistêmicas / Periodontal disease: association with smoking habit and systemic diseases

Este trabalho associa graus de severidade de periodontite agressiva e crônica ao hábito de fumar e à ocorrência de doenças sistêmicas. Selecionaram-se 83 pacientes com periodontite agressiva e crônica, classificados segundo parâmetros clínicos e radiográficos. A periodontite agressiva apresentou forte associação estatística com o hábito de fumar e moderada associação com doenças sistêmicas e a coexistência de ambas as variáveis. A periodontite crônica associou-se a ambos os fatores de modo independente. Hábito de fumar e doenças sistêmicas associaram-se fortemente aos diagnósticos de periodontite moderada e severa, tanto para periodontite agressiva como crônica. Quando coexistiram ambos os fatores, a severidade da doença relacionou-se ao número de cigarros e à complicação sistêmica.

This article addresses the association of the severity of aggressive, chronic periodontitis and smoking habits, and the establishment of systemic diseases. Eighty-three patients presenting aggressive, chronic periodontitis were selected, according to clinical and radiographical parameters. It has been established a strong correlation between the periodontitis and smoking, and a moderate correlation to the establishment of systemic diseases and the presence of both variables. Chronic periodontitis was associated to both factors independently. Smoking habit and systemic diseases have been strongly associated to moderate and severe periodontitis, regardless they were aggressive or chronic. When both factors were present, the severity of the disease was related to the number of cigarettes and systemic complications.

Type of delivery and gestational age is not affected by pregnant Latin-American women engaging in vigorous exercise. A secondary analysis of data from a controlled randomized trial / El tipo de parto y la edad gestacional no se afectan por el ejercicio aeróbico vigoroso en mujeres gestantes latinas. Análisis secundario de un ensayo clínico

ABSTRACT Objective There is controversy concerning whether exercise during pregnancy may increase preterm delivery risk and type of delivery. The effect of pregnant Latin-American women engaging in vigorous exercise during the second and third trimester was examined regarding type of delivery and gestational age. Materials and Methods This was a secondary analysis of data from a controlled randomized trial for determining the influence of physical exercise on pregnant women's endothelial function. The study included 35 nulliparous women, gestational week 16-20 attending prenatal care at three tertiary hospitals in Colombia, who were randomly assigned to one of two groups. The experimental group engaged in aerobic exercise involving 55 % - 75 % maximum heart rate for 60 min, three times a week for 12 weeks. The control group engaged in their usual physical activity. Maternal weight, height, weight gain, blood pressure and type of delivery were recorded; gender, abdominal and head circumference (cm), weight (g), height (cm), vitality (Apgar score at 1 and 5 min) and gestational age at the time of delivery (in weeks, days) were recorded for the newborn. Results There was no difference in type of delivery by the end of the 12-week program (p>0.05), nor regarding newborn anthropometric variables, Apgar score, or maternal variables concerning weight, height, relative weight gain, blood pressure or weeks of gestation (p>0.05). Conclusion The potential public health benefits of vigorous exercise were enormous. This study support ed existing guidelines indicating that Latin-American women may begin or maintain an on-going exercise program during pregnancy. Trial registration: NCT00741312.

Objetivo Existe controversia acerca del efecto del ejercicio físico vigoroso (EFV) durante el embarazo por sus posibles consecuencias en el tipo de parto y la edad gestacional. El objetivo de este estudio fue evaluar el efecto del EFV durante el segundo y tercer trimestre, en mujeres gestantes latinas sobre el tipo de parto y la edad gestacional. Materiales y Métodos Se trata de un análisis secundario de un ensayo clínico controlado en 35 gestantes, asignadas al azar en dos grupos. Grupo experimental (n=18): EFV entre el 55 % y 75 % de la FC max, por 60 min, 3 veces por sem. Por 12 sem. Grupo Control (n=17): actividad física cotidiana y control prenatal habitual. Se registraron en las maternas: peso, talla, ganancia de peso, presión arterial y tipo de parto. En el recién nacido se registró: género, perímetro cefálico y abdominal (cm), peso (g), talla (cm), semanas de gestación, vitalidad (score Apgar al 1 y 5 min), y semanas de gestación. Resultados No se encontraron diferencias estadísticamente significativas respecto al tipo de parto (p>0,05). Tampoco en las variables antropométricas del recién nacido, ni en las variables maternas: peso, talla, ganancia de peso, presión arterial o semanas de gestación (p>0,05). Conclusión Los beneficios potenciales en salud pública del efecto EFV durante la gestación son importantes y este estudio favorece que mujeres latinas puedan comenzar o mantener un programa de ejercicios durante el embarazo. Trial registration: NCT00741312.

Sodium deoxycholate inhibits chick duodenal calcium absorption through oxidative stress and apoptosis.

High concentrations of sodium deoxycholate (NaDOC) produce toxic effects. This study explores the effect of a single high concentration of NaDOC on the intestinal Ca(2+) absorption and the underlying mechanisms. Chicks were divided into two groups: 1) controls and 2) treated with different concentrations of NaDOC in the duodenal loop for variable times. Intestinal Ca(2+) absorption was measured as well as the gene and protein expressions of molecules involved in the Ca(2+) transcellular pathway. NaDOC inhibited the intestinal Ca(2+) absorption, which was concentration dependent. Ca(2+)-ATPase mRNA decreased by the bile salt and the same occurred with the protein expression of Ca(2+)-ATPase, calbindin D(28k) and Na(+)/Ca(2+) exchanger. NaDOC produced oxidative stress as judged by ROS generation, mitochondrial swelling and glutathione depletion. Furthermore, the antioxidant quercetin blocked the inhibitory effect of NaDOC on the intestinal Ca(2+) absorption. Apoptosis was also triggered by the bile salt, as indicated by the TUNEL staining and the cytochrome c release from the mitochondria. As a compensatory mechanism, enzyme activities of the antioxidant system were all increased. In conclusion, a single high concentration of NaDOC inhibits intestinal Ca(2+) absorption through downregulation of proteins involved in the transcellular pathway, as a consequence of oxidative stress and mitochondria mediated apoptosis.

Changes in saliva protein composition in patients with periodontal disease

Periodontitis is a chronic inflammatory disease characterized by tissue destruction which is usually diagnosed through clinical and radiographic signs. The detection of changes in the chemical composition of saliva could be used to reflect gingivo- periodontal alterations. The aim of this study was to identify salivary parameters that could identify different stages of the periodontal disease. The study group included 118 adults, 89 of them with mild, moderate or severe chronic periodontitis. The remaining participants comprised the control group. Total saliva was analyzed for physical and chemical properties. Dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) was used for protein detection and zymography for type IV collagenase identification. Salivary flow rate, pH and buffer capacity showed similar values in all groups. Proteins were augmented in severe periodontitis, as also shown by SDS-PAGE. Hydroxyproline rose significantly in all periodontal groups as secretory Immunoglobulin A significantly diminished compared with the control group. An increase in peroxidase was detected in moderate and severe periodontitis. All salivary samples contained 200-116-92 kDa gelatinases; minor bands at 66-31 kDa were also present in all periodontitis groups. Calcium levels showed significant differences between all periodontitis groups compared with the control group. Quantitative changes in the chemical composition of the saliva of patients with periodontal disease could be of significance in the diagnosis and progression of periodontal disease.

La Periodontitis es una enfermedad inflamatoria crónica caracterizada por destrucción tisular que se diagnostica generalmente a través de signos clínicos y radiográficos. Sin embargo la detección de cambios en la composición química de la saliva podrían ser empleados para reflejar alteraciones gingivo-periodontales. El objetivo de este estudio fue encontrar parámetros salivales que pudieran identificar diferentes estadios de la enfermedad periodontal. El grupo de estudio incluyo 118 adultos, 89 de los cuales con enfermedad periodontal crónica leve, moderada o severa El resto constituyo el grupo control. Se analizaron las propiedades físicas y químicas de la saliva total. La separación de proteínas fue realizada empleando la electroforesis en geles de poliacrilamida conteniendo dodecil sulfato de sodio y la identificación de colagenasa tipo IV se realizo empleando la zimografia. Flujo salival, pH y capacidad bufferante mostraron valores similares en todos los grupos. Las proteínas estuvieron aumentadas en la periodontitis grave lo cual también se mostró por medio de la electroforesis. Hidroxiprolina aumento significativamente en todos los grupos de pacientes con enfermedad periodontal, mientras IgA secretoria se encontró significativamente disminuida respecto al grupo control. Un incremento en los valores de peroxidasa se detecto en las periodontitis moderada y grave. Todas las muestras contenían gelatinasas de 200-116-92 kDa; sin embargo todos los grupos de pacientes con enfermedad periodontal también presentaron bandas de peso molecular menor (66-31 kDa). Los niveles de calcio mostraron diferencias significativas entre todos los grupos de pacientes con periodontitis cuando se los comparo con el grupo control. Cambios cuantitativos en la composición química de la saliva de pacientes con enfermedad periodontal podrían tener significancia en el diagnostico y progresión de la enfermedad periodontal.

Aislamiento y caracterización de cepas de Adenovirus que colonizan el tracto gastrointestinal de pacientes cubanos seropositivos al VIH / Isolation and characterization of Adenovirus strains that invade the gastrointestinal tract of Cuban HIV-positive patients

Introducción: el tracto gastrointestinal es uno de los sistemas que se afecta con frecuencia en el paciente seropositivo al virus de la inmunodeficiencia humana (VIH), de manera que las alteraciones o enfermedades en este sitio representan una causa importante de morbilidad y mortalidad. El hallazgo de cepas de adenovirus, raramente aisladas en pacientes inmunocompetentes, ha sido asociado en ocasiones a la presencia de diarrea, lo cual refleja la importancia del estudio y la tipificación de estas cepas. Objetivos: conocer la prevalencia de los Adenovirus en muestras de heces fecales de pacientes infectados con el VIH, con diarrea aguda o crónica, así como la caracterización de los agentes aislados, mediante la implementación de métodos rápidos y confiables. Métodos: fueron analizadas 167 muestras de heces fecales de individuos seropositivos al VIH y 127 seronegativos como grupo control. La prevalencia fue investigada mediante el aislamiento en cultivo celular, se realizó además la tipificación de las cepas aisladas, mediante técnicas de biología molecular como la reacción en cadena de la polimerasa y la secuenciación nucleotídica. El análisis estadístico se efectuó mediante la prueba exacta de Fisher contenido en el paquete estadístico Epi Info (Versión 6.04). Resultados: la prevalencia en los pacientes VIH+ fue de 15 por ciento, mientras que en los VIH- fue de 4 por ciento; la diferencia resultó estadísticamente significativa; 96 por ciento de las cepas aisladas en los pacientes VIH+ correspondieron al subgénero D, asociadas en 62,5 por ciento a cuadros diarreicos y estadios avanzados de la infección por VIH. Conclusiones: los resultados sugieren la importancia de incluir a los adenovirus y su tipificación en el diagnóstico de rutina de los pacientes VIH+, lo cual sería de interés en el manejo clínico de la infección y aportaría datos claves en la vigilancia y el control de la transmisión de la infección hospitalaria y los análisis epidemiológicos.

Bacckground: the gastrointestinal tract is one of the most frequently affected systems in HIV-positive patients, therefore, changes or diseases occurring in this site represent an important cause of morbidity and mortality. The finding of adenovirus strains, rarely isolated in immunocompetent patients, has been occasionally associated to diarrheas, which reflects the importance of study and typing of these strains. Objectives: to find out the prevalence of Adenovirus in feces samples from HIV patients having chronic or acute diarrheas, as well as the characterization of isolated agents through the application of reliable and quick methods. Methods: one hundred and sixty seven fecal samples from HIV-positive patients and 127 from seronegative subjects as the control group were analyzed. Isolation in cell cultures determined the prevalence and molecular biology techniques as the polymerase chain reaction and nucleotide sequencing allowed typing of isolated strains. The statistical analysis was based on the Fisher´s exact test included in Epi Info (6.04) statistical software. RESULTS: the prevalence in HIV positive patients was 15 percent whereas in the HIV-negative was 4 percent. The difference was statistically significant; 96 percent of isolated strains in HIV positive patients belonged to subgenus D, which are linked in 62.5 percent of cases to acute diarrheal condition and advanced stages of HIV infection. Conclusions: the results indicated the importance of including adenovirus and their typing in the routine diagnosis of patients positive to HIV, all of which would be useful in the clinical management of infection and would contribute key data on surveillance and control of hospital infection transmission and the epidemiological analysis.