Impact of immunoprophylaxis with palivizumab on respiratory syncytial virus infection in preterm infants less than 35 weeks in Colombian hospitals.

OBJECTIVE: To evaluate the impact of immunoprophylaxis with palivizumab in preterm infants less than 35 weeks in terms of hospitalization rate, intensive care unit requirement, and mortality. METHODS: A prospective cohort study was conducted at six Colombian hospitals. Preterm infants less than 35 weeks who received at least one dose of palivizumab during the first 6 months of life were included. The primary outcome was the hospitalization rate related to respiratory syncytial virus (RSV) infection. RESULTS: A total of 222 newborns participated in the study; 204 (91.8%) completed the 6-month follow-up, and three died during the study. 88.7% received a second dose of palivizumab, 79.7% a third, 34.7% a fourth, and 25.2% a fifth. The nonadjusted incidence rate of RSV infection was 2.4%, and the overall RSV-positive hospitalization rate was 1.9%. The proportion of patients that required Neonatal Intensive Care Unit (NICU) and mechanical ventilation in relation to RSV infection was 1.4%. Discharge with home oxygen, pulmonary dysplasia, and being younger than 6 months were significantly associated with respiratory infection. Furthermore, exposition to cigarette smoke was the only factor associated with increased risk of hospitalization. The group that required hospitalization received fewer doses of palivizumab (p = 0.049). No discontinuation of treatment due to adverse events were reported. No death was judged to be related to palivizumab. CONCLUSION: The hospitalization rate and the need for NICU admission were lower than those reported in the literature. In this real-life setting, palivizumab appears to be effective in preventing serious cases of RSV infection.

Calvaria Bone Transcriptome in Mouse Models of Osteogenesis Imperfecta.

Osteogenesis imperfecta (OI) is a bone fragility disorder that is usually caused by mutations affecting collagen type I. We compared the calvaria bone tissue transcriptome of male 10-week-old heterozygous Jrt (Col1a1 mutation) and homozygous oim mice (Col1a2 mutation) to their respective littermate results. We found that Jrt and oim mice shared 185 differentially expressed genes (upregulated: 106 genes; downregulated: 79 genes). A total of seven genes were upregulated by a factor of two or more in both mouse models (Cyp2e1, Slc13a5, Cgref1, Smpd3, Ifitm5, Cthrc1 and Rerg). One gene (Gypa, coding for a blood group antigen) was downregulated by a factor of two or more in both OI mouse models. Overrepresentation analyses revealed that genes involved in 'ossification' were significantly overrepresented among upregulated genes in both Jrt and oim mice, whereas hematopoietic genes were downregulated. Several genes involved in Wnt signaling and transforming growth factor beta signaling were upregulated in oim mice, but less so in Jrt mice. Thus, this study identified a set of genes that are dysregulated across various OI mouse models and are likely to play an important role in the pathophysiology of this disorder.

Disección axilar dirigida: Nuestra experiencia con el uso de suspensión de carbón activado / Target axillary dissection: Our experience with the use of charcoal suspension

Objetivo: Determinar la tasa de identificación intra operatoria por el médico cirujano de los ganglios marcados con suspensión de carbón activado previo a la neoadyuvancia. El objetivo secundario es determinar la concordancia entre los ganglios linfáticos marcados con carbón y aquellos considerados ganglios centinelas. Material y método: Es un estudio retrospectivo desde el año 2016 hasta el año 2020. Se incluyeron 27 pacientes con cáncer de mama en estadios T1 - T3 que realizaron quimioterapia neoadyuvante y con axila con estadio N1 y N2. Los ganglios axilares biopsiados con resultado positivo fueron marcados con suspensión de carbón activado, posteriormente las pacientes realizaron quimioterapia neoadyuvante. Se evaluó la tasa de detección y concordancia del ganglio marcado con el ganglio centinela durante el procedimiento quirúrgico. Resultados: Del total de pacientes en 20 casos se realizó efectivamente la identificación por inspección visual de la suspensión de carbón activado en la cavidad axilar durante la cirugía. La tasa de detección fue del 74%. Del total de 20 pacientes en los cuales se identificó carbón visualmente en el acto quirúrgico, 16 se sometieron a biopsia de ganglio centinela. En 81% de los casos hubo una coincidencia entre el ganglio marcado con carbón y el ganglio centinela. Conclusión: En nuestro trabajo la tasa de detección intraoperatoria de los ganglios marcados con carbón está en concordancia con lo publicado en la literatura. Esto catapulta a este método de marcación como una alternativa factible para realizar una disección axilar dirigida asegurándole al médico cirujano la resección de una ganglio positivo de inicio para su análisis anatomopatológico de respuesta. Hemos comprobado que la marcación con carbón no interfiere con la técnica estándar utilizada para la biopsia de ganglio centinela sino que su uso en conjunto mejora la técnica dignóstica.

Objetive: The aim of this study was to determine the rate of identification of activated charcoal suspension during surgery in positive lymph nodes before neadjuvant chemotherapy. The secondary objetive is to determine the rate of concordance between the marked lymph nodes and the sentinel lymph nodes. Material and method: A retrospective study that goes from the year 2016 - 2020. It includes 27 patients with breast cancer (T1 - T3) and positive lymph nodes (N1 - N2). Patients with biopsy - confirmed nodal metatases were marked with activated charcoal suspension in the sampled node. After this procedure patients underwent neoadjuvant chemotherapy and axillary surgery. The rate of detection and the concordance of the marked lymph node with the sentinel lymph nodes was calculated. Results: Of the 27 patients enrolled in this study in 20, the marked node was detected during surgery. The detection rate was of 74%. Of these 20 patientes, 16 had sentinel node biopsy. There was an 81% rate of concordance between the sentinel lymph node and the tattooed lymph node. Conclusions: In our study, the detection rate of marked lymph node is concordant with the numbers publised by other studies. This shows that axillary lymph node tattooing with activated charcoal suspension is a viable, low cost and precise method when performing targeted axillary dissection. We identified that the tattooing procedure does not affect the standard sentinel node biopsy, in fact, when used together it improves its diagnostic performance.

Matrix Gla protein deficiency impairs nasal septum growth, causing midface hypoplasia.

Genetic and environmental factors may lead to abnormal growth of the orofacial skeleton, affecting the overall structure of the face. In this study, we investigated the craniofacial abnormalities in a mouse model for Keutel syndrome, a rare genetic disease caused by loss-of-function mutations in the matrix Gla protein (MGP) gene. Keutel syndrome patients show diffuse ectopic calcification of cartilaginous tissues and impaired midface development. Our comparative cephalometric analyses of micro-computed tomography images revealed a severe midface hypoplasia in Mgp-/- mice. In vivo reporter studies demonstrated that the Mgp promoter is highly active at the cranial sutures, cranial base synchondroses, and nasal septum. Interestingly, the cranial sutures of the mutant mice showed normal anatomical features. Although we observed a mild increase in mineralization of the spheno-occipital synchondrosis, it did not reduce the relative length of the cranial base in comparison with total skull length. Contrary to this, we found the nasal septum to be abnormally mineralized and shortened in Mgp-/- mice. Transgenic restoration of Mgp expression in chondrocytes fully corrected the craniofacial anomalies caused by MGP deficiency, suggesting a local role for MGP in the developing nasal septum. Although there was no up-regulation of markers for hypertrophic chondrocytes, a TUNEL assay showed a marked increase in apoptotic chondrocytes in the calcified nasal septum. Transmission electron microscopy confirmed unusual mineral deposits in the septal extracellular matrix of the mutant mice. Of note, the systemic reduction of the inorganic phosphate level was sufficient to prevent abnormal mineralization of the nasal septum in Mgp-/-;Hyp compound mutants. Our work provides evidence that modulation of local and systemic factors regulating extracellular matrix mineralization can be possible therapeutic strategies to prevent ectopic cartilage calcification and some forms of congenital craniofacial anomalies in humans.

Odontología para pacientes autistas / Dentistry for the Autistic Patient

La relación entre enfermedades orales y mala higiene oral ha sido bien establecida en la literatura. Sin embargo, su relación directa con el autismo no ha sido demostrada. A pesar de su discapacidad psicomotora, el paciente autista no está limitado para utilizar los servicios odontológicos, más bien, la falta de conocimiento y entrenamiento de los odontólogos generales para la atención de este grupo de pacientes parece ser el problema. El propósito de este artículo es hacer una revisión detallada de la literatura científica existente encontrada en las principales bases de datos internacionales, con el fin de ofrecerle al odontólogo general y al odontopediatra una herramienta para el entendimiento de la condición autista, los conceptos básicos, generalidades, etiología y una detallada descripción de las condiciones orales y los distintos enfoques de tratamiento odontológico. Se describirán con detalle las técnicas de manejo del comportamiento y técnicas de comunicación necesarias para que el profesional de la salud pueda brindar una atención integral desde el punto de vista clínico y humano, teniendo en cuenta que para lograr mantener la salud y mejorar la calidad de vida de este grupo de pacientes, se requiere un enfoque multidisciplinario, donde el odontólogo es parte fundamental del grupo.

The relationship between oral diseases and poor oral hygiene has been well established, however, there is a lack of direct relation with autism. Despite their psychomotor disabilities, the autistic patient is not limited to use the dental services, in the contrary, the lack of knowledge and training of general practitioners to care for this group of patients seem to be the problem. The purpose of this article consists in a detailed scientific literature review found in the major international databases, to provide to the general dentist and the pediatric dentist a tool for understanding the autistic condition, the basic concepts, overview, etiology, and a detailed description of oral conditions and dental treatment approaches. This article describes in detail the behavior management and communication techniques necessary for the dentist to provide a comprehensive and humanized dental care, taking into account that in order to maintain health and improve quality of life, this patients require a multidisciplinary approach, where the dentist is a fundamental part of the group.

Salud oral en discapacitados / Oral health for the disabled

La salud oral en pacientes con necesidades especiales ha representado un reto para el profesional de la salud oral a través de la historia, pues las diferentes discapacidades físicas y cognitivas limitan la adecuada remoción de placa dentobacteriana, llevando consigo el desarrollo de enfermedades orales de alta prevalencia en esta población, como la caries dental y la enfermedad periodontal. Con este artículo se pretende presentar al odontólogo información relevante a cerca de las enfermedades bucales prevenibles de origen dentobacteriano y las principales necesidades de las personas en condición de discapacidad referentes a su higiene oral. Del mismo modo, se enfatiza en los métodos de remoción de placa mecánicos y químicos estudiados en esta población, para actualizar los conocimientos y así contribuir en gran medida a la práctica clínica, para ofrecer una adecuada atención odontológica a dichos pacientes. Es necesario el desarrollo de nuevos implementos de higiene oral enfocados a la población discapacitada que faciliten el control de la placa dentobacteriana, para contribuir a la prevención de las enfermedades orales más prevalentes.

Oral health in patients with special health care needs is a challenge for the professional practitioner. Physical and mental disabilities limit adequate plaque removal, leading to the development of high prevalence of oral diseases in this population such as dental caries and periodontal disease. The aim of this article is to present relevant data concerning dentobacterial preventable oral diseases and their main oral healthcare needs. In addition, it emphasizes chemical and mechanical plaque removal systems that have been studied in this population, to update knowledge and contribute to clinical practice and in the same way, to help the dentist to render an adequate dental care to these patients. The development of new oral hygiene devices is needed, focused on the disabled population which facilitate easy plaque control, and prevent the most prevalent oral diseases.

Salud oral en discapacitados / Salud oral en discapacitados

La salud oral en pacientes con necesidades especiales ha representado un reto para elprofesional de la salud oral a través de la historia, pues las diferentes discapacidades físicas ycognitivas limitan la adecuada remoción de placa dentobacteriana, llevando consigo el desarrollo deenfermedades orales de alta prevalencia en esta población, como la caries dental y la enfermedadperiodontal.