Comparison of blastocyst euploidy rates following luteal versus follicular phase stimulation in a GnRH antagonist protocol: a prospective study with repeated ovarian stimulation cycles.

STUDY QUESTION: Is there any difference in the mean number of euploid embryos following luteal phase start (LS) and follicular phase start (FS) of ovarian stimulation? SUMMARY ANSWER: The mean number of euploid blastocysts is equivalent independent of whether the inseminated oocytes are derived from FS or LS. WHAT IS KNOWN ALREADY: Starting ovarian stimulation at any time of the cycle ('random-start') is commonly used for emergency fertility preservation in cancer patients. A few retrospective studies have been published evaluating LS in women undergoing ovarian stimulation in the context of IVF, but there is a lack of robust data on the comparative efficacy of LS versus FS.Although 'random start' is commonly used in cancer survivors, few retrospective and uncontrolled studies have been published evaluating luteal phase stimulation in women undergoing ovarian stimulation in the context of IVF. Owing to this evident lack of robust data on the efficacy of LS, guidelines typically recommend the LS approach only for medical reasons and not in the context of IVF. STUDY DESIGN, SIZE, DURATION: This is a prospective, equivalence study, with repeated stimulation cycles, conducted between May 2018 and December 2021. Overall, 44 oocyte donors underwent two identical consecutive ovarian stimulation cycles, one initiated in the FS and the other in the LS. The primary outcome of the study was to evaluate whether FS and LS in the same patient would result in equivalent numbers of euploid embryos following fertilization of oocytes with the same sperm sample. PARTICIPANTS/MATERIALS, SETTING, METHODS: Overall, 44 oocyte donors underwent two consecutive ovarian stimulation protocols with 150 µg corifollitropin alpha followed by 200 IU recombinant FSH (rFSH) in a fixed GnRH antagonist protocol. The only difference between the two cycles was the day of initiation of ovarian stimulation, which was in the early follicular phase (FS) in one cycle, and in the luteal phase (LS) in the other. Forty-four oocyte recipients participated in the study receiving a mean of six metaphase II (MII) oocytes from each stimulation cycle (FS and LS). All MIIs were inseminated with the corresponding recipient's partner sperm (which had been previously frozen) or donor sperm, in order to safeguard the use of the same sample for either the FS or LS. Following fertilization and blastocyst culture, all generated embryos underwent genetic analysis for aneuploidy screening (preimplantation genetic testing for aneuploidy). MAIN RESULTS AND THE ROLE OF CHANCE: FS resulted in a significantly shorter duration of ovarian stimulation (difference between means (DBM) -1.05 (95% CI -1.89; -0.20)) and a lower total additional dose of daily rFSH was needed (DBM -196.02 (95% CI -319.92; -72.12)) compared with LS. The donors' hormonal profile on the day of trigger was comparable between the two stimulation cycles, as well as the mean number of oocytes (23.70 ± 10.79 versus 23.70 ± 8.81) (DBM 0.00 (95% CI -3.03; 3.03)) and MII oocytes (20.27 ± 9.60 versus 20.73 ± 8.65) (DBM -0.45 (95% CI -2.82; 1.91)) between FS and LS cycles, respectively. Following fertilization, the overall blastocyst formation rate was 60.70% with a euploid rate of 57.1%. Comparisons between the two stimulation cycles did not reveal any significance differences in terms of fertilization rates (71.9% versus 71.4%), blastocyst formation rates (59.4% versus 62%) and embryo euploidy rates (56.9 versus 57.3%) for the comparison of FS versus LS, respectively. The mean number of euploid blastocysts was equivalent between the FS (1.59 ± 1.30) and the LS (1.61 ± 1.17), (DBM -0.02 (90%CI -0.48; 0.44)). LIMITATIONS, REASONS FOR CAUTION: The study was performed in young, potentially fertile oocyte donors who are patients with high blastocyst euploidy rates. Although results may be extrapolated to young infertile women with good ovarian reserve, caution is needed prior to generalizing the results to infertile women of older age. WIDER IMPLICATIONS OF THE FINDINGS: The current study provides evidence that initiation of ovarian stimulation in the luteal phase in young potentially fertile women may result in a comparable number of oocytes and comparable blastocyst euploidy rates compared with follicular phase stimulation. This may imply that in case of a freeze-all protocol in young patients with good ovarian reserve, clinicians may safely consider initiation of ovarian stimulation during the luteal phase. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by an unrestricted grant from MSD/Organon. N.P.P. has received Research grants and honoraria for lectures from: Merck Serono, MSD/Organon, Ferring Pharmaceuticals, Besins Intenational, Roche Diagnostics, IBSA, Theramex, Gedeon Richter. F.M., E.C., M.R. and S.G. declared no conflict of interests. TRIAL REGISTRATION NUMBER: The study was registered at Clinical Trials Gov (NCT03555942).

LC-MS metabolomics of urine reveals distinct profiles for non-muscle-invasive and muscle-invasive bladder cancer.

PURPOSE: Bladder cancer (BC) is among the most frequent malignancies worldwide. Novel non-invasive markers are needed to diagnose and stage BC with more accuracy than invasive procedures like cystoscopy. To date, no study has identified urine metabolites characteristic of all BC stages. To discover novel urine metabolomic profiles to diagnose and stage non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) patients using mass spectrometry-based metabolomics. METHODS: We prospectively recruited 198 BC patients and 98 age- and sex-matched healthy volunteers without evidence of renal or bladder condition confirmed by ultrasound, from whom we collected a first morning urine sample (before surgery in patients). In a discovery stage, an untargeted metabolomic analysis was conducted in urine samples of a selection of 64 BC patients (19 TaG1, 11 TaG3, 20 T1G3, 12 T2G3, 1 T2G2, 1 T3G3) and 20 controls to identify dysregulated metabolites. Next, after exhaustive multivariate analysis, confirmed dysregulated metabolites were validated in an independent cohort of 134 BC patients (19 TaG1, 62 TaG2, 9 TaG3, 15 T1G2, 16 T1G3, 4 T2G2, 9 T2G3) and 78 controls. RESULTS: We validated p-cresol glucuronide as potential diagnostic biomarker for BC patients compared to controls (AUC = 0.79). For NMIBC, p-cresol glucuronide was valuable as staging biomarker (AUC = 0.803). And among NMIBCs, p-coumaric acid may be a potential specific staging biomarker for the TaG1 NMIBC; however, future validation experiments should be conducted once the precise version of the standard is commercially available. Remarkably, for MIBC we validated spermine as potential specific staging biomarker (AUC = 0.882). CONCLUSION: Ours is the first metabolomics study conducted in urine of a thoroughly characterized cohort comprising all stages of NMIBC, MIBC and healthy controls in which we identified non-invasive diagnostic and staging biomarkers. These may improve BC management, thus reducing the use of current harmful diagnostic techniques.

Post-Conization FIGO stage IA1 squamous cell cervical carcinoma; is hysterectomy necessary?

OBJECTIVE: To compare and evaluate the results and suitability of two different approaches to the treatment of post-conization International Federation of Gynaecology and Obstetrics (FIGO) stage IA1 cervical carcinoma: a more radical approach, directly scheduling a second surgery versus a more conservative one, which consists of performing a cotest (PAP plus HPV-test) in a follow-up visit and deciding whether to apply a second surgery on the basis of the results. STUDY DESIGN: Retrospective descriptive study including 144 cases of stage IA1 cervical carcinoma diagnosed after a loop electrosurgical excisional procedure (conization), between 1987 and 2019 in the Mother-and-Child University Hospital of Gran Canaria (Spain). Selected patients were split into two groups for analysis: patients directly undergoing a second surgical intervention (hysterectomy or re-conization) after diagnosis and patients who were followed-up before making a decision whether to schedule a second surgery or continue to follow-up. RESULTS: 75% of women directly receiving a second surgical intervention (no post-conization follow-up) underwent hysterectomy, while 25% underwent re-conization. Histological outcomes from hysterectomized patients showed 65% negative results for intraepithelial lesions, 9% low-grade squamous intraepithelial lesions (LSIL), 16% high-grade squamous intraepithelial lesions (HSIL) and only 10.5% confirmed invasive lesions: hysterectomy complication rate was 7%. Histological studies from women subjected to re-conization showed 32% negative results, 37% LSIL, 5% HSIL and 26% malignancy. In the group of patients who were followed-up after diagnosis, 8.8% needed a second intervention; none of them showed negative histological results, while 100% hysterectomized and 25% patients with re-conization showed HSIL. No unnecessary hysterectomy procedures were conducted in this group. HPV-16 was the most common genotype in both groups. CONCLUSION: Conization proved to be a suitable alternative to hysterectomy as a treatment for post-conization stage IA1 cervical cancer. Our results showed that 65% hysterectomy procedures conducted without previously monitoring for residual disease corresponded to negative results and were therefore, unnecessary. We conclude that confirmation of the presence of residual disease by using cotest is essential to make a decision on further treatment and that a conservative management is often possible and, in our opinion, preferable.

Urine metabolomic analysis in clear cell and papillary renal cell carcinoma: A pilot study.

Renal cell carcinoma (RCC) is one of the most lethal type of tumors and is twice more frequent in men than in women. Initial symptoms are unspecific and belated thus increasing mortality. Moreover, current diagnostic and monitoring tools are harmful for the patient and unspecific in low-grade tumors. Therefore, novel minimally-invasive markers are needed to diagnose and monitor RCC patients. Urine represents the ideal sample source of non-invasive biomarkers for RCC. In our study we aimed to identify a urine metabolomic profile characteristic of RCC patients with diagnostic purposes and also to identify a profile with prognostic value. By an UPLC-Q-ToF MS untargeted metabolomic analysis, we compared the metabolomic profile of 23 RCC patients (14 clear cell RCC and 9 papillary RCC) before surgery and that of 23 healthy controls. Additionally, for the first time, we compared the metabolomic profile of these RCC patients pre-nephrectomy and 3 months and one year post-nephrectomy. We identified the dysregulated metabolomic variables by querying their exact mass against those presented in the Metlin and Human Metabolome Database. Next, we experimentally confirmed their identity. Both RCC subtypes showed similar metabolomic patterns at all stages. 51 metabolomic variables were significantly increased in RCC compared to controls and, among them, 4 were selected as potential discriminant metabolites between groups. We could experimentally confirm the identity of p-cresol glucuronide thus describing for the first time an increase in this metabolite in urine of RCC patients (fold change = 2.922, P = .012). Additionally, we confirmed that no metabolomic differences occur 3 months post-nephrectomy in RRC, while 188 variables were significantly increased one year post-nephrectomy. Of the 15 most discriminant metabolomic variables, we could experimentally confirm the identity of isobutyryl-l-carnitine (fold change = 2.098, P = .004) and l-proline betaine (fold change = 3.328, P = .004), for the first time. In summary, we have identified urine p-cresol glucuronide as potential diagnostic marker for RCC and isobutyryl-l-carnitine and l-proline betaine as potential prognostic markers. When confirmed in an independent cohort of RCC patients, these markers may improve the diagnosis and monitoring of RCC patients thus reducing current harmful diagnostic procedures. SIGNIFICANCE: The high-radiation dose of current imaging techniques available to diagnose and monitor renal cell carcinoma (RCC) are harmful for the patient and unspecific in low-grade tumors. Our untargeted metabolomic analysis carried out in urine samples from RCC patients and healthy individual reveals p-cresol glucuronide as potential diagnostic marker for RCC. Additionally, the analysis of RCC urine samples one year post-nephrectomy reveals isobutyryl-l-carnitine and l-proline betaine as potential prognostic markers. These novel non-invasive urine biomarkers may improve RCC management thus reducing the use of current harmful diagnostic techniques.

Prediagnostic Plasma Bile Acid Levels and Colon Cancer Risk: A Prospective Study.

BACKGROUND: Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. METHODS: Associations between prediagnostic plasma levels of 17 primary, secondary, and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Bile acid levels were quantified by tandem mass spectrometry in samples from 569 incident colon cancer cases and 569 matched controls. Multivariable logistic regression analyses were used to estimate odds ratios (ORs) for colon cancer risk across quartiles of bile acid concentrations. RESULTS: Positive associations were observed between colon cancer risk and plasma levels of seven conjugated bile acid metabolites: the primary bile acids glycocholic acid (ORquartile 4 vs quartile 1= 2.22, 95% confidence interval [CI] = 1.52 to 3.26), taurocholic acid (OR = 1.78, 95% CI = 1.23 to 2.58), glycochenodeoxycholic acid (OR = 1.68, 95% CI = 1.13 to 2.48), taurochenodeoxycholic acid (OR = 1.62, 95% CI = 1.11 to 2.36), and glycohyocholic acid (OR = 1.65, 95% CI = 1.13 to 2.40), and the secondary bile acids glycodeoxycholic acid (OR = 1.68, 95% CI = 1.12 to 2.54) and taurodeoxycholic acid (OR = 1.54, 95% CI = 1.02 to 2.31). By contrast, unconjugated bile acids and tertiary bile acids were not associated with risk. CONCLUSIONS: This prospective study showed that prediagnostic levels of certain conjugated primary and secondary bile acids were positively associated with risk of colon cancer. Our findings support experimental data to suggest that a high bile acid load is colon cancer promotive.

Biomonitoring of non-persistent pesticides in urine from lactating mothers: Exposure and risk assessment.

The aim of the present study was to assess the exposure to pesticides in urine from Spanish lactating mothers (n = 116). Six nonspecific (dialkyl phosphates) and 20 specific metabolites of organophosphate pesticides (OPs), herbicides and pyrethroids were analyzed. The most frequently detected biomarkers were diethyl phosphate, p-nitrophenol, 3,5,6-trichloro-2-pyridinol and 3-phenoxybenzoic acid, whose geometric means were 1.9 ng·mL-1, 0.8 ng·mL-1, 1.5 ng·mL-1 and 1.4 ng·mL-1, respectively. Herbicide metabolites were the least frequently detected biomarkers with detection frequencies between 0% (2,4,5-Trichlorophenoxyacetic acid) and 22% (2,4-Dichlorophenoxyacetic acid). Multiple regression analyses showed that the closeness to a farming activity, the place of residence and the presence of garden/plants at home were some of the most important contributors to urinary levels of pesticide metabolites. Estimated daily intake (EDI), hazard quotient (HQ) and hazard index (HI) were obtained in order to interpret urinary levels of the most frequently detected pesticide metabolites in a risk assessment context. The highest EDIs were obtained for chlorpyrifos (0.40-1.14 µg·kg bw-1·day-1) and deltamethrin (0.34-4.73 µg·kg bw-1·day-1). The calculated HQ for chlorpyrifos, dimethoate, parathion and deltamethrin ranged from 0.01 to 0.47, and HI for OPs ranged from 0.09 to 0.33 showing that apparently there were low health risks due to the exposure to these pesticides in this group of Spanish breastfeeding women.

Exposure and risk assessment to arsenic species in Spanish children using biomonitoring.

We present a new approach to arsenic (As) risk assessment using biomonitoring. In this pilot study we determined the levels of total and speciated urinary arsenicin 109 Spanish school children aged between 6 and 11 years, and interpreted these concentrations in a risk assessment context. The geometric mean (GM) for total As (TAs) was 33.82 µ/L. The order of occurrence and average concentrations of the different species was arsenobetaine (AsB) (100%, 15 µg/L), dimethylarsinic (DMA) (97%, 8.32 µg/L), monomethylarsonic (MMA) (26%, 0.27 µg/L) and inorganic As (iAs) (4%, 0.14 µg/L). 18% of children presented exposures to inorganic arsenic (7.52 µg/g creatinine) higher than guidance value for non-cancer risk (8.3 µg/g creatinine). For cancer risk the exposure to inorganic arsenic was much higher than the guidance value. Urinary DMA was positively associated with urinary AsB, suggesting exposure directly to this specie or metabolism of organic arsenicals to this specie, mainly through seafood consumption. Consequently, the exposure to inorganic As needs to be carefully interpreted because it may be overestimated. Our study supports the hypothesis that urinary iAs + MMA is the most reliable biomarker of exposure to inorganic As.

Biomonitoring of mercury in hair of breastfeeding mothers living in the Valencian Region (Spain). Levels and predictors of exposure.

This study focused on the evaluation of the levels of total mercury in hair among 120 breastfeeding mothers aged 20 to 45 -. The concentrations of Hg ranged from 0.07 to 6.87 µg/g with a geometric mean (GM) of 1.22 µg/g. This GM is six times higher than the average internal exposure of mothers from other 17 European countries (0.225 µg/g). Near 70% of mothers presented levels of Hg above the USA EPA internal exposure guideline of 1 µg/g, and 27% exceeded the EFSA health-based guidance value of 1.9 µg/g. The multivariate regression analysis revealed that age, smoking and fish consumption (sword fish, small fat fish, small lean fish) were the major predictors of mercury in hair.

Distributions and determinants of urinary biomarkers of organophosphate pesticide exposure in a prospective Spanish birth cohort study.

BACKGROUND: Prenatal exposure to organophosphate pesticides (OPs) has been associated with impaired child development. Pesticide exposure determinants need to be studied in order to identify sources and pathways of pesticide exposure. The aim of this paper is to describe prenatal exposure to OPs and evaluate the associated factors in pregnant women. METHODS: The study population consisted of pregnant women (n = 573) who participated in the INMA birth cohort study in Valencia (Spain, 2003-2006). OP metabolites were analyzed in maternal urine at the 32nd week of gestation using a liquid chromatography-high resolution mass spectrometry method. The analysis included non-specific (diethyl phosphate [DEP], diethyl thiophosphate [DETP], dimethyl thiophosphate [DMTP], dimethyl dithiophosphate [DMDTP]) and specific metabolites (2-diethylamino-6-methyl-4-pyrimidinol [DEAMPY], 2-isopropyl-4-methyl-6-hydroxypyrimidine [IMPY], para-nitrophenol [PNP], and 3,5,6-trichloro-2-pyridinol [TCPY]). Information about the sociodemographic, environmental, and dietary characteristics was obtained by questionnaire. The association between log-transformed OPs and covariates was analyzed using multivariable interval censored regression. RESULTS: The detection frequencies were low, DMTP and TCPY being the most frequently detected metabolites (53.8% and 39.1%, respectively). All the OP metabolites were positively associated with maternal intake of fruits and vegetables. Other maternal characteristics related to the OPs were body mass index (BMI) before pregnancy and smoking habit during pregnancy. Women with lower BMI and those who did not smoke presented higher OP concentrations. Moreover, mothers who had a yard or garden with plants at home or who lived in an urban area were also more exposed to OPs. CONCLUSIONS: The OP detection frequencies and the concentrations observed in our study population were low, compared with most of the previously published studies. Given the high vulnerability of the fetus to neurotoxicant exposure, further research on the determinants of the body burden of OPs during pregnancy would be necessary. The knowledge gained from such studies would enhance the effectiveness of public health control and future recommendations in order to reduce the risk to both the health of pregnant women and the health and development of their children.

Analytical methods for human biomonitoring of pesticides. A review.

Biomonitoring of both currently-used and banned-persistent pesticides is a very useful tool for assessing human exposure to these chemicals. In this review, we present current approaches and recent advances in the analytical methods for determining the biomarkers of exposure to pesticides in the most commonly used specimens, such as blood, urine, and breast milk, and in emerging non-invasive matrices such as hair and meconium. We critically discuss the main applications for sample treatment, and the instrumental techniques currently used to determine the most relevant pesticide biomarkers. We finally look at the future trends in this field.

Biomonitoring exposure assessment to contemporary pesticides in a school children population of Spain.

The exposure to pesticides amongst school-aged children (6-11 years old) was assessed in this study. One hundred twenty-five volunteer children were selected from two public schools located in an agricultural and in an urban area of Valencia Region, Spain. Twenty pesticide metabolites were analyzed in children's urine as biomarkers of exposure to organophosphate (OP) insecticides, synthetic pyrethroid insecticides, and herbicides. These data were combined with a survey to evaluate the main predictors of pesticide exposure in the children's population. A total of 15 metabolites were present in the urine samples with detection frequencies (DF) ranging from 5% to 86%. The most frequently detected metabolites with DF>53%, were 3,5,6-trichloro-2-pyridinol (TCPy, metabolite of chlorpyrifos), diethyl phosphate (DEP, generic metabolite of OP insecticides), 2-isopropyl-4-methyl-6-hydroxypyrimidine (IMPY, metabolite of diazinon) and para-nitrophenol (PNP, metabolite of parathion and methyl parathion). The calculated geometric means ranged from 0.47 to 3.36 µg/g creatinine, with TCPy and IMPY showing the higher mean concentrations. Statistical significant differences were found between exposure subgroups (Mann-Whitney test, p<0.05) for TCPy, DEP, and IMPY. Children living in the agricultural area had significantly higher concentrations of DEP than those living in the urban area. In contrast, children aged 6-8 years from the urban area, showed statistically higher IMPY levels than those from agricultural area. Higher levels of TCPy were also found in children with high consumption of vegetables and higher levels of DEP in children whose parents did not have university degree studies. The multivariable regression analysis showed that age, vegetable consumption, and residential use of pesticides were predictors of exposure for TCPy, and IMPY; whereas location and vegetable consumption were factors associated with DEP concentrations. Creatinine concentrations were the most important predictors of urinary TCPy and PNP metabolites.

Area radiopaca mandíbulo-ptérigo-turbinal: su importancia en las telerradiografías normal lateral / Radiopaque area mandibulo-pterygo-turbinate: its importance in the teleradiographs lateral rule

La imagenología convencional es una reproducción bidimensional de una realidad anatómica tridimensional. En una radiografía convencionalse superponen imágenes radiopacas y radiolúcidas, para cuya interpretación se debe conocer en detalle la anatomía descriptivay en especial la anatomía topográfica tridimensional. De esta superposición pueden surgir imágenes que no se correspondan conelementos anatómicos ni patológicos, son las llamadas imágenes fantasmas, que pueden inducir a importantes errores de diagnóstico.Por el contrario, como las Tomografías computo asistidas (TC) y las Resonancias magnéticas nucleares (RMN) son cortes tomográficosde espesores variables y regulables, las superposiciones no se producen.En las Telerradiografías norma lateral (TRG -NL) convencionales, debido a las superposiciones se encuentra, en muchas de ellas, un árearadiopaca esferoidal que se investigó a los efectos de saber, si correspondía a un elemento anatómico, a una patología o a una imagenfantasma. Se procedió a estudiar las apófisis pterigoides, las apófisis coronoides y los cornetes inferiores, efectuando mediciones de laaltura, del ancho y del espesor de estos elementos. Sobre ellos y en un hemicráneo seco, se realizó la Técnica con alambre de cobre yen cada etapa se tomaron TRG-NL experimentales. Así mismo, se realizó una revisión bibliográfica sobre la anatomía, fisiología y patologíadel cornete inferior, llegándose a la conclusión de que el área radiopaca estudiada corresponde a la superposición bilateral de lasapófisis coronoides, de las apófisis pterigoides junto con la apófisis piramidal del palatino, de la tuberosidad del maxilar, ocasionalmentedel germen del 3er molar y de la cola del cornete inferior. A esta imagen, se le llamó área radiopaca mandíbulo-ptérigo-turbinal. De todos los elementos involucrados en la conformación de esta área se debe jerarquizar el cornete inferior y especialmente su cola...

The conventional imaging is a two-dimensional reproduction of three-dimensional anatomical reality. In a conventional X-ray images are superimposed radiopaque and radiolucent, to whose interpretation must know in detail the descriptive anatomy and especially three dimensional topographical anatomy. This overlap may arise images that do not correspond with anatomical and pathological elements, are called ghost images, which can induce significant diagnostic errors. On the contrary, such as computing assisted CT (CT) and nuclear magnetic resonances (NMR) tomographic slices thicknesses are variable and adjustable, overlaps do not occur. In lateral cephalometric standard (TRG-NL) conventional, due to overlap is found, in many of them, an area radiopaque spheroidal investigate the effects of knowing if corresponded to an anatomical element, to a pathology or a ghost image. We proceeded to study the pterygoid process, the coronoid process and inferior turbinates, taking measurements of the height, width and thickness of these elements.On them and on a dry hemicráneo, was performed technology with copper wire and at each stage were taken experimental TRG-NL.Likewise, a literature review of the anatomy, physiology and pathology of the inferior turbinate, and concluded that the radiopaque area studied corresponds to the superposition of bilateral coronoid process of the pterygoid with the pyramidal process of the palatine , the maxillary tuberosity, occasionally 3rd molar germ and tail of the inferior turbinate. This picture, was called " radiopaque area mandibulo-pterygo-turbinate ". Of all the elements involved in forming this area should prioritize the inferior turbinate and particularly its tail by the variability in shape and density, due to the presence of lymphoid follicles and arteriovenous plexus.

Reproducción facial experimental / Experimental facial reproduction

Este trabajo describe la realización de una reproducción facial experimental en el marco de un curso práctico en la Facultad de Odontología de la Universidad Católica del Uruguay. Dentro de los muchos objetivos se destacan: el objetivo didáctico y académico, el testeo del método empleado y la pericia de los operadores.Para la realización de la misma se cuenta con una cabeza ósea que tenía sus partes blandas momificadas y a la que se le tomaron registrosfotográficos previos para la posterior comparación. Una vez limpio el cráneo se procede a la realización de la reproducción facial empleando una técnica de modelado de las partes blandas, usando topes de goma según medidas obtenidas en las tablas de Stewart y material plástico para el relleno de las mismas. Es de destacar que los operadores no tenían experiencia previa ni conocían el material fotográfico testigo. Una vez finalizada la misma se compara con la fotografía del cadáver y se constata un aceptable parecido entre ambos.Esta reproducción facial experimental pone en manifiesto, una vez más, la utilidad que puede tener esta técnica de acercamiento a una identificación positiva y que la misma puede y debe ser utilizada cuando han fracasado todas las otras técnicas de cetreza conocidas.

This paper describes the realization of experimental facial reproduction within a workshop at the School of Dentistry, Catholic University of Uruguay. Among the many objectives are: the learning objective and academic testing of the method used and the skill of the operators. For the realization of the same will have a bone head was mummified soft parts and it were taken prior photographic records for subsequent comparison. After cleaning the skull comes to performing facial reproduction using a modeling technique of soft tissues, using rubber stoppers as measurements obtained in Stewart tables and plastic to fill them. It is noteworthy that the operators had no previous experience or witness knew the photographic material. Once it is compared with the photograph of the corpse and finds an acceptableresemblance between the two.This experimental facial reproduction starts demonstrated once again the usefulness of this technique can have a positive identification approach and that it can and should be used when they have failed all other known certainly techniques.