Historical Perspectives on the Removal of Intraradicular Posts Prior to the Availability of Ultrasonic Applications.

For decades the dismantling of previous dental work to correct inferior root canal procedures or to address recurrent dental caries has provided a significant amount of work for the restorative dentist. When coupled with teeth that have been root treated and also have an intraradicular post or dowel, the clinician was often presented with the challenge of post removal, without fracturing the root, and revision (retreatment) of the root canal procedures. While today's contemporary dentistry has the wherewithal to use ultrasonic devices to loosen and remove the post, this was not always the case historically, and creativity in this process was the hallmark of many of our predecessors.

Medium Cutoff Versus High-Flux Hemodialysis Membranes and Clinical Outcomes: A Cohort Study Using Inverse Probability Treatment Weighting.

Rationale & Objective: This study investigated the effects on patients' outcomes of using medium cutoff (MCO) versus high-flux (HF) dialysis membranes. Study Design: A retrospective, observational, multicenter, cohort study. Setting & Participants: Patients aged greater than 18 years receiving hemodialysis at the Baxter Renal Care Services dialysis network in Colombia. The inception of the cohort occurred from September 1, 2017, to November 30, 2017, with follow-up to November 30, 2019. Exposure: The patients were divided into 2 cohorts according to the dialyzer used at the inception: (1) MCO membrane or (2) HF membrane. Outcomes: Primary outcomes were the hospitalization rate from any cause and hospitalization days per patient-year. Secondary outcomes were acute cardiovascular events and mortality rates from any cause and secondary to cardiovascular causes. Laboratory parameters were assessed throughout the 2-year follow-up period. Analytical Approach: Descriptive statistics were used to report population characteristics. Inverse probability of treatment weighting was applied to each group before analysis. All categorical variables were compared using Pearson's χ2 test, and continuous variables were analyzed with the t test. Baseline differences between groups with a value of >10% were considered clinically meaningful. Laboratory variables were measured at 5 consecutive time points. A between-patient effect was analyzed using a split-plot factorial analysis of variance. Results: The analysis included 1,098 patients, of whom 564 (51.3%) were dialyzed with MCO membranes and 534 (48.7%) with HF membranes. Patients receiving hemodialysis with MCO membranes had a lower all-cause hospitalization incidence rate (IR) per patient-year (IR = 0.93; 95% CI, 0.82-1.03) than those receiving hemodialysis with HF membranes (IR = 1.13; 95% CI, 0.96-1.30), corresponding to a significant incident rate ratio (MCO/HF) of 0.82 (95% CI, 0.68-0.99; P = 0.04). The frequency of nonfatal cardiovascular events showed statistical significance, with a lower incidence in the MCO group (incident rate ratio = 0.66; 95% CI, 0.46-0.96; P = 0.03). No statistically significant differences in all-cause time until death were observed (P = 0.48). Albumin levels were similar between the 2 dialyzer cohorts. Limitations: Despite the robust statistical analysis, there remains the possibility that unmeasured variables may still generate residual imbalance and, therefore, skew the results. Conclusions: The incidences of hospitalization and cardiovascular events in patients receiving hemodialysis were lower when dialyzed with MCO membranes than HF membranes. A randomized controlled trial would be desirable to confirm these results. Trial Registration: Clinical Trials.gov, ISRCTN12403265.

18F-choline PET/computed tomography and clinical parameters in the detection of significant prostate cancer in patients with increased prostate-specific antigen levels and previous negative biopsies.

OBJECTIVES: The aim of this study is to assess the value of the F-choline PET/computed tomography (CT) in predicting significant prostate cancer (sPCa) in patients with persistently increased prostate-specific antigen (PSA) levels and previous negative biopsies. To study the possible predictive added value of F-choline PET/CT to clinical variables and biomarkers derived from PSA in detecting sPCa. METHODS: We evaluated patients who underwent F-choline PET/CT because of ongoing suspicion of prostate cancer (PCa) due to elevated PSA levels (4-20 ng/mL) and at least one previous negative or no conclusive prostate biopsy for PCa. Age, PSA, free PSA, free/total PSA ratio, PSA velocity, PSA doubling time, PSA density and score risk were obtained. F-choline PET/CT was classified as negative/positive (PET-categorical). Additionally, we subclassified F-choline PET/CT according to the radiotracer uptake patterns (PET-pattern). The reference standard was the histological confirmation. Accuracy of PET/CT was evaluated. Univariate and multivariate logistic regression analyses were performed for metabolic and clinical variables. RESULTS: A total of 78 patients were included in our study, 23 had PCa (15 with sPCa). The PET pattern showed the highest accuracy and was the most powerful predictor of sPCa. In this research, the prediction of sPCa was improved combining PET pattern and score risk. CONCLUSION: F-choline PET/CT is a potential tool for predicting sPCa in patients with persistently increased PSA levels and previous negative biopsies, and also it could improve the performance of score risk in predicting sPCa.

Quantifying Flabby Ridge Tissue Displacement During Impression-Making for Patients With Combination Syndrome.

Patients with Combination syndrome present with early bone loss and flabby hyperplastic tissues in the anterior maxilla caused by functional loads exerted by mandibular anterior teeth on maxillary complete dentures. Use of conventional mucocompressive impression techniques captures flabby maxillary anterior ridge tissue in a distorted state, and dentures made from such impressions could displace flabby tissues when loaded and become loose when unloaded. In this study, which examined two patients diagnosed with Combination syndrome, computer-aided design/computer-aided manufacturing (CAD/CAM) technology was used to determine the degrees of displacement when six impression materials were used for making final impressions for complete dentures.

[Intratumoral endometriosis in renal angiomyolipomas associated to medium vessel necrotizing vasculitis in a patient with Wünderlich syndrome. A rare finding]. / Endometriosis intratumoral en angiomiolipomas renales asociados a vasculitis necrosante de vaso mediano en una paciente con síndrome de Wünderlich: descripción de un hallazgo inusual.

Spontaneous perirenal hematoma or Wünderlich syndrome is a rare entity that requires urgent attention. The most frequent causes are renal neoplasms, mainly renal angiomyolipoma, and vascular diseases (vasculitis). We present a case of a woman with a history of renal angiomyolipomas associated with tuberous sclerosis complex, who developed Wünderlich's syndrome associated with medial vessel vasculitis as well as an uncommon instance of intratumoral endometriosis.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la lesión renal aguda por SARS-CoV-2/COVID-19 / Colombian consensus of experts on recommendations informed in the evidence for the prevention, diagnosis and management of acute kidney injury by SARS-CoV-2/COVID-19

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Abstract Introduction: Acute kidney injury is a frequent complication in patients with COVID-19 and its occurrence is a potential indicator of multi-organ dysfunction and disease severity. Objective: Develop, through an expert consensus, evidence-based recommendations for the prevention, diagnosis, and management of acute kidney injury in patients with SARS CoV2 / COVID-19 infection. Materials and methods: Based on a rapid systematic review in Embase and Pubmed databases and documents from scientific societies, we made preliminary recommendations and consulted with an expert group through an online tool. Then we defined agreement after at least 70 % consensus approval. Quality evidence was evaluated according to the type of document included. The strength of the recommendations was graded as strong or weak. Results: Fifty clinical experts declared their conflict of interest; the consultation took place between May 2 and 29, 2020. The range of agreement ranged from 75.5 % to 100 %. Recommendations for prevention, diagnosis and management of acute kidney injury in patients with SARS CoV2 infection are presented. Conclusions: Although the good quality information available regarding acute kidney injury in patients with COVID-19 is scarce, the recommendations of clinical experts will guide clinical decision-making and strategies around patients with this complication, guaranteeing care focused on the people, with high quality standards, and the generation of safety, health and wellness policies for multidisciplinary care teams.

Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con Enfermedad Renal Crónica en diálisis / Colombian Expert Consensus on Evidence-Informed Recommendations for the Prevention, Diagnosis, and Management of SARS-CoV-2 / COVID-19 Infection in Patients with Chronic Kidney Disease on Dialysis

Resumen Introducción: Las personas con diálisis de mantenimiento se consideran una población en alto riesgo de infección por SARS-CoV-2, complicaciones y muerte. La periodicidad de la diálisis, la organización y la demanda en las unidades de diálisis y las limitaciones de alfabetización en salud poblacional limitan el cumplimiento del aislamiento y el distanciamiento social. Objetivo: Desarrollar, mediante un consenso de expertos, recomendaciones informadas en evidencia para la prevención, el diagnóstico y el manejo de la infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Materiales y métodos: Se realizó una revisión rápida de literatura en Pubmed, Embase y sociedades científicas. La calidad de evidencia fue evaluada según el tipo de estudio incluido. El acuerdo se definió para cada recomendación con umbral de al menos 70% de aprobación. La fuerza de las recomendaciones fue graduada como fuerte o débil. Resultados: El colectivo fue consultado entre el 17 y 19 de mayo de 2020. Se obtuvo respuesta de 44 expertos clínicos que declararon conflicto de interés previo a la consulta. El acuerdo de las recomendaciones estuvo entre 70,5 y 100%. Se presentan las recomendaciones de un colectivo experto para la prevención, el diagnóstico y el manejo de infección por SARS-CoV-2/COVID-19 en pacientes con enfermedad renal crónica. Conclusión: Debido a la reciente aparición de la infección por SARS-CoV-2 y las incertidumbres respecto a la prevención, el diagnóstico y el manejo, las recomendaciones presentadas se conciben como un estándar colombiano que permita garantizar un cuidado centrado en las personas con enfermedad renal crónica y la protección de los profesionales de la salud.

Abstract Introduction: People with chronic dialysis are considered a population at high risk of SARS CoV2 infection and its derived complications and death. The need to go to strict dialysis schedules, the high demand in the kidney facilities and the difficulties derived from the time and space organization in the rooms in the face to the pandemic added to the difficult learning, teaching and adapting new protocols manifest the needed of standard recommendation according to this problem in people who couldn't have an ideal isolation. Objective: Develop through an expert consensus, evidence-informed recommendations for the prevention, diagnosis, and management of SARS-CoV-2/COVID-19 infection in patients with chronic kidney disease on Dialysis. Materials and methods: We carried out a quick literature review, PubMed, Embase and scientific societies were consulted. The quality of the evidence was considered according to the type of study included. The agreement threshold defined for each recommendation was > 70% approval among experts. The strength of the recommendations was rated as strong or weak. Results: Between May 17 and 19, 2020, was conformed a team of 44 clinical experts who declared their interest conflict prior to the consultation. The agreement of the recommendations was between 70.5% and 100%. The recommendations were separated in prevention, early identification, and diagnostic, isolation in hemodialysis facilities and peritoneal dialysis, and team protection. Ethical considerations also were included. Conclusion: Due to the recent appearance of SARS-CoV-2 infection and the uncertainties regarding prevention, diagnosis and management, the recommendations presented are conceived as a Colombian standard that allows guaranteeing focused care for people with chronic kidney disease and the protection of health team.

Actividad citotóxica y genotóxica de ácidos grasos omega en células de cáncer de próstata PC-3 / Cytotoxic and Genotoxic Activity of Omega Fatty Acids in Prostate Cancer Cells PC-3

RESUMEN Introducción: en el mundo, el cáncer de próstata es la principal causa de muerte en hombres. Algunas evidencias sugieren que los ácidos grasos omega-3 reducen la viabilidad de las células tumorales mientras que los ácidos omega-6 promueven su proliferación; al respecto, otros estudios han mostrado resultados controvertidos. Objetivo: evaluar los efectos citotóxicos, genotóxicos y anticlonogénicos de ácidos omega-3: α-linolénico (ALA), eicosapentaenoico (EPA) y docosahexaenoico (DHA), omega-6: linoleico (LA), araquidónico (AA) y omega-9: oleico (OA) en células de cáncer de próstata (PC-3). Metodología: se evaluó el efecto sobre la viabilidad celular relativa mediante las pruebas de MTT y Azul de Tripano, el efecto genotóxico mediante intercambios de cromátidas hermanas (ICHs) y ensayo cometa, y el efecto anticlonogénico in vitro, en diferentes concentraciones (25, 50, 100 y 150 µM) de seis ácidos grasos omega en células de cáncer de próstata (PC-3). Resultados: la viabilidad relativa por MTT mostró valores ≤ IC50 con las concentraciones mayores (100 y 150 µM) para los ácidos grasos omega-3 EPA y DHA y omega-6 AA (150 µM), mientras que la viabilidad relativa, evaluada con Azul de Tripano, con estos mismos ácidos, redujeron la viabilidad a 0 %. DHA y EPA mostraron efecto genotóxico y la disminución de la clonogenicidad celular (p < 0,01). Por otro lado, LA y AA disminuyeron la viabilidad relativa observada con Azul de Tripano, sugiriendo diferentes mecanismos de acción de los ácidos grasos en la membrana celular. Conclusión: los resultados mostraron que los ácidos grasos omega-3, EPA, DHA, y omega-6, AA, disminuyen la formación de colonias, reducen la viabilidad celular y aumentan el efecto genotóxico respecto al control no tratado, en el modelo in vitro de células tumorales de próstata PC-3.

SUMMARY Introduction: Prostate cancer is the main cause of cancer related deaths in men worldwide. Previous studies have suggested that omega-3 fatty acids reduce cell viability in tumour cells, whereas omega-6 fatty acids increase clonogenicity. Nevertheless, other reports have shown controversial results. Objective: Evaluate cytotoxicity, genotoxicity and clonogenicity in a prostate cancer derived human cell line (PC-3), treated with fatty acids omega-3: α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); omega-6: linoleic acid (LA) and arachidonic acid (AA); omega-9: oleic acid (OA). Methods: The tests included (a) cytotoxicity assays by MTT and Trypan Blue; (b) genotoxicity evaluation by the sister-chromatid exchanges technique (SCE) and the DNA-comet assay; and (c) in vitro clonogenic assay of six fatty acids in prostate cancer cell (PC-3) at different concentrations (25 µM, 50 µM, 100 µM and 150 µM). Results: The cell viability by MTT data showed ≤ IC50 values for the omega-3 EPA and DHA and omega-6 AA fatty acids at the two major concentrations (100 µM and 150 µM). Moreover, the same fatty acids viability values dropped to 0 % with Trypan Blue test. EPA and DHA showed genotoxic effect and a clonogenic cell decrease (p<0,01). The latter test also revealed a viability diminishment for LA and AA, suggesting different mechanisms of action of fatty acids on cell membrane. Conclusion: The in vitro evaluation revealed that EPA, DHA and AA reduce the clonogenicity and cell viability of prostate tumour cells and cause genotoxicity in prostate tumour derived PC-3 cells.

Copépodos epipelágicos en Bahía Cupica, Pacífico colombiano: composición de especies, distribución y variación temporal / Epipelagic copepods in Bahía Cupica, Colombian Pacific: species composition, distribution and temporal variation

Resumen: Los cambios en la composición y abundancia de las especies de copépodos a escala espacial y temporal, ayudan a comprender el funcionamiento de los ecosistemas y de cómo la dinámica oceanográfica afecta su variación. Debido a los pocos estudios de este grupo en zonas costeras del Pacífico colombiano, se estudiaron los cambios en la distribución espacial y temporal de la comunidad de copépodos de Bahía Cupica, durante diciembre 2012 y febrero 2013. Se realizaron arrastres oblicuos en 22 estaciones a lo largo de seis transectos perpendiculares a línea de costa, durante dos periodos oceanográficos contrastantes, usando una red bongo (30 cm de diámetro, 2.1 m de largo, con mallas de 250 µm y 500 µm) equipada con un flujómetro. Los resultados mostraron cambios significativos en las condiciones oceanográficas y en el patrón de circulación superficial. Se identificaron en total 52 especies de copépodos de las cuales 35 son nuevos registros para el Pacífico colombiano. La mayor abundancia se presentó durante febrero 2013 (28 604 ind. 100 m-3), con una prevalencia de especies de pequeña talla en los dos periodos. Durante diciembre 2012 se registró una mayor abundancia de especies del orden Poecilostomatoida (58.2 %), y durante febrero 2013 por especies del orden Calanoida (69.5 %). Se identificaron cinco agrupaciones significativas con diferente estructura y composición de especies, tres en diciembre 2012, y dos durante febrero 2013, dividiendo la bahía en diferentes zonas. La estructura del ensamblaje de copépodos presentó una correlación positiva con la temperatura en ambos periodos, siendo mayor durante diciembre 2012. Los resultados sugieren que la zona nerítica del norte del Pacífico colombiano se ve modulada por procesos de surgencia, el patrón de circulación superficial local y la descarga de agua continental de la región, lo que determina la estructura y composición del ensamblaje de copépodos, además de cambios significativos en la abundancia de las especies. Los resultados son útiles para entender la estructura de la comunidad de copépodos, y los estudios futuros deberían intentar examinar otras variables (e.g. el efecto de la disponibilidad de alimento y la concentración de oxígeno disuelto) para mejorar el entendimiento de la estructura de copépodos en la región costera del Pacífico colombiano.

Abstract: The study of changes in abundance and composition of copepod species, at different temporal and spatial scales, help to understand the ecosystems function and how the oceanographic dynamics affects their variability and other resources abundances. Since very few studies have been developed on this group in Colombian Pacific coastal areas, the purpose of this study was to assess the spatial and temporal changes in the copepods community distribution at Cupica Bay, between December 2012 and February 2013. For this, oblique plankton hauls were performed along six transects perpendicular to the coast, in 22 stations, using a Bongo Net (30 cm diameter, 2.1 m large, with mesh size 250 µm and 500 µm) equipped with a flowmeter, during two contrasting oceanographic periods. The results showed significant changes in oceanographic conditions and superficial circulation patterns. Fifty two (52) copepods species were identified, from which thirty five (35) were new records for the Colombian Pacific. The biggest copepod abundance was recorded in February 2013 (28 604 ind. 100 m-3), and small copepods species were the most dominant. During December 2012, species of the order Poecilostomatida were the most abundant (58.2), but during February were the species of the order Calanoida (69.5 %). The community structure and species composition was characterized by five significant groups, three groups during December 2012 and two during February 2013, dividing the bay in different zones. A positive correlation between temperature and copepods assemblages was evident during both periods, but stronger during December 2012. The results suggested that community structure and species composition of resident copepods in North Colombian Pacific neritic zones, are modelled by the intensity of upwelling, superficial local pattern circulation, and continental freshwater discharges in the region. The results are helpful to understand the copepods community structure, and the future studies should attempt to examine other variables (e.g. effect of food available and oxygen concentration dissolved) to improve understanding of copepods structure in the Pacific coast region of Colombia. Rev. Biol. Trop. 65 (3): 1046-1061. Epub 2017 September 01.

Efecto de extractos de la esponja calcarea Leucetta aff. floridana sobre el ciclo de líneas celulares leucemoides / Effect of extracts from the calcareous sponge Leucetta aff. floridana on the cell cycle of leukemoid cell lines

La esponja Leucetta aff. floridana produce compuestos con actividad antiproliferativa diferencial en células tumorales de pulmón y mama, la cual no ha sido explorada en otras líneas tumorales y se desconoce si su potencial antiproliferativo está relacionado con la progresión de células a través del ciclo celular. Objetivo: evaluar el potencial antiproliferativo, anticlonogénico y el efecto sobre el ciclo celular de los extractos hexánico y metanólico de la esponja Leucetta aff. floridana del Caribe colombiano en las líneas celulares leucemoides Jurkat y K562. Métodos: la viabilidad y proliferación celular se determinaron mediante el ensayo de azul de tripano a 0, 24, 48, 72 y 96 h. La eficiencia de clonación y el efecto sobre el ciclo celular se evaluaron a 10 y 100 µg/mL. Los datos se analizaron usando ANOVA multifactorial y la prueba Tukey. Resultados: el extracto hexánico presentó actividad antiproliferativa en ambas líneas celulares siendo Jurkat más sensible que K562, lo cual se corroboró con los ensayos de clonogenicidad. Este extracto también mostró un efecto de acumulación de células Sub-G1 dependiente de la dosis, el cual fue diferencial entre las dos líneas celulares. La duración del tratamiento con el extracto hexánico no fue significativa para las células K562 pero sí para la línea celular Jurkat. Además, el porcentaje de acumulación de las células Sub-G1 fue mayor para células K562 comparado con Jurkat. El extracto metanólico presentó un efecto antiproliferativo similar al hexánico, pero fue más potente con la menor concentración (10 µg/mL) en la clonogenicidad de K562. El efecto sobre el ciclo celular, también fue similar al hexánico, pero la duración del tratamiento no fue significativa en la acumulación de células en Sub-G1. Conclusiones: los resultados muestran el potencial diferencial de los extractos sobre el ciclo celular de las líneas leucemoides evaluadas...

Leucetta aff. floridana sponge produces compounds with differential antiproliferative activity on lung and breast cancer. Nevertheless, this activity in other tumour cell lines has not yet been tested and it remains unknown whether its antiproliferative potential is correlated with the cell progression through cell cycle or not. Objective: To evaluate the antiproliferative and anticlonogenic potential and the effect of methanolic and hexanic extracts of sponge L. aff. floridana from the Colombian Caribbean region on the cell cycle of Jurkat and K562 leukemoid cell lines. Methods: The viability and antiproliferative effect were determined using trypan blue assay at 0, 24, 48, 72 and 96 hours. Clongenicity and effect on cell cycle were assayed at 10 and 100 µg/mL Data obtained were analyzed using multifactorial ANOVA and Tukey's test. Results: The hexanic extract presented antiproliferative activity in both Jurkat and K652 cell lines; Jurkat being more sensitive than K652. These results were confirmed by clongenicity assays. The hexanic extract also showed its effect on the dose-dependent accumulation of Sub-G1 cells, although it was different in the two cell lines. The duration of the treatment with the hexanic extract was not significant for K562 cell line, but it was for Jurkat cells. Additionally, the percentage of cell accumulation in Sub-G1 was higher in K562 than in Jurkat cells. The methanolic extract showed antiproliferative effect similar to that of the hexanic extract, but more potent at the lowest concentration (10 µg/mL) in K652 cell line clonegenicity. The effect on cell cycle was also similar to that of the hexanic extract, but in this case the duration of treatment was not significant in the cell accumulation in Sub-G1. Conclusions: Altogether these results show the differential potential of the extracts on the cell cycle of the evaluated leukemoid cell lines...

Eficacia de la anestesia intraligamentaria en tratamientos endodonticos de molares inferiores en pulpitis irreversibles / Effectiveness of the anesthesia in endodontics treatments of molars with pulpitis

En molares inferiores con pulpitis irreversible aguda o crónica fue administrada la anestesia intraligamentaria utilizando una jeringa de presión "Ligmajet" para estudiar su grado de efectividad. Esto fue determinado mediante el dolor experimentado por los pacientes después de la administración de la solución anestésica, durante los procedimientos de apertura de la cámara pulpar y refuerzo anestésico intrapulpar. De este estudio se concluyó que esxiste una alternativa para obtener anestesia solo en el área del diente afectado alcanzando un nivel adecuado de control del dolor durante el tratamiento endondóntico. Por otra parte, la anestesia intraligamentaria no causa efectos secundarios si es adecuadamente aplicada, además, causa muy poco dolor en el momento de su aplicación, permite iniciar el trabajo inmediatamente después de su aplicación y evita el bloqueo anéstesico del nervio dentario inferior, disminuyendo molestias pots-operatorias.