Risk Factors Associated with COVID-19 Mortality in the State of Durango, Mexico.

The coronavirus disease 2019 (COVID-19) has caused over six million deaths worldwide since its emergence in Wuhan China, factors associated with COVID-19 mortality, such as comorbidities, age, and observed symptomatology still remain a major subject of study. In the present work, a total of 16,345 SARS-CoV-2 positive cases from Durango Mexico diagnosed from May 2020 to December 2021 were analyzed to establish an association of COVID-19 mortality with clinical and demographic variables in a case-control study. Selected variables include patient age, smoking status, sex, presence of comorbidities such as hypertension, diabetes and obesity, as well as patient symptomatology such as fever, dyspnea, abdominal pain and diarrhea. Results indicate that among analyzed data, the median age was 43 years; 54% were female, with a mortality rate of 5.66%. Multivariate regression analysis indicated that the comorbidities associated with the highest risk factor were advanced age (>60) with an odds ratio of 4.127 (IC 95%, 3.37-5.05), hypertension with 1.961 (IC 95%, 1.57-2.45), diabetes with 1.753 (IC 95%, 1.39-2.20) and obesity with 1.413 (IC 95%, 1.11-1.78) respectively. On the other hand, the symptom associated with the highest risk factor was dyspnea with an odds ratio of 18.369 (IC 95%, 14.42-23.39). Our data suggests an association between hypertension and old age with COVID-19 mortality. Other findings include the prevalence of dyspnea, polypnea and cyanosis as a major predictor for COVID-19 mortality, as well as lower mortality risks among health workers.

[Alteración del gen AMELX en amelogénesis imperfecta. Una breve revisión].

Amelogenesis imperfecta is a group of developmental disorders of the dental enamel that is mainly associated with mutations in the AMELX gene. Clinically, it presents different phenotypes that affect the structure and function of dental enamel both in primary and secondary dentition. The purpose of this study was to conduct a literature review on the AMELX functions and mutations that are related to amelogenesis imperfecta. A literature search was carried out in two databases: PubMed and Web of Science, using the keywords "AMELX", "amelogenin", "amelogenesis imperfecta" and "AMELX mutation". Forty articles were reviewed, with AMELX being found to be the predominant gene in the development of dental enamel and amelogenesis imperfecta by altering the structure of amelogenin. In the past few years, the characteristics of the amelogenesis imperfecta process have been described with different phenotypes of hypoplastic or hypo-mineralized enamel, and different mutations have been reported, by means of which the gene sequencing and the position of mutations have been determined.

La amelogénesis imperfecta es un grupo de trastornos de desarrollo del esmalte dental asociados principalmente con mutaciones en el gen AMELX. Clínicamente presenta diferentes fenotipos que afectan la estructura y función del esmalte, tanto de la dentición primaria como secundaria. El objetivo de este estudio fue realizar una revisión bibliográfica de las funciones y mutaciones de AMELX relacionadas con amelogénesis imperfecta. Se llevó a cabo una revisión bibliográfica en dos bases de datos: PubMed y Web of Science, usando las palabras clave "AMELX", "amelogenina", "amelogénesis imperfecta" y "mutación de AMELX". Fueron revisados 40 artículos y se encontró que AMELX es el gen predominante en el desarrollo del esmalte dental y de la amelogénesis imperfecta, alterando la estructura de la amelogenina. En los últimos años se han descrito las características en el proceso de amelogénesis imperfecta con diferentes fenotipos de esmalte hipoplásico o hipomineralizado y se han reportado diferentes mutaciones, con lo que se ha determinado la secuenciación del gen y las posiciones de las mutaciones.

The Frequency of Risk Factors for Cleft Lip and Palate in Mexico: A Systematic Review.

BACKGROUND: Cleft lip and palate is an anomaly that affects both women and men. It is considered to be among the most frequent congenital abnormalities and is related to modifications in chromosomal DNA and multiple genetic alterations. This anomaly can also be associated with various environmental factors, such as tobacco and alcohol consumption, medication use, and exposure to different environmental and industrial toxic substances. The objective of this study was to document the frequency of risk factors related to cleft lip and palate through a systematic review of Mexican studies. METHODS: In this systematic review, a bibliographic search was conducted following PRISMA guidelines in the databases Scielo, ScienceDirect, PubMed, and EBSCO. Keywords related to cleft lip and palate, epidemiology, and risk factors were used. In all, 3 independent reviewers (J.A.S.L., S.L.V., and N.M.F.) selected and evaluated a total of 17 articles included in this analysis, achieving a coefficient of κ = 0.84. RESULTS: The analysis revealed that the highest frequency of conducted studies was in the State of Mexico. The most common risk factors identified were environmental, pharmacological, consumption habits, and gynecological factors. CONCLUSIONS: Identifying the main risk factors for cleft lip and palate in the Mexican population will enable the implementation of preventive measures aimed at reducing exposure to these factors. Additionally, early intervention can improve the quality of life for individuals affected by this condition.

Epithelial-Mesenchymal Transition Associated with Head and Neck Squamous Cell Carcinomas: A Review.

Head and neck squamous cell carcinomas (HNSCCs) are aggressive, recurrent, and metastatic neoplasms with a high occurrence around the world and can lead to death when not treated appropriately. Several molecules and signaling pathways are involved in the malignant conversion process. Epithelial-mesenchymal transition (EMT) has been described in HNSCCs, a major type of aggressive carcinoma. EMT describes the development of epithelial cells into mesenchymal cells, which depends on several molecular interactions and signaling pathways that facilitate mesenchymal conversion. This is related to interactions with the microenvironment of the tumor, hypoxia, growth factors, matrix metalloproteinases, and the presence of viral infections. In this review, we focus on the main molecules related to EMT, their interactions with the tumor microenvironment, plasticity phenomena, epigenetic regulation, hypoxia, inflammation, their relationship with immune cells, and the inhibition of EMT in the context of HNSCCs.

ENAM Gene Variation in Students Exposed to Different Fluoride Concentrations.

The ENAM gene is important in the formation of tooth enamel; an alteration can affect the lengthening of the crystals, and the thickness in enamel. The objective was to determine the presence of the single nucleotide variant (SNV) rs12640848 of the ENAM gene in students exposed to different concentrations of fluoride. METHODS: A cross-sectional study was conducted on students exposed to high concentrations of fluoride in the city of Durango which were divided according to the severity of fluorosis and dental caries. Genotype determination was performed by DNA sequencing. The relationship between the severity of dental fluorosis and the allele distribution was determined by the Fisher's exact and Kruskal-Wallis tests. RESULTS: Seventy-one students were included for the sequencing. In the different allelic variations, for the normal genotype AA/TT, the control group presented 75%, for the AG/TC variation, 70.8% in the TF ≤ 4 group, 65% in TF ≥ 5, and 16.7% in TF = 0; with respect to GG/CC variation, 12.5% in TF ≤ 4, 22% in TF ≥ 5, and 8.3% in TF = 0 group (p = 0.000). CONCLUSION: The ENAM gene showed an association in the population exposed to different concentrations of fluoride.

Environmental Exposure of Arsenic in Groundwater Associated to Carcinogenic Risk in Underweight Children Exposed to Fluorides.

BACKGROUND: The purpose of this study was to determine the concentration of inorganic arsenic (As) in the potable water available to the population to be able to estimate the non-carcinogenic risks for underweight children and the carcinogenic risk for adults exposed to As intake who live in the Mezquital municipality, Durango, Mexico. METHODS: The As content was quantifed in the water supply sources for human use and its intake was estimated in Mezquital population, southern Durango. With the data obtained, the hazard quotient (HQ) was calculated to determine the non-carcinogenic risk to develop chronic systemic effects in underweight children. The Environmental Protection Agency (EPA) reference health values estimating As exposure risk are from 0.0003 mg/kg/day (non-carcinogenic) to 1.5 mg/kg/day (carcinogenic risk). RESULTS: The analyzed waters presented as concentrations that varied from 0.3 to 10.2 µg/L, with a mean of 7.35 µg/L (CI 95% 6.27-8.38). The exposure dose was 0.4 to 1.36, and the HQ was 1.90 to 6.48 mg/kg/day, the estimated carcinogenic risk from adults varied from 1.28 to 4.37E-4, with values of 3.74-4.37E-4 mg/kg/day in central area. CONCLUSIONS: The children are at risk to develop chronic systemic effects due to ingestion of As from water.

DNA sequencing reveals AMELX, ODAM and MMP20 variations in dental fluorosis.

OBJECTIVE: Dental fluorosis (DF) is a dental development disorder caused by chronic fluoride overconsumption. There are differences in the susceptibility to and severity of DF in studied populations. The objective of the present study was to determine if single-nucleotide variations (SNVs) in the genes Amelogenin (AMELX), Odontogenic Ameloblast Associated (ODAM) and Matrix Metalloproteinase 20 (MMP20) are associated with DF by evaluating the relationship between variations in these genes and the degree of DF severity. SUBJECTS AND METHODS: Schoolchildren from two regions of Durango State and Mexico City, Mexico, were studied. The DF phenotype was determined using the Thylstrup and Fejerskov (TF) index. DNA was obtained from the buccal mucosa of each participant, and the presence of the variations rs946252 in AMELX, rs1514392 in ODAM and rs1784418 in MMP20 was determined by bidirectional DNA sequencing. RESULTS: A total of 180 DNA samples from 30 schoolchildren from 2 areas of Durango State were sequenced and analyzed. Differences in the severity of DF were found between the study areas (p = 0.006). SNVs in theMMP20 gene were present in 76.9 % of the participants in the high fluoride concentration and lower DF severity area. CONCLUSION: AMELX and ODAM variations was not different between the two populations with respect to DF severity; however, the presence of rs1784418 differed between phenotypes with regard to susceptibility to DF. Therefore, MMP20 might be related to the various phenotypes of DF and may serve as a protective marker.

Tomografía computarizada de haz cónico como auxiliar para el tratamiento de incisivo superior con anatomía inusual: reporte de un caso

El fracaso en el tratamiento de conductos puede conducir a la pérdida del órgano dental, distintos factores han sido reportados como causantes del fracaso en la terapia endodóntica, dentro de estos factores los conductos omitidos tienen un influencia mayor debido a que permiten una colonización y multiplicación de las bacterias dentro del conducto radicular. Variaciones anatómicas anormales pueden aumentar las posibilidades de fracaso debido a la imposibilidad de diagnosticar de manera correcta, es en estos casos que la tomografía computarizada de haz cónico ha demostrado ser de gran ayuda para interpretarlas.

O fracasso no tratamento de canais radiculares pode levar à perda do órgão dental. Vários fatores têm sido relatados como causas de fracasso na terapia endodôntica. Dentre esses fatores, os canais omitidos têm uma influência maior, pois permitem a colonização e multiplicação de bactérias dentro do canal radicular. Variações anatômicas anormais podem aumentar as chances de fracasso devido à dificuldade de diagnóstico preciso. Em tais casos, a tomografia computadorizada de feixe cônico demonstrou ser de grande auxílio para a interpretação.

The failure in root canal treatment can lead to the loss of the dental organ. Various factors have been reported as causes of failure in endodontic therapy. Among these factors, omitted canals have a greater influence, as they allow colonization and multiplication of bacteria within the root canal. Abnormal anatomical variations can increase the chances of failure due to the inability to diagnose accurately. In these cases, cone-beam computed tomography has proven to be of great assistance in their interpretation.

Ep-CAM (MOC-31) expression in tooth germ and ameloblastoma

Background: Ep-CAM, a transmembrane glycoprotein expressed in most epithelium in normal conditions, hasdiverse roles in these tissues, including in cell adhesion, proliferation, differentiation, cell cycle regu-lation, migration and intracellular signaling. It is also over-expressed in most malignant neoplasia, partic-ipating in theinitiation, progression, and metastatic dissemination of the tumor. The expression and roles of this protein in oralneoplasia, particularly in odontogenic tumors, remain unestablished. The objective of this study consisted in analyzing the expression of this protein in ameloblastoma and tooth germ.Material and Methods: Ep-CAM (MOC-31) expression was evaluated by immunohistochemistry in tooth germs(TG) (n = 16) ameloblastomas (AM) (n = 60) and 2 ameloblastic carcinomas. Sections were visualized in theirtotality with an optical microscope, and positivity observed in cell membrane and cytoplasm was graded according to the following semi-quantitative scale: Neg, "essentially unstained", for negative sections or staining <5% ofcells; + for staining of 5-50% of cells; ++ for staining >50% of cells.Results: Most tooth germs expressed MOC-31 (81.3%), strong staining was observed both in the inner epitheliumof the enamel organ and in the adjacent stellate reticulum. 16.7% of the AM cases showed MOC-31 expression,the immunoexpression expression was diffuse at the cytoplasmic and membrane level. The only two cases ofameloblastic carcinoma included were strong positive to MOC-31. No correlation was observed between proteinexpression and gender, age, clinical variants, or histological subtypes.Conclusions: Overexpression was found in TG and ameloblastic carcinoma compared to AM; further studies withdifferent experimental strategies are suggested to clarify the biological significance of this finding. (AU)

Perfil inmunohistoquímico del mixoma odontogénico, con énfasis en marcadores de agresividad tumoral y microdensidad vascular / Perfil imuno-histoquímico do mixoma odontogênico, com ênfase em marcadores de agressividade tumoral e microdensidade vascular / Immunohistochemical profile of odontogenic myxoma, with a focus on microvascular density and tumor aggressiveness markers

Con el fin de tener una mayor comprensión sobre el comportamiento biológico del mixoma odontogénico (MO), se realizó inmunohistoquímica en 31 muestras, utilizando marcadores relacionados con mecanismos de progresión tumoral (adhesión, angiogénesis, apoptosis, inflamación y proliferación celular). El epitelio odontogénico fue detectado en cuatro muestras mediante CK19 y CD138, este último, mostró expresión baja en matriz extracelular (MEC) y alta en las células tumorales. La microdensidad vascular (MDV) media fue de 7.51 y 5.35 vasos marcados con CD34 y VEGF-A respectivamente. Una alta expresión de Orosomucoide-1 y Mast Cell Tryptase se observó células tumorales y en MEC. El MO mostró negatividad para Calretinina. Este perfil inmunohistoquímico, la baja expresión para Ki-67, Bcl-2 y p53, y la relativamente baja MDV, sugieren que la actividad proliferativa, anti-apoptótica o angiogénica no representan los principales mecanismos de crecimiento del MO, los cuales podrían estar asociados a eventos como inmunomodulación y degradación de la MEC.

Immunohistochemistry tests were performed in 31 samples to elucidate the biological behavior of the odontogenic myxoma (OM), using markers related to mechanisms of tumor progression (adhesion, angiogenesis, apoptosis, inflammation and cell proliferation). Odontogenic epithelium was detected in four samples with CK19 and CD138; the latter had a low expression in the extracellular matrix (ECM) and a high expression in tumor cells. The mean microvascular density (MVD), assessed with CD34 and VEGF-A, was 7.51 and 5.35 blood vessels. A high expression of orosomucoid-1 and mast cell tryptase was observed in tumor cells and ECM, while calretinin was negative. The immunohistochemical profile mentioned above, as well as the low expression of Ki67, Bcl-2 and p53 and the relatively low MVD, suggest that the proliferative, antiapoptotic and angiogenic activities do not represent the main growing mechanisms of OM, which could be associated to other events, such as immunomodulation and ECM degradation.

Para melhor compreensão do comportamento biológico do mixoma odontogênico (MO), imuno-histoquímica foi realizada em 31 amostras, utilizando marcadores relacionados aos mecanismos de progressão tumoral (adesão, angiogênese, apoptose, inflamação e proliferação celular). Epitélio odontogênico foi detectado em quatro amostras por CK19 e CD138, o último mostrou baixa expressão na matriz extracelular (MEC) e alta em células tumorais. A microdensidade vascular (MDV) média foi de 7.51 e 5.35 vasos marcados com CD34 e VEGF-A, respectivamente. Uma alta expressão de Orosomucoide-1 e Mast Cell Tryptase foi observada nas células tumorais e na MEC. O MO mostrou negatividade para Calretinina. O perfil imuno-histoquímico mencionado acima, a baixa expressão de Ki-67, Bcl-2 e p53 e a relativamente baixa MDV, sugerem que a atividade proliferativa, anti-apoptótica ou angiogênica não representam os principais mecanismos de crescimento do MO, os quais poderiam estar associados com eventos como imunomodulação e degradação da MEC.

Alteración del gen AMELX en amelogénesis imperfecta. Una breve revisión / Alteration of the AMELX gene in amelogenesis imperfecta. A brief review

Resumen La amelogénesis imperfecta es un grupo de trastornos de desarrollo del esmalte dental asociados principalmente con mutaciones en el gen AMELX. Clínicamente presenta diferentes fenotipos que afectan la estructura y función del esmalte, tanto de la dentición primaria como secundaria. El objetivo de este estudio fue realizar una revisión bibliográfica de las funciones y mutaciones de AMELX relacionadas con amelogénesis imperfecta. Se llevó a cabo una revisión bibliográfica en dos bases de datos: PubMed y Web of Science, usando las palabras clave “AMELX”, “amelogenina”, “amelogénesis imperfecta” y “mutación de AMELX”. Fueron revisados 40 artículos y se encontró que AMELX es el gen predominante en el desarrollo del esmalte dental y de la amelogénesis imperfecta, alterando la estructura de la amelogenina. En los últimos años se han descrito las características en el proceso de amelogénesis imperfecta con diferentes fenotipos de esmalte hipoplásico o hipomineralizado y se han reportado diferentes mutaciones, con lo que se ha determinado la secuenciación del gen y las posiciones de las mutaciones.

Abstract Amelogenesis imperfecta is a group of developmental disorders of the dental enamel that is mainly associated with mutations in the AMELX gene. Clinically, it presents different phenotypes that affect the structure and function of dental enamel both in primary and secondary dentition. The purpose of this study was to conduct a literature review on the AMELX functions and mutations that are related to amelogenesis imperfecta. A literature search was carried out in two databases: PubMed and Web of Science, using the keywords “AMELX”, “amelogenin”, “amelogenesis imperfecta” and “AMELX mutation”. Forty articles were reviewed, with AMELX being found to be the predominant gene in the development of dental enamel and amelogenesis imperfecta by altering the structure of amelogenin. In the past few years, the characteristics of the amelogenesis imperfecta process have been described with different phenotypes of hypoplastic or hypo-mineralized enamel, and different mutations have been reported, by means of which the gene sequencing and the position of mutations have been determined.

Nuevas tecnologías en educación superior. Estudio de percepción en estudiantes acerca del uso de WhatsApp y Entornos Virtuales de Aprendizaje (Plataforma Moodle) / New technologies in higher education. Perception study among students on the use of WhatsApp and Virtual Learning Environments (Moodle Platform)

El presente trabajo tiene como finalidad la valoración estudiantil respecto al uso de WhatsApp (WAP) y los Entornos Virtuales de Aprendizaje (EVA) en la Facultad de Odontología (FO), de la Udelar (Montevideo - Uruguay). Se realizó estudio descriptivo observacional en estudiantes de la generación 2016 - FO - UdelaR. Se utilizó una encuesta con 5 items en relación a tres aplicaciones tecnológicas (WhatsApp, Plataforma Moodle y Polimedias), fueron valorados de 0-12 puntos. En WhatsApp se consultó acerca de la posibilidad de consultar dudas, compartir imágenes, informarse, interactuar con el docente y compañeros, dando como resultado en cada item un puntaje promedio de 10.77-10.63-10.63-10.63 y 9.20 respectivamente. En EVA se consultaron los mismos ítems salvo el dos (fue acceder a presentaciones de clase), recibiendo un puntaje promedio de 8.53-11.27-10.33-9.47 y 5.53. Se percibe un alto grado de aceptación entre las diferentes tecnologías, con un mayor grado de aceptación en cuanto a la comunicación de WhatsApp frente a la plataforma Moodle.

The aim of this work was to have students evaluate the use of WhatsApp (WAP) and a Virtual Learning Environment (VLE) at the School of Dentistry, UdelaR (Montevideo - Uruguay). An observational descriptive study was conducted on students from the 2016 generation. A survey with five items was implemented, including three technological applications (WhatsApp, Moodle Platform and Polimedias), which were rated 0 to 12 points. As for WhatsApp, we asked about the possibility of clarifying doubts, sharing images, getting information, interacting with the teacher and classmates. The average score obtained was 10.77-10.63-10.63-10.63 and 9.20 for each item, respectively. In the VLE, the same items were included except for number two (access to class presentations), receiving an average score of 8.53-11.27-10.33-9.47 and 5.53. There is a high degree of acceptance of the different technologies, WhatsApp communication being more widely accepted than communication in the Moodle platform.