Relationship between drugs affecting the renin-angiotensin system and colorectal cancer: The MCC-Spain study.

The potential protective effect of renin-angiotensin system (RAS) inhibitors is a subject of increasing interest due to their possible role as chemopreventive agents against colorectal cancer (CRC). To evaluate this association, we conducted a case-control study with 2165 cases of colorectal cancer, diagnosed between 2007 and 2012, and 3912 population controls frequency matched (by age, sex and region) from the Spanish multicenter case-control study MCC-Spain. We found a significant protective effect of the angiotensin-converting enzyme Inhibitors (ACEIs) against CRC, limited to the under-65years group (OR=0.65 95%CI (0.48-0.89)) and to a lesser degree to men (OR=0.81 95%CI (0.66-0.99). In contrast, the angiotensin receptor blockers (ARBs) did not show a significant effect. Regarding the duration of use, a greater protection was observed in men as the length of consumption increases. In contrast, in the under-65 stratum, the strongest association was found in short-term treatments. Finally, by analyzing ACEIs effect by colon subsite, we found no differences, except for under 65years old, where the maximum protection was seen in the proximal intestine, descending in the distal and rectum (without statistical significance). In conclusion, our study shows a protective effect on CRC of the ACEis limited to males and people under 65years old, which increases in proximal colon in the latter. If confirmed, these results may suggest a novel approach to proximal CRC prevention, given the shortcomings of colonoscopy screening in this location.

Role of Rapid Antigen Testing in Population-Based SARS-CoV-2 Screening.

This study evaluates a population-based screening of asymptomatic people, using a rapid antigen diagnostic test (RADT), in areas of high transmission. To detect sources of SARS-CoV-2 infection, nasopharyngeal samples were taken and were tested using RADT. Confirmatory RT-qPCR tests were performed in both positive and negative cases. The internal validity of the RADT, the prevalence of infection, and the positive and negative predictive values (PPV and NPV) were estimated, based on the percentages of confirmed cases with 95% confidence interval. Of the 157,920 people registered, 50,492 participated in the screening; 50,052 were negative, and 440 were positive on the RADT (0.87%). A total of 221 positive RADT samples were reanalysed using RT-qPCR and 214 were confirmed as positive (96.8%; 95% CI: 93.5-98.7%), while 657 out of 660 negative RADT samples were confirmed as RT-qPCR negative (99.5%; 95% CI 98.7-99.9%). The sensitivity obtained was 65.1% (38.4-90.2%) and the specificity was 99.97% (99.94-99.99%). The prevalence of infection was 1.30% (0.95-2.13%). The PPVs were 95.4% (85.9-98.9%) and 97.9% (93.3-99.5%), respectively, while the NPVs were 99.7% (99.4-100%) and 99.2% (98.7-100%), respectively. The high specificity found allow us to report a high screening performance in asymptomatic patients, even in areas where the prevalence of infection was less than 2%.

Concordance between two rapid diagnostic tests for the detection of antibodies against SARS-CoV-2.

OBJECTIVE: To assess the agreement between two rapid detection tests (RDT) for antibodies against SARS-CoV-2 infection. MATERIALS AND METHODS: This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-PCR-positive cases and 52 RT-PCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two RDTs (Combined - cRDT and Differentiated - dRDT). The results of both tests were evaluated using the chi-square test and, for degree of agreement, the kappa coefficient. RESULTS: About 52% of the participants were women (mean age: 48.2±11.0 years). A total of 58.2% were positive for d-RDT and 41.2% were positive for c-RDT. In the subjects who were RT-PCR-positive, d-RDT was positive in 72.4% and c-RDT in 55.2%; in those who were RT-PCR-negative, the percentages were 42.3% and 26.9%, respectively. The kappa coefficient observed between the two RDTs was 0.644, and was higher in patients without a fever or anosmia (0.725) and lower in those with a fever or anosmia (0.524). CONCLUSIONS: There is good agreement between the tests used in this study. Given the sensitivity observed, they can be very useful as a complement to RT-PCR.

Experimental evidence of pharmacological management of anchorage in Orthodontics: A systematic review.

INTRODUCTION: Orthodontic anchorage is one of the most challenging aspects of Orthodontics. Preventing undesired movement of teeth could result in safer and less complicated orthodontic treatment. Recently, several reviews have been published about the effects of different molecules on bone physiology and the clinical side effects in Orthodontics. However, the effects of local application of these substances on the rate of orthodontic tooth movement have not been assessed. OBJECTIVES: The aim of this research was to analyze the scientific evidence published in the literature about the effects of different molecules on orthodontic anchorage. METHODS: The literature was systematically reviewed using PubMed/Medline, Scopus and Cochrane databases from 2000 up to July 31st, 2014. Articles were independently selected by two different researchers based on previously established inclusion and exclusion criteria, with a concordance Kappa index of 0.86. The methodological quality of the reviewed papers was performed. RESULTS: Search strategy identified 270 articles. Twenty-five of them were selected after application of inclusion/exclusion criteria, and only 11 qualified for final analysis. Molecules involved in orthodontic anchorage were divided into three main groups: osteoprotegerin (OPG), bisphosphonates (BPs) and other molecules (OMs). CONCLUSIONS: Different drugs are able to alter the bone remodeling cycle, influencing osteoclast function and, therefore, tooth movement. Thus, they could be used in order to provide maximal anchorage while preventing undesired movements. OPG was found the most effective molecule in blocking the action of osteoclasts, thereby reducing undesired movements.

Concordance between two rapid diagnostic tests for the detection of antibodies against SARS-CoV-2 / Concordancia entre dos pruebas de detección rápida para la exploración de anticuerpos contra el SARS-CoV-2

OBJECTIVE: To assess the agreement between two rapid detection tests (RDT) for antibodies against SARS-CoV-2 infection. MATERIALS AND METHODS: This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-PCR-positive cases and 52 RT-PCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two RDTs (Combined - cRDT and Differentiated - dRDT). The results of both tests were evaluated using the chi-square test and, for degree of agreement, the kappa coefficient. RESULTS: About 52% of the participants were women (mean age: 48.2±11.0 years). A total of 58.2% were positive for d-RDT and 41.2% were positive for c-RDT. In the subjects who were RT-PCR-positive, d-RDT was positive in 72.4% and c-RDT in 55.2%; in those who were RT-PCR-negative, the percentages were 42.3% and 26.9%, respectively. The kappa coefficient observed between the two RDTs was 0.644, and was higher in patients without a fever or anosmia (0.725) and lower in those with a fever or anosmia (0.524). CONCLUSIONS: There is good agreement between the tests used in this study. Given the sensitivity observed, they can be very useful as a complement to RT-PCR

OBJETIVO: Evaluar la concordancia entre dos pruebas de detección rápida (PDR) de anticuerpos en la infección por SARS-CoV-2. MATERIALES Y MÉTODOS: Estudio transversal. Se utilizó una muestra aleatoria de pacientes no hospitalizados de la Gerencia de Atención Primaria del Área de Salud de León (58 con RT-PCR positiva y 52 con RT-PCR negativa). Se recogió información sobre síntomas y a todos se les realizó simultáneamente dos PDR (combinada: PRD-C y diferenciada: PRD-D). Los resultados de ambas pruebas fueron evaluados mediante X2 y el grado de concordancia con el índice Kappa. RESULTADOS: Un 52% de los participantes fueron mujeres (edad media: 48,2 ± 11,0 años). El 58,2% fue positivo a la PDR-D y 41,2% a la PDR-C. En los sujetos RT-PCR + la PDR-D fue positiva en el 72,4% y la PDR-C en el 55,2%; en el caso de los RT-PCR - en el 42,3% y 26,9%, respectivamente. El índice Kappa observado entre las dos PDR fue del 0,644, siendo mayor en pacientes sin fiebre ni anosmia (0,725) y menor en aquellos con fiebre o anosmia (0,524). CONCLUSIONES: Existe una buena concordancia entre los test utilizados en este estudio. Dada la sensibilidad obtenida, pueden ser de gran utilidad como complemento a las RT-PCR

Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Health Area of León and associated factors / Prevalencia de la infección por SARS-CoV-2 en médicos y enfermeras de atención primaria y residencias de ancianos del Área de Salud de León y factores asociados

OBJECTIVE: To evaluate the prevalence and associated factors with SARS-CoV-2 infection in general practitioners and nurses of primary care centers and nursing homes in the health area of León (Spain). MATERIALS AND METHODS: Cross-sectional study in a convenience sample of professionals from 30 health centers and 30 nursing homes from the primary care management division of the Healthcare Area of Leon. The work center, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. The true prevalence of SARS-CoV-2 infection was calculated according to two scenarios for RDT (Sensitivity=0.6 and Specificity=0.985; Sensitivity=0.8 and Specificity=1). RESULTS: The true prevalence of SARS-CoV-2 infection was between 4.9% - 11.0%. The observed prevalence was 5.9%, being higher in nursing home compared to primary care centers (9.5% vs. 5.5%). No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures. CONCLUSIONS: The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially in nursing home professionals

OBJETIVO: Evaluar la prevalencia y los factores asociados a la infección por SARS-CoV-2 en médicos y enfermeras de centros de atención primaria y residencias de ancianos del área de salud de León (España). MATERIAL Y MÉTODOS: Estudio observacional realizado en una muestra de conveniencia de profesionales de 30 centros de salud y 30 residencias de ancianos, de la Gerencia de Atención Primaria del área de salud de León. Se recogió información del centro de trabajo, tipo de profesión, infección por COVID-19, nivel de exposición, cumplimiento de medidas preventivas, aislamiento (si fue requerido) y test diagnósticos realizados. La determinación de infección fue llevada a cabo mediante prueba de diagnóstico rápido diferenciado (PDRd), usando muestra de sangre capilar. La asociación de las variables con la infección se evaluó mediante regresión logística multivariable no condicional. La prevalencia real de infección por SARS-CoV-2 fue calculada de acuerdo a dos escenarios para el PDRd (Sensibilidad=0,6 y Especificidad=0,985; Sensibilidad=0,8 y Especificidad=1). RESULTADOS: La prevalencia real de infección por SARS-CoV-2 se encontró entre 4,9%-11,0%. La prevalencia observada fue de 5,9%, siendo mayor en trabajadores de residencias de ancianos que de centros de salud de atención primaria (9,5% vs 5,5%). No hubo diferencias estadísticamente significativas por sexo, tipo de profesional, nivel de exposición o cumplimiento de medidas preventivas. CONCLUSIONES: La prevalencia de la infección por el SARS-CoV-2 en este grupo es baja. Un gran número de profesionales siguen siendo susceptibles a la infección por el SARS-CoV-2 y, por lo tanto, medidas de protección deben ser adoptadas, especialmente en los profesionales de las residencias de ancianos

Atención primaria: El eje de la continuidad asistencial / Primary care: the axis of continuity of care

No disponible

Experimental evidence of pharmacological management of anchorage in Orthodontics: A systematic review

Introduction: Orthodontic anchorage is one of the most challenging aspects of Orthodontics. Preventing undesired movement of teeth could result in safer and less complicated orthodontic treatment. Recently, several reviews have been published about the effects of different molecules on bone physiology and the clinical side effects in Orthodontics. However, the effects of local application of these substances on the rate of orthodontic tooth movement have not been assessed.Objectives: The aim of this research was to analyze the scientific evidence published in the literature about the effects of different molecules on orthodontic anchorage.Methods: The literature was systematically reviewed using PubMed/Medline, Scopus and Cochrane databases from 2000 up to July 31st, 2014. Articles were independently selected by two different researchers based on previously established inclusion and exclusion criteria, with a concordance Kappa index of 0.86. The methodological quality of the reviewed papers was performed.Results: Search strategy identified 270 articles. Twenty-five of them were selected after application of inclusion/exclusion criteria, and only 11 qualified for final analysis. Molecules involved in orthodontic anchorage were divided into three main groups: osteoprotegerin (OPG), bisphosphonates (BPs) and other molecules (OMs).Conclusions: Different drugs are able to alter the bone remodeling cycle, influencing osteoclast function and, therefore, tooth movement. Thus, they could be used in order to provide maximal anchorage while preventing undesired movements. OPG was found the most effective molecule in blocking the action of osteoclasts, thereby reducing undesired movements.

Introdução: a ancoragem ortodôntica é um dos aspectos mais desafiadores da Ortodontia. A prevenção de movimentos dentários indesejados poderia resultar em um tratamento ortodôntico mais seguro e menos complexo. Recentemente, foram publicadas várias revisões de literatura sobre os efeitos de diferentes substâncias na fisiologia do tecido ósseo e os efeitos colaterais clínicos na Ortodontia. Porém, os efeitos da aplicação local dessas substâncias no grau de movimentação dentária ortodôntica não foram avaliados.Objetivos: o objetivo da presente pesquisa foi analisar a evidência científica publicada na literatura sobre os efeitos de diferentes substâncias na ancoragem ortodôntica.Métodos: a literatura foi sistematicamente revisada utilizando-se as bases de dados PubMed/Medline, Scopus e Cochrane, de 2000 a 31 de julho de 2014. Os artigos foram selecionados, de maneira independente, por dois pesquisadores diferentes, tendo como base critérios de inclusão e exclusão previamente estabelecidos, com um índice Kappa de concordância de 0,86. A qualidade metodológica dos artigos revisados foi analisada.Resultados: a estratégia de pesquisa identificou 270 artigos; 25 artigos foram selecionados após a aplicação dos critérios de inclusão e exclusão, mas apenas 11 foram qualificados para a análise final. As substâncias envolvidas na ancoragem ortodôntica foram divididas em três grupos principais: osteoprotegerina (OPG), bisfosfonatos (BFs) e outras substâncias (OSs).Conclusões: diferentes substâncias são capazes de alterar o ciclo de remodelação óssea, influenciando na função dos osteoclastos e, portanto, na movimentação dentária. Sendo assim, essas substâncias podem ser utilizadas para promover o máximo de ancoragem e prevenir movimentos indesejados. A OPG foi a substância mais eficaz no bloqueio da ação dos osteoclastos, reduzindo os movimentos indesejados.

Axiografía y registros posicionales en la determinación de la inclinación condílea / Axiography and plastic bite records for the adjustement of the condilar trayectory inclination angle

Conocida la importancia de la ITC y de su ajuste en el articulador para un buen resultado clínico y teniendo en cuenta que se puede determinar por diferentes procedimientos, nuestro objetivo es valorar si existe concordancia, a nivel de este parámetro, utilizando dos métodos distintos para su registro como son la axiografia y los registros posicionales de cera (RPC). Material y método: se realizaron RPC y axiografías a 16 pacientes y se valoró la concordancia entre ambos mediante el índice kappa de Cohen. Conclusión: el grado de concordancia entre estos dos métodos de registro es insignificante( índice Kappa entre 0 y 0,2) (AU)

Taking into account the well-know importane of the condilar path inclination angle and its adjustment in the articulator for a good clinical result, our aim is to see if there is concordance between two different methods: axiography and wax positional bite records. Material and method: axiographies and wax bite records were taken to 16 patients. Throughout the results we obtained we were able to see the concordance between these two methods with Cohen´s kappa index. Conclussion: the concordance between these methods was insignificant (kappa index 0 and 0,2) (AU)

Planos bioscópicos de interés protésico y su influencia en la altura coronal / Bioscopic planes of prosthetic interest and their influence on crown height

Introducción: La correcta determinación del plano oclusal es necesaria para la elaboración de restauraciones protésicas que afecten a los sectores posteriores. El objetivo de este trabajo es verificar que parte del borde posterior del trago nos permite trazar el plano protésico más paralelo al plano oclusal, así como la influencia de dicha elección en la altura de las coronas clínicas. Material y método: Se efectuaron 40 telerradiografías laterales de cráneo a otros tantos sujetos (17 mujeres y 23 hombres). A cada participante se le habían colocado previamente tres testigos radiológicos en el trago y uno en la base del ala nasal. En cada radiografía se determinó el paralelismo del plano oclusal con cada una de las tres líneas ala de la nariz-trago trazadas (parte superior, media e inferior del trago) y la modificación de la altura de la corona clínica del primer molar superior según la línea ala de la nariz-trago tomada como referencia. A los resultados se les aplicaron métodos estadísticos. Resultados: La línea de Camper trazada por la parte inferior del trago fue la más paralela, seguida de la trazada por la parte media y de la trazada por la parte superior; entre los tres procedimientos hubo diferencias significativas. La altura clínica de la corona del primer molar superior fue 1,53 mm más corta al tomar como referencia el punto medio del trago y 2,93 más corta al tomar como referencia el punto superior; estas diferencias también fueron significativas. Conclusión: La línea de Camper que pasa por la parte inferior del trago es la más paralela con el plano oclusal y determina una corona clínica en el primer molar superior significativamente más larga que los trazados por la parte superior y media del trago. (AU)

Relación morfofuncional del plano oclusal con el músculo masetero / Morphofunctional relationship between the occlusal plane and the masseter muscle

Introducción (fundamento y objetivo): La relación morfofuncional entre el músculo masetero (MM) y el plano oclusal no ha sido investigada en profundidad. El presente trabajo tiene por objetivo fundamental demostrar que las fibras musculares del masetero muestran una posición perpendicular al plano oclusal. Método: Se ha procedido a la evaluación de las relaciones entre el fascículo superficial del MM y la posición de los incisivos, primer molar inferior, plano oclusal y plano de Francfort, a partir de las teleradiografías de 21 voluntarios sanos, a quienes se les había colocado un dispositivo de silicona intraoral para la identificación del MM. Resultados: El ángulo que forman las fibras del fascículo superficial del MM y el plano oclusal es muy variable situándose entre 70 y 99° con un rango de 29° y la media es de 80,7°. Con el plano de Francfort obtuvimos una media de 65,8° con un rango de 31,5. Conclusión: Las fibras del fascículo superficial del MM no son perpendiculares al plano oclusal. (AU)

Axiografía y registros posicionales en la determinación de la inclinación condílea / Axiography and plastic bite records for the adjustement of the condilar trayectory inclination angle

Conocida la importancia de la ITC y de su ajuste en el articulador para un buen resultado clínico y teniendo en cuenta que se puede determinar por diferentes procedimientos, nuestro objetivo es valorar si existe concordancia, a nivel de este parámetro, utilizando dos métodos distintos para su registro como son la axiografia y los registros posicionales de cera (RPC). Material y método: se realizaron RPC y axiografías a 16 pacientes y se valoró la concordancia entre ambos mediante el índice kappa de Cohen. Conclusión: el grado de concordancia entre estos dos métodos de registro es insignificante( índice Kappa entre 0 y 0,2)

Taking into account the well-know importane of the condilar path inclination angle and its adjustment in the articulator for a good clinical result, our aim is to see if there is concordance between two different methods: axiography and wax positional bite records. Material and method: axiographies and wax bite records were taken to 16 patients. Throughout the results we obtained we were able to see the concordance between these two methods with Cohen´s kappa index. Conclussion: the concordance between these methods was insignificant (kappa index 0 and 0,2)