Periodontal pathogens promote cancer aggressivity via TLR/MyD88 triggered activation of Integrin/FAK signaling that is therapeutically reversible by a probiotic bacteriocin.

Epidemiological studies reveal significant associations between periodontitis and oral cancer. However, knowledge about the contribution of periodontal pathogens to oral cancer and potential regulatory mechanisms involved is limited. Previously, we showed that nisin, a bacteriocin and commonly used food preservative, reduced oral cancer tumorigenesis and extended the life expectancy in tumor-bearing mice. In addition, nisin has antimicrobial effects on key periodontal pathogens. Thus, the purpose of this study was to test the hypothesis that key periodontal pathogens (Porphyromonas gingivalis, Treponema denticola, and Fusobacterium nucleatum) promote oral cancer via specific host-bacterial interactions, and that bacteriocin/nisin therapy may modulate these responses. All three periodontal pathogens enhanced oral squamous cell carcinoma (OSCC) cell migration, invasion, tumorsphere formation, and tumorigenesis in vivo, without significantly affecting cell proliferation or apoptosis. In contrast, oral commensal bacteria did not affect OSCC cell migration. Pathogen-enhanced OSCC cell migration was mediated via integrin alpha V and FAK activation, since stably blocking alpha V or FAK expression abrogated these effects. Nisin inhibited these pathogen-mediated processes. Further, Treponema denticola induced TLR2 and 4 and MyD88 expression. Stable suppression of MyD88 significantly inhibited Treponema denticola-induced FAK activation and abrogated pathogen-induced migration. Together, these data demonstrate that periodontal pathogens contribute to a highly aggressive cancer phenotype via crosstalk between TLR/MyD88 and integrin/FAK signaling. Nisin can modulate these pathogen-mediated effects, and thus has therapeutic potential as an antimicrobial and anti-tumorigenic agent.

Maintaining homeostatic control of periodontal epithelial tissue.

Years of coevolution with resident microbes has made them an essential component of health. Yet, little is known about oral commensal bacteria's contribution to and role in the maintenance of oral health and homeostasis. Commensal bacteria are speculated to play a host protective role in the maintenance of health. In this review, we describe and provide examples of the coordinate regulation that occurs between oral commensal bacteria and the host innate immune response to modulate and maintain oral homeostasis.

Identification of PGN_1123 as the Gene Encoding Lipid A Deacylase, an Enzyme Required for Toll-Like Receptor 4 Evasion, in Porphyromonas gingivalis.

Removal of one acyl chain from bacterial lipid A by deacylase activity is a mechanism used by many pathogenic bacteria to evade the host's Toll-like receptor 4 (TLR4)-mediated innate immune response. In Porphyromonas gingivalis, a periodontal pathogen, lipid A deacylase activity converts a majority of the initially synthesized penta-acylated lipid A, a TLR4 agonist, to tetra-acylated structures, which effectively evade TLR4 sensing by being either inert or antagonistic at TLR4. In this paper, we report successful identification of the gene that encodes the P. gingivalis lipid A deacylase enzyme. This gene, PGN_1123 in P. gingivalis 33277, is highly conserved within P. gingivalis, and putative orthologs are phylogenetically restricted to the Bacteroidetes phylum. Lipid A of ΔPGN_1123 mutants is penta-acylated and devoid of tetra-acylated structures, and the mutant strain provokes a strong TLR4-mediated proinflammatory response, in contrast to the negligible response elicited by wild-type P. gingivalis Heterologous expression of PGN_1123 in Bacteroides thetaiotaomicron promoted lipid A deacylation, confirming that PGN_1123 encodes the lipid A deacylase enzyme.IMPORTANCE Periodontitis, commonly referred to as gum disease, is a chronic inflammatory condition that affects a large proportion of the population. Porphyromonas gingivalis is a bacterium closely associated with periodontitis, although how and if it is a cause for the disease are not known. It has a formidable capacity to dampen the host's innate immune response, enabling its persistence in diseased sites and triggering microbial dysbiosis in animal models of infection. P. gingivalis is particularly adept at evading the host's TLR4-mediated innate immune response by modifying the structure of lipid A, the TLR4 ligand. In this paper, we report identification of the gene encoding lipid A deacylase, a key enzyme that modifies lipid A to TLR4-evasive structures.

Exposure to light-emitting diodes may be more damaging to the sensory properties of fat-free milk than exposure to fluorescent light.

Light exposure can damage the sensory properties of milk, leading to adverse consumer responses. This is presumed to be through the action of photosensitive compounds such as riboflavin, present in milk and capable of releasing energy when irradiated, leading to damage of proteins and fats in the milk. Light-emitting diode (LED) lighting is assumed to be less damaging to milk due to lower inherent power consumption. In this study, fat-free milk was exposed to LED and fluorescent light at 2,000 lx to compare the sensory thresholds of exposure, the flavor profile of milk produced by these exposures, and resultant consumer acceptance of the samples. Additionally, the effectiveness of light-protective packaging and supplementation with antioxidants was evaluated. The sensory threshold from LED exposure was no longer than from fluorescence, whereas with antioxidants (tocopherols and ascorbic acid), the majority of the panelists failed to discriminate milk exposed to LED light even at 48 h of exposure. Trained panelists described light-exposed milk as significantly higher in cardboard, old oil, and plastic, with LED exposure resulting in a marginally more plastic aroma, and fluorescent marginally more cardboard. Consumers reported higher liking for fluorescent-exposed samples versus those exposed to LED. The antioxidant-supplemented samples, and those exposed to LED light engineered to eliminate wavelengths below 480 nm (thus most of riboflavin's absorption peaks), resulted in significantly higher old oil aroma; however, the former received higher liking scores than LED-exposed samples. Light-protective packaging offered near-complete protection from LED exposure, with a similar flavor profile as unexposed milk, and the best liking scores of any treatment. Nevertheless, consumers disliked its appearance, due to unfamiliarity, suggesting some consumer education may be needed if this were to be an efficient protective strategy.

Inflammation and tissue remodeling mediator expression during gingivitis: A comparison between experimental, naturally occurring gingivitis, and periodontal health.

BACKGROUND: The aim of this study is to evaluate the immune regulation and tissue remodeling responses during experimental gingivitis (EG) and naturally occurring gingivitis (NG) to provide a comprehensive analysis of host responses. Gingival crevicular fluid (GCF) was obtained from 2 human studies conducted in university settings. METHODS: The EG study enrolling 26 volunteers provided controls for the baseline (Day 0) from healthy disease-free participants, while Day 21 (the end of EG induction of the same group) was used to represent EG. Twenty-six NG participants age-matched with those of the EG group were recruited. GCF samples were analyzed for 39 mediators of inflammatory/immune responses and tissue remodeling using commercially available bead-based multiplex immunoassays. The differences in GI and mediator expression among groups were determined at a 95% confidence level (p ≤ 0.05) by a 2-way analysis of variance (ANOVA) with a post-hoc Tukey's test. RESULTS: Our findings showed that EG had a greater gingival index than NG and was healthy (p < 0.01 of all comparisons). Furthermore, EG showed significantly higher levels of MPO (p < 0.001), CCL3 (p < 0.05), and IL-1B (p < 0.001) than NG. In contrast, NG had increased levels of MIF (p < 0.05), Fractalkine (p < 0.001), angiogenin (p < 0.05), C3a (p < 0.001), BMP-2 (p < 0.001), OPN (p < 0.05), RANKL (p < 0.001), and MMP-13 (p < 0.001) than EG. CONCLUSIONS: Consistent with the findings from chronic (NG) versus acute (EG) inflammatory lesions, these data reveal that NG displays greater immune regulation, angiogenesis, and bone remodeling compared to EG.

Potent neutralization by a receptor binding domain monoclonal antibody with broad specificity for SARS-CoV-2 JN.1 and other variants.

SARS-CoV-2 continues to be a public health burden, driven in-part by its continued antigenic diversification and resulting emergence of new variants. While increasing herd immunity, current vaccines, and therapeutics have improved outcomes for some; prophylactic and treatment interventions that are not compromised by viral evolution of the Spike protein are still needed. Using a rationally designed SARS-CoV-2 Receptor Binding Domain (RBD) - ACE2 fusion protein and differential selection process with native Omicron RBD protein, we developed a recombinant human monoclonal antibody (hmAb) from a convalescent individual following SARS-CoV-2 Omicron infection. The resulting hmAb, 1301B7 potently neutralized a wide range of SARS-CoV-2 variants including the original Wuhan and more recent Omicron JN.1 strain, as well as SARS-CoV. Structure determination of the SARS-CoV-2 EG5.1 Spike/1301B7 Fab complex by cryo-electron microscopy at 3.1Å resolution demonstrates 1301B7 contacts the ACE2 binding site of RBD exclusively through its VH1-69 heavy chain, making contacts using CDRs1-3, as well as framework region 3 (FR3). Broad specificity is achieved through 1301B7 binding to many conserved residues of Omicron variants including Y501 and H505. Consistent with its extensive binding epitope, 1301B7 is able to potently diminish viral burden in the upper and lower respiratory tract and protect mice from challenge with Omicron XBB1.5 and Omicron JN.1 viruses. These results suggest 1301B7 has broad potential to prevent or treat clinical SARS-CoV-2 infections and to guide development of RBD-based universal SARS-CoV-2 prophylactic vaccines and therapeutic approaches.

A novel class of lipoprotein lipase-sensitive molecules mediates Toll-like receptor 2 activation by Porphyromonas gingivalis.

Infection by the chronic periodontitis-associated pathogen Porphyromonas gingivalis activates a Toll-like receptor 2 (TLR2) response that triggers inflammation in the host but also promotes bacterial persistence. Our aim was to define ligands on the surfaces of intact P. gingivalis cells that determine its ability to activate TLR2. Molecules previously reported as TLR2 agonists include lipopolysaccharide (LPS), fimbriae, the lipoprotein PG1828, and phosphoceramides. We demonstrate that these molecules do not comprise the major factors responsible for stimulating TLR2 by whole bacterial cells. First, P. gingivalis mutants devoid of the reported protein agonists, PG1828 and fimbriae, activate TLR2 as strongly as the wild type. Second, two-phase extraction of whole bacteria resulted in a preponderance of TLR2 agonist activity partitioning to the hydrophilic phase, demonstrating that phosphoceramides are not a major TLR2 ligand. Third, analysis of LPS revealed that TLR2 activation is independent of lipid A structural variants. Instead, activation of TLR2 and TLR2/TLR1 by LPS is in large part due to copurifying molecules that are sensitive to the action of the enzyme lipoprotein lipase. Strikingly, intact P. gingivalis bacterial cells treated with lipoprotein lipase were attenuated in their ability to activate TLR2. We propose that a novel class of molecules comprised by lipoproteins constitutes the major determinants that confer to P. gingivalis the ability to stimulate TLR2 signaling.

Multi-omic longitudinal study reveals immune correlates of clinical course among hospitalized COVID-19 patients.

The IMPACC cohort, composed of >1,000 hospitalized COVID-19 participants, contains five illness trajectory groups (TGs) during acute infection (first 28 days), ranging from milder (TG1-3) to more severe disease course (TG4) and death (TG5). Here, we report deep immunophenotyping, profiling of >15,000 longitudinal blood and nasal samples from 540 participants of the IMPACC cohort, using 14 distinct assays. These unbiased analyses identify cellular and molecular signatures present within 72 h of hospital admission that distinguish moderate from severe and fatal COVID-19 disease. Importantly, cellular and molecular states also distinguish participants with more severe disease that recover or stabilize within 28 days from those that progress to fatal outcomes (TG4 vs. TG5). Furthermore, our longitudinal design reveals that these biologic states display distinct temporal patterns associated with clinical outcomes. Characterizing host immune responses in relation to heterogeneity in disease course may inform clinical prognosis and opportunities for intervention.

Macrophage migration inhibitory factor regulates specific innate immune sensor responses in gingival epithelial cells.

BACKGROUND: The gingival epithelium protects periodontal tissues and the alveolar bone by maintaining a steady state of regulated inflammatory surveillance, also known as healthy homeostasis. Accordingly, the repertoire of receptors present within the gingival epithelium showcases its ability to recognize microbial colonization and contribute to bacterial sensing. Macrophage migration inhibitory factor (MIF) is one of many cytokines that are expressed in this protective state and is involved in neutrophil regulation. However, its role in the maintenance of healthy gingival tissue has not been described. METHODS: Gingival tissues from wild-type (WT) and Mif knock-out (KO) mice were stained for neutrophils and three key neutrophil chemoattractants: MIF, Gro-α/CXCL1, and Gro-ß/CXCL2 in the junctional epithelium (JE). In addition, gene silencing studies were performed using gingival epithelial cells (GECs) to examine the role of MIF on transcription of key bacterial recognition receptors Toll-like receptors (TLR)-1, -2, -4, -6, -9 and interleukin-1 receptors (IL-1R1 and IL-1R2) in response to oral bacterial stimulation. RESULTS: WT murine gingival tissues demonstrated high expression of MIF in the JE. In Mif KO mice, despite the significant reduction of Gro-α/CXCL1 and Gro-ß/CXCL2, there was a slight increase in neutrophils. Gene silencing experiments showed that MIF down-regulated the mRNA expression of TLR4, IL-1R1, and IL-1R2 in GEC, in addition to decreasing secreted IL-8/CXCL8 in response to bacteria. CONCLUSIONS: MIF regulates the expression of TLR4, IL-1Rs, and IL-8/CXCL8, components that are all involved in maintaining oral health. Our data demonstrate that MIF is a significant contributor to the maintenance of healthy oral homeostasis.

Comparison of the sealing ability of various bioceramic materials for endodontic surgery.

OBJECTIVES: Endosequence Bioceramic Root Repair Material (BC-RRM) is used in endodontic microsurgery. It is available as a paste and a putty. However, no studies to date have examined the sealing ability of these forms alone or in combination as root-end filling materials. Hence, this study aimed to compare the sealing properties of these 2 forms of BC-RRM. MATERIALS AND METHODS: Forty-two extracted upper anterior teeth were divided into 3 experimental groups, a positive and negative control. After the root canal treatment, the root ends were resected, retroprepared and retrofilled with either putty, paste + putty or mineral trioxide aggregate (MTA). The teeth were mounted in tubes so the apical 3 mm was submerged in Brain Heart Infusion (BHI) broth. The coronal portions of the canals were inoculated with Enterococcus faecalis and BHI broth and incubated for 30 days. The broth in the tubes was analyzed for colony forming units to check for leakage of bacteria from the canal. The teeth from the groups were sectioned and analyzed using scanning electron microscopy (SEM). The Kruskal-Wallis test and analysis of variance were used to analyze the data with a significance level p < 0.05. RESULTS: The BC-RRM and MTA groups showed similar sealing ability. The positive control showed leakage in all samples. The SEM imaging showed the presence of bacteria in all experimental groups at the material-tooth interface. CONCLUSIONS: No significant differences were noted in the experimental groups, providing sufficient evidence that any combination could be effectively used during endodontic microsurgery.

Clinically Healthy Human Gingival Tissues Show Significant Inter-individual Variability in GCF Chemokine Expression and Subgingival Plaque Microbial Composition.

Aim: Clinically healthy gingival tissue is maintained through controlled regulation of host defense mechanisms against plaque biofilm overgrowth. One key component is the transit of neutrophils from the vasculature into gingival tissue where the expression of different neutrophil chemokines are tightly regulated. This cross-sectional study examines the inter-individual variability in chemokine profiles within gingival crevicular fluid (GCF) in relation to the subgingival bacterial community in a state of gingival health. Methods: Gingival crevicular fluid and subgingival plaque samples were collected from mesiobuccal surfaces of all six Ramfjord teeth of 20 systemically healthy individuals (14.55 ± 1.67 years). A multiplex immunoassay was carried out to quantify the expression of 40 different chemokines in the healthy gingival tissue. Neutrophils were assessed indirectly by myeloperoxidase (MPO) in GCF using traditional ELISA. Characterization of healthy subgingival plaque was conducted with the Illumina Miseq targeting the 16S rRNA gene. Results: In health, there are distinct variations within individual gingival crevicular fluid chemokine expression profiles, as well as in the concentration of neutrophils, that divided the participants into high or low chemokine expressing groups. Specifically, key differences were identified within MIF (2683.54 ± 985.82 pg per 30-s sample), IL-8/CXCL8 (170.98 ± 176.96 pg per 30-s sample), Gro-α/CXCL1 (160.42 ± 94.21 pg per 30-s sample), ENA-78/CXCL5 (137.76 ± 76.02 pg per 30-s sample), IL-1ß (51.39 ± 37.23 pg per 30-s sample), TNF-α (1.76 ± 1.79 pg per 30-s sample), and IFN-γ (0.92 ± 0.54 pg per 30-s sample). Of these identified chemokines, the highest correlation was associated between IL-8/CXCL8 and neutrophils (r = 0.54, p = 0.014). Furthermore, species characterization of healthy subgingival plaque revealed significant inter-individual variability that identified two unique groups unrelated to the previously identified chemokine groups. Conclusion: The lack of concordance between the microbial composition and chemokine profile during health may be a reflection of the unique microbial composition of each individual coupled with variations within their host response, emphasizing the vast complexity of the defense mechanisms in place to maintain gingival health.

Pandemic-Related Instructor Talk: How New Instructors Supported Students at the Onset of the COVID-19 Pandemic.

At the same time that COVID-19 cases in the United States first began to increase, fellows in a mentored teaching apprenticeship for postdoctoral scientists began to teach undergraduate seminars. The fellows suddenly needed to support students emotionally and switch to online instruction. They were encouraged to acknowledge and address the pandemic during each class and decided to do so. In this case study, we examined the language fellows used in response to this encouragement, hypothesizing that they would engage in a variety of pandemic-related instructor talk, i.e., language that instructors use in the classroom that is not directly tied to educational content. We analyzed transcripts from 17 2-hour undergraduate biology seminar courses and found 167 instances of pandemic-related instructor talk. We used grounded theory to identify categories that emerged from these quotations: Positive coping mechanisms and self-care; Adjusting to online learning; Compassionate instruction; Personal impacts; COVID-19 and society; Dreaming; and Biology of COVID-19. Talk in these categories may help build relationships among instructors and students. The category about quickly Adjusting to online learning is unique, in that it is unlikely that there will be another time that will require simultaneous and rapid national movement to online instruction. In addition, four of the seven categories are direct consequences of COVID-19 specifically, and thus are unique to this time. Analyzing pandemic-related instructor talk has shed light on how new instructors navigated the trials of teaching in 2020.

An Ayurvedic herbal extract inhibits oral epithelial cell IL-8 responses to host and bacterial agonists.

BACKGROUND: Natural products constitute a promising class of therapeutics for the treatment of gingivitis and periodontitis as well as the maintenance of oral health. However, the limited understanding behind their potential mechanisms and modes of action have hampered their incorporation into popular western therapeutics. This in vitro study characterizes an Ayurvedic herbal extract mixture, which has been clinically shown to promote gingival health and homeostasis. METHODS: Telomerase immortalized gingival keratinocytes (TIGK) were infected with either Fusobacterium nucleatum cell wall, live F. nucleatum, IL-1ß or TNF-α for 4 hours with and without the herbal extract. The immunomodulatory effects of the extract on host IL-8 production was measured by ELISA. RESULTS: It was found that the Ayurvedic herbal extract mixture inhibited gingival epithelial cell IL-8 expression in response to both bacterial and host cytokine agonists. The herbal extract inhibited IL-8 stimulated by F. nucleatum cell wall, live F. nucleatum, IL-1ß, and TNF-α in a dose-dependent manner that was not a result of host cell death. Furthermore, the extract showed significantly different ID50 doses demonstrating the differential ability to modulate both stimulated and basal IL-8 levels. CONCLUSIONS: In vitro investigation of this herbal extract mixture revealed that it has the ability to modulate gingival epithelial cell IL-8 expression in response to stimulation by bacterial components and host pro-inflammatory signals. This data demonstrates that the reduction in the gingival epithelial cell IL-8 response may in part be responsible for the previously reported ability of the Ayurvedic herbal extract mixture to reduce gingivitis in two separate human clinical studies.

An Ayurvedic Herbal Extract Inhibits Streptococcus mutans Biofilm Formation and Disrupts Preformed Biofilms in vitro.

OBJECTIVE: Sudantha® (SUD), a natural proprietary mixture of herbal extracts that has been incorporated into toothpaste, has been shown in two separate placebo controlled human clinical studies to promote gingival health; and reduce gingival bleeding and plaque formation. However, the herbal based anti-gingivitis mechanisms of Sudantha are not fully understood. The objective of this study was to determine the effect of Sudantha on dental plaque biofilms by investigating its effect on mono-culture biofilms of a primary colonizer, Streptococcus mutans, in vitro. RESULTS: This study found that SUD contributes to the maintenance of oral health through the inhibition of S. mutans biofilm formation. In addition, SUD disrupted preformed S. mutans biofilms after exposure to SUD for 4 hours. Together, this pilot data suggests the inhibition of S. mutans biofilm formation and disruption represents one potential mechanism by which the herbal extract is able to reduce the oral bacterial biofilm resulting in its effective against gingivitis and its potential use in countering biofilm associated oral disease.

Toll-like receptor-2 and -4 responses regulate neutrophil infiltration into the junctional epithelium and significantly contribute to the composition of the oral microbiota.

BACKGROUND: Oral gingival tissue, especially the junctional epithelium (JE), is constantly exposed to sub-gingival plaque. A key component of gingival health is the regulation of the number of neutrophils that migrate into the gingival crevice to counteract its harmful effects. This report investigates the contribution of innate defense receptors, Toll-like receptor (TLR)2, TLR4, and both (TLR2/4) to the maintenance of neutrophil homeostasis in the JE. METHODS: Bacterial composition was analyzed from whole oral swabs collected from 12- to 14-week-old TLR2, TLR4, TLR2/4 double knock-out (KO) mice using a MiSeq platform targeting the V3-V4 region of the 16S ribosomal RNA gene. Mandibles were histologically examined for quantification of neutrophils in the JE and bone loss. Lastly, total bacterial load was quantitated using quantitative real-time PCR. RESULTS: Compared with wild-type, all TLR KO mice displayed significantly increased recruitment of neutrophils (P = 0.0079) into the JE. In addition, TLR4 and TLR2/4 KO mice demonstrated a significant increase in the number of bacteria (P = 0.0022 and P = 0.0152, respectively). Lastly, comparative compositional analyses of the oral microbiome revealed that each KO strain harbored unique microbial communities that are distinct from each other but maintained similar levels of alveolar bone. CONCLUSIONS: Neutrophil migration into healthy mouse JE does not require TLR2 or TLR4. However, a significant increase in the number of neutrophils as well as a significant change in the oral microbial composition in both TLR2 and TLR4 KO mice demonstrate that these TLRs contribute to the homeostatic relationship between bacteria and the host in healthy mice periodontal tissue.

El absceso tubo-ovárico. Evolución en cuatro décadas en el Hospital Nacional Arzobispo Loayza

Introducción: El absceso tubo-ovárico (ATO) es la respuesta de los órganos genitales de la mujer a la invasión de gérmenes; el proceso se focaliza formando un absceso y la cápsula permite la perpetuación de la infección y disminuye la acción antibiótica, siendo necesario la intervención quirúrgica como parte de la solución. Esta entidad se origina como secuela del aborto séptico (AS), enfermedad pélvica inflamatoria (EPI) y en mucha menor medida la infección puerperal. La rotura del absceso puede causar la muerte. Objetivo: Determinar la evolución de la prevalencia del absceso tubo-ovárico en un hospital nacional peruano, desde 1970 hasta 2010. Diseño: Estudio retrospectivo. Institución: Hospital Arzobispo Loayza, Lima, Perú. Participantes: Mujeres con absceso tuvo-ovárico. Intervenciones: Revisión de historias clínicas de pacientes con diagnóstico de absceso tubo-ovárico, en quienes se determinó la causa y su variación con el tiempo. Principales medidas de resultados: Prevalencia y causas del absceso tubo-ovárico en cuatro décadas. Resultados: En el estudio se observa la disminución de la presencia del ATO a través del tiempo y la inversión de las causas; en los inicios del estudio, la mayor causal de ATO fue el aborto séptico y en la década final fue la EPI. Conclusiones: En las cuatro décadas revisadas, disminuyó la frecuencia de absceso tubo-ovárico, variando la causa principal el aborto séptico a enfermedad pélvica inflamatoria.

Background: Tubo-ovarian abscess (TOA) is the response of female genitalia to focus infection; the abscess capsule allows perpetuation of the infection by isolation of germs and reduces antibiotics performance, becoming necessary surgical intervention as part of the problem solution. TOA is sequel of septic abortion, pelvic inflammatory disease (PID), and less frequently due to puerperal infection. Abscess rupture can be mortal. Objectives: To determine variation of tubo-ovarian abscess prevalence at a Peruvian national hospital since 1970 through 2010. Design: Retrospective study. Setting: Hospital Arzobispo Loayza, Lima, Peru. Participants: Women with tubo-ovarian abscess. Interventions: Review of clinical charts of patients with tubo-ovarian abscess and determination of the cause and variation throughout time. Main outcome measures: Prevalence and causes of tuboovarian abscess during four decades. Results: TOA decreased over the time studied with inversion of its main cause; in the early stage of this study the major cause was septic abortion (SA), whereas in recent years PID became the major cause. Conclusions: During the four decades studied tubo-ovarian abscess frequency decreased and the main cause septic abortion was displace by pelvic inflammatory disease.

Comparación de tres géneros musicales como método analgésico no farmacológico: estudio randomizado ciego simple / Comparison of three musical genders as a non pharmacological method: randomized simple blind trial

Objetivo: Comparación de tres géneros musicales como método analgésico no farmacológico para la determinación del género musical que posee mayor efecto analgésico entre niños de 2 a 11 años de edad. Material y Métodos: 150 niños participantes en una campaña de despistaje de anemia realizada en el Hospital Nacinal Arzobispo Laoyza, fueron agrupados aleatoriamente en 4 grupos con 3 distintos géneros musicales y un grupo control (A=Mozart; B=Daddy Yankee; C=Marc Anthony; D= sin estímulo musical). Los niños fueron expuestos a 2 minutos de música o silencio, realizándose el estímulo doloroso (punción para la toma de muestra) a los 60 segundos. Se evaluó la intensidad del dolor según dos escalas: CHEOPS y Autoinforme (según el grupo etario: 2-6 años y 7-11 años, respectivamente); además, se midió la frecuencia cardíaca y saturación de oxígeno, un minuto antes, durante y un minuto después del estímulo doloroso. Se utilizó para el análisis, la pureba de Kruskal-Wallis (prueba no paramétrica). Resultados: El grupo C (Marc Anthony) mostró mayor efecto analgésico al ser comparado con los grupos A y D, al utilizar la escala de Autoinforme (p:0,03); no hubo diferencia significativa con el grupo B. Al comparar los géneros musicales en el grupo etáreo menor (2-6 años, CHEOPS), se encontró un mayor efecto analgésico en el grupo A (Mozart), aunque sin significancia estadística (p: 0,859). Se encontró también mayores niveles de dolor en los grupos B y C. No se hallo diferencia significativa al comparar las curvas de saturación de oxígeno ni frecuencia cardiaca entre los grupos. Conclusiones: La salsa parece otorgar un mayor efecto analgésico en los niños entre 7 y 11 años al ser evaluados con la escala de Autoinforme, comparándolos con los otros géneros musicales y el control; mientras que en los niños entre 2 y 6 años, al ser evaluados con la escala de CHEOPS, ...

Objetive: To compare three music genders as a non pharmacological analgesic method to determine which one has the most analgesic effect in children between 2 and 11 years old. Material and Methods: our study population was a hundred and fifty children who participated on an anemia screening campaign held at the Hospital Nacional Arzobispo Loayza. They were grouped randomly in 4 groups with 3 different musical genders and 1 control group (A=Mozart; B=Daddy Yankee; C=Marc Anthony; D=no musical stimuli). The pain level was assessed by 2 scales: The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Self assessment Scale (the younger age group from 2 to 6 years old, the older age group from 7 to 11 years old respectably), it was also measured heart rate and oxygen saturation 60 seconds before painful stimuli, during stimuli and 30 and 60 seconds post-stimuli. The Kruskal-Wallis Test (non parametric test) was used to analyze the results we obtained. Results: When Self-assessment scale was used, Group C (Marck Anthony) showed the most analgesic effect, compared to groups A and D (p: 0,03); on the other side there was nor significant effect with Group B. When the 3 musical genders where compared in the younger age group (from 2 to 6 years old, CEHOPS), it was found that Group A (Mozart) had the best analgesic effect, even though it did not have any statistic significance (p:0,859). It was also found higher pain levels in Group B and C. No statistical significant difference was found when Oxygen Saturation curves where compared between the four groups, neither heart rate curves. Conclusions: Salsa seems to offer the best analgesic effects in children from 7 to 11 years old, when self-assessment scale was used. Children from 2 to 6 years old were evaluated by CHEOPS scale. We found out that without any statistical significance classical music seems to have the best analgesic effect during painful stimuli.

La adaptación del niño obeso y la relación con la actitud materna / The process of adaptation of an obese child and its relationships with maternal attitude

Se informa los resultados de una investigación de tipo descriptivo correlacional, en muestra de 50 niños y adolescentes entre 9 y 15 años con el diagnóstico médico de Obesidad exógena tomando un grupo de contratación de 50 niños que no presentan Obesidad exógena proveniente de un centro educativo de Lima Metropolitana, también se consideraron en la muestra a las madres de los niños de ambos grupos. Se hallaron diferencias significativas tanto en relación madre niño como en el proceso de adaptación personal entre los grupos de estudio.

The descriptive and co-relational research shows the results obtained from simple 50 9-15 year old children and adolescents who were diagnosed exogenous obesity and control group of 50 children who did not present exogenous obesity, both from a school in Metropolitan Lima. A sample of the mothers from both groups was also considered. Significant differences in the relationships mother-children and in the process of personal adaption between both groups were also found.

Ansiedad en el niño hospitalizado / Anxiety in hospitalized children

La ansiedad es un sentimiento que puede ser vivido intensamente por los niños, más cuando estos son a situación de tensión. Se pretende medir la ansiedad rasgo y estado en niños y adolescentes hospitalizados en el Instituto de Salud del Niño. Los resultados sugieren que no hay diferencias significativas en los niveles de conducta ansiosa en los niños y adolescentes hospitalizados a nivel de los servicios evaluados: Cardiología, Traumatología, Gastroenterología y Dermatología. Sin embargo a través del análisis de los ítems de la prueba aplicada se encuentran características que refieren Ansiedad como Rasgos. Por lo que es necesario la consideración individual antes que la consideración estadística.

Anxiety is a feeling which can be lived intensively by children when they are exposed to under pressure situations. This research pretends to measure trait and state anxiety in hospitalized children and young people. Results show no significant differences in anxious behavior levels of hospitalized children and young people in Cardiology, Traumatology, Gastroenterology and Dermatology services. However through the analysis of applied test items, characteristics referring anxiety as trait are found being necessary the individual consideration before the statistical one because people answer in a different way depending on their personal history, education, culture and relationship with back figures.

Niñas y adolescentes con historia de abuso sexual infantil / Girls and teenagers with history of sexual infantile abuse

Se realiza un estudio descriptivo en base a 30 casos de niñas-adolescentes con historia de abuso sexual, atendidas en el Servicio de Psicología - Ginecología del Instituto Especializado de Salud del Niño, en el período de enero a octubre del 2003. Encontramos que el 33.2 por ciento de las niñas que son llevadas por sus familiares en busca de ayuda psicológica cuentan con edades comprendidas entre los 3-8 años, el 46.2 por ciento son adolescentes tempranas es decir se encuentran entre los 10 y 13 años de edad y el 19.9 por ciento son adolescentes medias de 14 a 17 años de edad.