Background rates of 41 adverse events of special interest for COVID-19 vaccines in 10 European healthcare databases - an ACCESS cohort study.

BACKGROUND: In May 2020, the ACCESS (The vACCine covid-19 monitoring readinESS) project was launched to prepare real-world monitoring of COVID-19 vaccines. Within this project, this study aimed to generate background incidence rates of 41 adverse events of special interest (AESI) to contextualize potential safety signals detected following administration of COVID-19 vaccines. METHODS: A dynamic cohort study was conducted using a distributed data network of 10 healthcare databases from 7 European countries (Italy, Spain, Denmark, The Netherlands, Germany, France and United Kingdom) over the period 2017 to 2020. A common protocol (EUPAS37273), common data model, and common analytics programs were applied for syntactic, semantic and analytical harmonization. Incidence rates (IR) for each AESI and each database were calculated by age and sex by dividing the number of incident cases by the total person-time at risk. Age-standardized rates were pooled using random effect models according to the provenance of the events. FINDINGS: A total number of 63,456,074 individuals were included in the study, contributing to 211.7 million person-years. A clear age pattern was observed for most AESIs, rates also varied by provenance of disease diagnosis (primary care, specialist care). Thrombosis with thrombocytopenia rates were extremely low ranging from 0.06 to 4.53/100,000 person-years for cerebral venous sinus thrombosis (CVST) with thrombocytopenia (TP) and mixed venous and arterial thrombosis with TP, respectively. INTERPRETATION: Given the nature of the AESIs and the setting (general practitioners or hospital-based databases or both), background rates from databases that show the highest level of completeness (primary care and specialist care) should be preferred, others can be used for sensitivity. The study was designed to ensure representativeness to the European population and generalizability of the background incidence rates. FUNDING: The project has received support from the European Medicines Agency under the Framework service contract nr EMA/2018/28/PE.

Long-term survival outcomes of reduced-intensity allogeneic or autologous transplantation in relapsed grade 3 follicular lymphoma.

Grade 3 follicular lymphoma (FL) has aggressive clinical behavior. To evaluate the optimal first transplantation approach in relapsed/refractory grade 3 FL patients, we compared the long-term outcomes after allogeneic (allo-) vs autologous hematopoietic cell transplantation (auto-HCT) in the rituximab era. A total of 197 patients undergoing first reduced-intensity conditioning (RIC) allo-HCT or first auto-HCT during 2000-2012 were included. Rituximab-naive patients were excluded. Allo-HCT recipients were younger, more heavily pretreated and had a longer interval between diagnosis and HCT. The 5-year probabilities of non-relapse mortality (NRM), relapse/progression, PFS and overall survival (OS) for auto-HCT vs allo-HCT groups were 4% vs 27% (P<0.001), 61% vs 20% (P<0.001), 36% vs 51% (P=0.07) and 59% vs 54% (P=0.7), respectively. On multivariate analysis, auto-HCT was associated with reduced risk of NRM (relative risk (RR)=0.20; P=0.001). Within the first 11 months post HCT, auto- and allo-HCT had similar risks of relapse/progression and PFS. Beyond 11 months, auto-HCT was associated with higher risk of relapse/progression (RR=21.3; P=0.003) and inferior PFS (RR=3.2; P=0.005). In the first 24 months post HCT, auto-HCT was associated with improved OS (RR=0.42; P=0.005), but in long-time survivors (beyond 24 months) it was associated with inferior OS (RR=3.6; P=0.04). RIC allo-HCT as the first transplant approach can provide improved PFS and OS, in long-term survivors.

Optimizing indoor illumination quality and energy efficiency using a spectrally tunable lighting system to augment natural daylight.

This article demonstrates the benefits of complementing a daylight-lit environment with a spectrally tunable illumination system. The spectral components of daylight present in the room are measured by a low-cost miniature spectrophotometer and processed through a number of optimization algorithms, carefully trading color fidelity for energy efficiency. Spectrally-tunable luminaires provide only those wavelengths that ensure that either the final illumination spectrum inside the room is kept constant or carefully follows the dynamic spectral pattern of natural daylight. Analyzing the measured data proves that such a hybrid illumination system brings both unprecendented illumination quality and significant energy savings.

A prognostic model predicting autologous transplantation outcomes in children, adolescents and young adults with Hodgkin lymphoma.

Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pretransplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995 and 2010. The probabilities of PFS at 1, 5 and 10 years were 66% (95% confidence interval (CI): 62-70), 52% (95% CI: 48-57) and 47% (95% CI: 42-51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score ⩾90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low-, intermediate- and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64-80), 53% (95% CI: 47-59) and 23% (95% CI: 9-36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk of progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT.

Topography of primitive reflexes in dementia: an F-18 fluorodeoxyglucose positron emission tomography study.

BACKGROUND AND PURPOSE: Although primitive reflexes (PRs) are inhibited during the first years of childhood, they may reappear with brain injury. PRs have been linked to frontal lobe dysfunction, but their precise topography has not yet been defined. The purpose of this study was to map which regions of the brain display a reduced glucose metabolism in patients with cognitive impairment and PRs. METHODS: A prospective study was conducted to evaluate PRs in a group of patients assessed due to suspected cognitive decline. Neurological and neuropsychological examinations and (18) F-fluorodeoxyglucose positron emission tomography fused with computerized tomography were performed. Voxel-based brain mapping analysis by means of statistical parametric mapping was used to compare patients with and without PRs. RESULTS: The study included 99 patients (33 diagnosed with Alzheimer's disease, 33 on the frontotemporal dementia spectrum and 33 with other diagnoses). Mean age was 71 ± 9.7 years; time since symptom onset was 3.6 ± 2.9 years. At least one PR was observed in 43 cases (43.4% of the whole sample; 48.5% in the Alzheimer disease group, 63.6% in frontotemporal dementia and 18.2% in the group with other diagnoses). The group of patients with PRs exhibited a decreased cerebral metabolism in the bilateral superior frontal gyri (Brodmann area 6), bilateral putamina and thalami. CONCLUSIONS: The presence of PRs was associated with hypometabolism at the superior frontal gyrus and putamen. This suggests that dysfunction in the corticostriatal motor circuit (supplementary motor area-putamen-thalamus) may constitute the anatomical basis of the recurrence of PRs.

Alternative donors extend transplantation for patients with lymphoma who lack an HLA matched donor.

Alternative donor transplantation is increasingly used for high-risk lymphoma patients. We analyzed 1593 transplant recipients (2000-2010) and compared transplant outcomes in recipients of 8/8 allele HLA-A, -B, -C and DRB1 matched unrelated donors (MUDs; n=1176), 7/8 allele HLA mismatched unrelated donors (MMUDs; n=275) and umbilical cord blood donors (1 or 2 units UCB; n=142). Adjusted 3-year non-relapse mortality of MMUD (44%) was higher as compared with MUD (35%; P=0.004), but similar to UCB recipients (37%; P=0.19), although UCB had lower rates of neutrophil and platelet recovery compared with unrelated donor groups. With a median follow-up of 55 months, 3-year adjusted cumulative incidence of relapse was lower after MMUD compared with MUD (25% vs 33%, P=0.003) but similar between UCB and MUD (30% vs 33%; P=0.48). In multivariate analysis, UCB recipients had lower risks of acute and chronic GVHD compared with adult donor groups (UCB vs MUD: hazard ratio (HR)=0.68, P=0.05; HR=0.35; P<0.001). Adjusted 3-year OS was comparable (43% MUD, 37% MMUD and 41% UCB). These data highlight the observation that patients with lymphoma have acceptable survival after alternative donor transplantation. MMUD and UCB can extend the curative potential of allotransplant to patients who lack suitable HLA matched sibling or MUD.

Allogeneic hematopoietic cell transplantation for mycosis fungoides and Sezary syndrome.

We describe outcomes after allogeneic hematopoietic cell transplantation (HCT) for mycosis fungoides and Sezary syndrome (MF/SS). Outcomes of 129 subjects with MF/SS reported to the Center for the International Blood and Marrow Transplant from 2000-2009. Median time from diagnosis to transplant was 30 (4-206) months and most subjects were with multiply relapsed/ refractory disease. The majority (64%) received non-myeloablative conditioning (NST) or reduced intensity conditioning (RIC). NST/RIC recipients were older in age compared with myeloablative recipients (median age 51 vs 44 years, P=0.005) and transplanted in recent years. Non-relapse mortality (NRM) at 1 and 5 years was 19% (95% confidence interval (CI) 12-27%) and 22% (95% CI 15-31%), respectively. Risk of disease progression was 50% (95% CI 41-60%) at 1 year and 61% (95% CI 50-71%) at 5 years. PFS at 1 and 5 years was 31% (95% CI 22-40%) and 17% (95% CI 9-26%), respectively. OS at 1 and 5 years was 54% (95% CI 45-63%) and 32% (95% CI 22-44%), respectively. Allogeneic HCT in MF/SS results in 5-year survival in approximately one-third of patients and of those, half remain disease-free.

Anomalías y displasias dentarias de origen genético-hereditario / Inherited dental abnormalities and dysplasias

Las alteraciones del desarrollo embriológico de la dentición provocan anomalías y displasias dentarias. Los factores etiopatogénicos implicados en las alteraciones del desarrollo dentario son básicamente dos: genéticos y ambientales. Según la fase del desarrollo en que afecten al órgano del esmalte y a los tejidos dentarios, aparecerán diferentes anomalías y/o displasias dentales. El control genético del desarrollo dentario se lleva a cabo mediante dos procesos: a) control de la histogénesis del esmalte y la dentina, y b) la especificación del tipo, tamaño y posición de cada diente. La mutación de los genes implicados en la amelogénesis (AMELX, ENAM, MMP20 y KLK4) o en la dentinogénesis (DSPP) produce alteraciones del desarrollo dentario aisladas o no sindrómicas. Por el contrario, las mutaciones de los genes reguladores morfogenéticos involucrados en la determinación de la posición y el desarrollo precoz de los órganos dentarios (genes homeobox), además de alterar la morfodiferenciación dentaria, tienen efectos pleiotrópicos y afectan a otros órganos, provocando síndromes hereditarios en los que uno de sus rasgos es la alteración dentaria. En este artículo se revisan las principales anomalías y displasias dentarias de causa genético-hereditaria (AU)

Alterations of the embryologic development of the dentition cause dental anomalies and dysplasias. The causing factors involved in the disturbances of tooth development are basically two: genetic and environmental factors. Depending on the phase of tooth development when the factors act, they will appear different dental anomalies and dysplasias. Genetic control of tooth development is carried out through two processes: a) control of amelogenesis and dentinogenesis, and b) the specification of the type, size and position of each tooth. Mutation of genes involved in amelogenesis (AMELX, ENAM, MMP20 and KLK4) and dentinogenesis (DSPP) produces non-syndromic alterations of tooth development. On the contrary, mutations in morphogenetic regulatory genes involved in determining the position and the early development of the teeth (homeobox genes), not only alter teeth morpho differentiation, but also have pleiotropic effects affecting other organs, causing hereditary syndromes in which one of its features is the presence of dental abnormalities. Dental anomalies and dysplasias of genetic origin are reviewed in this article (AU)

Preliminary evidence for biologic activity of toceranib phosphate (Palladia(®)) in solid tumours.

The purpose of this study was to provide an initial assessment of the potential biologic activity of toceranib phosphate (Palladia®, Pfizer Animal Health, Madison, NJ, USA) in select solid tumours in dogs. Cases in which toceranib was used to treat dogs with apocrine gland anal sac adenocarcinoma (AGASACA), metastatic osteosarcoma (OSA), thyroid carcinoma, head and neck carcinoma and nasal carcinoma were included. Clinical benefit (CB) was observed in 63/85 (74%) dogs including 28/32 AGASACA [8 partial response (PR), 20 stable disease (SD)], 11/23 OSAs (1 PR and 10 SD), 12/15 thyroid carcinomas (4 PR and 8 SD), 7/8 head and neck carcinomas [1 complete response (CR), 5 PR and 1 SD] and 5/7 (1 CR and 4 SD) nasal carcinomas. For dogs experiencing CB, the median dose of toceranib was 2.8 mg kg(-1) , 36/63 (58.7%) were dosed on a Monday/Wednesday/Friday basis and 47/63 (74.6%) were treated 4 months or longer. Although these data provide preliminary evidence that toceranib exhibits CB in dogs with certain solid tumours, future prospective studies are necessary to define its true activity.

Modification of loco-regional microenvironment in brain tumors by spinal cord stimulation. Implications for radio-chemotherapy.

The effectiveness of radiotherapy and chemotherapy in high grade gliomas (HGG) depends on tumor micro-environment. We summarize our experience of the influence of spinal cord stimulation (SCS) on this micro-environment. Patients with HGG (n = 26) were assessed pre- and post-SCS, using: (1) Doppler in middle cerebral arteries (MCA) and (2) in common carotid arteries (CCA); (3) tumor blood-flow using single photon emission computed tomography (SPECT); (4) tumor-pO(2) (mmHg) using polarographic probes (eight tumor areas from five patients); and (5) tumor glucose metabolism using (18)F-fluoro-2-deoxyglucose ((18)FDG) positron emission tomography ((18)FDG-PET). Pre-SCS: tumor blood-flow was lower (P < 0.001) than peri-tumor areas and healthy contra-lateral areas. Tumor-pO(2) was lower (P < 0.042) than healthy tissue. Tumor glucose metabolism was higher than peri-tumor areas (P = 0.017) and healthy contra-lateral areas (P = 0.048). Post-SCS: there were increases in: MCA blood-flow (P ≤ 0.002), CCA blood-flow (P ≤ 0.013), tumor blood-flow (P = 0.033), tumor glucose metabolism (P = 0.027) and tumor-pO(2) (P = 0.022). The percentage of hypoxic values decreased (P = 0.007). SCS can modify tumor micro-environment. The potential usefulness of SCS in improving the effectiveness of radio-chemotherapy in HGG needs to be evaluated.

Erupción forzada ortodóncica: Rápida vs. lenta. Revisión crítica de la literatura / No disponible

La erupción forzada ortodoncica se ha convertido en un arma terapéutica de rutina en la practica clínica. Las indicaciones de esta técnica podemos clasificarlas en tres grupos: a) tratamiento de dientes cariados o fracturados subgingivalmente; b) tratamiento de defectos periodontales aislados, yc) mejora del futuro lugar de colocación de un implante osteointegrado. Si bien parece existir un consenso en el uso de fuerzas ligeras y constantes para conseguir la erupción de diente, los términos erupción forzada rápida o lenta aparecen de forma constante en la literatura y lecciones magistrales de expertos sin que aparentemente quede claro en qué consiste dicha diferenciación o qué consecuencias puede traer el uso de uno u otro protocolo. El objetivo de este trabajo es revisar de manera critica la literatura, realizando una búsqueda bibliográfica con el fin de identificar los artículos más relevantes que aporten claridad a esta cuestión. Los estudios seleccionados fueron revisados y divididos en datos clínicos y animales. La erupción ortodoncica forzada se presenta, una vez concluida nuestra revisión, como una técnica adjunta valida y favorable. A pesar de ser una técnica ampliamente descrita en la literatura, parece existir una ausencia de estudios rigurosos que propongan protocolos estándares de tratamiento. Los términos erupción forzada rápida o lenta se usan de manera aleatoria sin que ningún estudio avale tal diferenciación, sin que existan datos claros que nos permitan diferenciar entre estos dos protocolos, planteándose asila necesidad de realizar estudios prospectivos y controlados (AU)

Forced eruption is defined as an orthodontic movement in a coronal direction through the application of light and continued forces to cause changes in the soft tissue and bone. The indications for this technique can be classified into three groups: a) treatment of decayed or fractured teeth subgingivally b) treatment of isolated periodontal defects, and c) improving bone and soft tissue for future implant sites. However, there seems to be controversy regarding the use of extrusion as a fast or slow technique. The aim of this paper is to critically review the literature regarding forced eruption and extrusion techniques. We conducted a literature search to identify the most relevant articles. These studies were then reviewed and divided into animal and clinical data. Despite being widely reported in the literature, there seems to be a lack of rigorous studies that propose standard protocols of treatment. The terms fast or slow forced eruption are used in a random way without any studies that support such differentiation. Orthodontic forced eruption seems to be a valid and favorable adjunctive technique. There is no clear data, however, that allows us to differentiate between fast or slow forced eruption thus raising the need for prospective and controlled studies (AU)

La extracción seriada: Manejo ortodóncico y aplicación clínica (2ª parte) / No disponible

Dentro del campo del tratamiento ortodoncico en dentición mixta, la exodoncia seriada ocupa una parcela de gran importancia. Quizás con el paso del tiempo esta terapia no tiene la vigencia que su eficiencia conlleva. Las situaciones que suponen una alteración en la secuencia eruptiva normal, -debidas fundamentalmente a la falta severa de espacio disponible en la arcada dentaria,- son su indicación preferente. Este procedimiento, mediante un manejo sencillo pero correctamente indicado, solventa estas alteraciones que pueden modificar o impedir el recambio dentario. En estos dos trabajos se intenta analizar cuales son los condicionantes, indicaciones y mecánicas a seguir, además de establecer los criterios terapéuticos para su realización (AU)

Regarding orthodontic treatment in the mixed dentition, serial extraction has an important role. This clinical approach is not used as frequent as it should be, considering the efficiency behind the procedure. The main indication for this technique is an alteration of normal eruption sequence caused by a severe arch-length-tooth-size discrepancy. This procedure, through an easy clinical management, can help tooth eruption disturbances. In this second-part series, the authors will establish the diagnostic criteria for the clinical management of serial extraction in orthodontic practice (AU)

Artículo de revisión: Sistemas y tipos de retención / No disponible

El manejo del tiempo posterior a la finalización de caso resulta de extremada importancia, tanto como el propio tratamiento en sí. Son muchas y variadas las formas de ejercerla contención del mismo. Existen diferentes corrientes acerca de estos métodos. Existen sistemas fijos o removibles, utilizados de forma temporal o permanente, así también la necesidad de retención según la calidad y estabilidad de los resultados obtenidos. En este artículo realizamos una revisión de la literatura, para intentar exponer las diferentes alternativas en los sistemas y tipos de retención y poder establecer unas pautas consensuadas sobre la actuación en la etapa siguiente al tratamiento activo (AU)

The management of the retention period after comprehensive orthodontic treatment is of paramount importance, as treatment itself. There are many retention protocols in the orthodontic literature. Different schools regarding retention needs and methods also are described in this review paper. Fixed and removable, semi-permanent and permanent retainers are found among the clinical preferences of different authors, depending on the quality and stability of treatment results. In this paper, a review of the literature was conducted to present the different approaches to orthodontic retention systems and to establish consensus clinical guidelines (AU)

Evaluación de la calidad docente y promoción del profesorado (VII). Legislación universitaria española (e): modificación de la Ley Orgánica de Universidades. Profesorado contratado permanente (2004-2008) / Evaluation of teaching and faculty promotion (VII). University Spanish legislation (e): modification of the Organic Law of Universities. Recruited staff with indefinite contract (2004-2008)

La Ley Orgánica de Modificación de la Ley Orgánica de Universidades (LOMLOU), promulgada el año 2007, incluyó disposiciones referentes al profesorado contratado doctor (PCD) que supusieron la consolidación de la vía laboral como alternativa a la vía funcionarial en la carrera universitaria. La Ley estableció que la contratación de los PCD sería de carácter indefinido y con dedicación a tiempo completo, determinó que dichos profesores tenían plena capacidad docente e investigadora, reconoció su condición de elegibles para los órganos unipersonales de gobierno (salvo para el cargo de rector), les atribuyó voto ponderado en la constitución del claustro universitario y en la elección de rector y, mediante modificación de la Ley General de Sanidad, determinó que podría establecerse vinculación de plazas asistenciales con plazas de PCD. Por lo que respecta a los requisitos para acceder a una plaza de PCD, la LOMLOU suprimió la necesidad de acreditar tres años de actividad docente e investigadora, establecida por la LOU, pero mantuvo como requisito una evaluación positiva por parte de un órgano externo (acreditación). En este artículo se analizan comparativamente los procesos de acreditación desarrollados por la Agencia Nacional de Evaluación de la Calidad y Acreditación (ANECA) y por los órganos de evaluación establecidos por las diversas comunidades autónomas, así como los concursos de acceso alas plazas convocadas por las universidades. Además, se describen las características de las diversas figuras de PCD establecidas por las comunidades autónomas (AU)

The Organic Law of Modification of the Organic Law of Universities (LOMLOU), promulgated the year 2007, included referring dispositions to the recruited professors with doctorate qualification (PCDs) that supposed the consolidation of the direct contracting way as alternative to the way functionarial in the academic career. The Law established that the contract of the PCDs would be indefinite and with full-time dedication. Determined that these professors had full autonomy in teaching and research, recognized their condition of eligible for the individual organs of government (save for the charge of Rector) and attributed them balanced votein the University Cloister and in the election of Rector. Furthermore, by means of modification of the General Law of Health, the LOMLOU determined that could be established linking of welfare positions with positions of PCD. For which it concerns to the requirements to achieve to a position of PCD, the Law suppressed the need to accredit three years of teaching and researcher, established by the previous Law of Universities; but maintained as requirement a positive evaluation of teaching and research by an external assessment body (accreditation).This article analyzes comparatively the processes of accreditation developed by the National Agency of Evaluation of the Quality and Acreditation (ANECA) and by the assessment bodies pecified by the Regional Autonomous Community laws, as well as the recruitment processes developed by the universities. Besides, the characteristics of the diverse figures of PCD established by the Autonomous Communities are described (AU)

¿Es necesaria la técnica combinada para la detección del ganglio centinela en el cáncer de mama? / No disponible

Objetivos: Determinar si la punción con colorante mejora los resultados de la biopsia del ganglio centinela. Material y métodos: Ciento cincuenta casos de carcinoma invasor de la mama fueron sometidos a biopsia del ganglio centinela mediante técnica combinada, para determinar si la punción con colorante es rentable. Se realizó inyección subareolar indérmica de una dosis de 0,4 mCi de radioisótopico el día previo a la cirugía. Se practicó gammagrafía en todos los casos. La inyección intraparenquimatosa de 4 cc. de colorante se realizó 20 minutos antes de la cirugía, y se siguió de masaje mamario. Resultados: La tasa de migración fue 92,3% para el radioisótopo y 75% para el colorante (p = 0,01). La media de ganglios resecados fue mayor para la técnica con colorante: 2,6 vs. 1,2 (p = 0,02). No se observaron diferencias en la tasa de falsos negativos (0,2 vs. 0,4) ni en el valor predictivo negativo. La precisión diagnóstica fue mayor para el radioisótopo (90,3% vs. 75% (p = 0,001). El mismo resultado se obtuvo para el porcentaje de éxito técnico (92,3 vs. 75% (0,001)). Conclusiones: La punción con colorante no añade información a la realizada con radioisótopo. A pesar de que la técnica se debe adaptar a las necesidades del centro y a las habilidades del cirujano, una vez superada la curva de validación la técnica radioisotópica por sí misma aporta suficiente información, con menor morbilidad y coste(AU)

Objetives: To determine whether blue dye enhances sentinel node biopsy detection. Material and methods: One hundred fifty hundred consecutive cases of breast cancer were submitted to sentinel node biopsy by combined technique in order to analyze if vital blue was cost-efective. Radioisotope dose was 0,4 mCi of Tc, subareolar intradermic inyection, the day before surgery. Gammagraphy was performed in every case. Colorant was methylene blue, 4 cc administered by intraparenchimatous inyection in upper-outer quadrant 20 minutes previous to surgery, followed by breast massagge. Results: Migration rate was 92.3% for radioisotope and 75% for colorant (p = 0.01). Mean number of nodes excised was higher for colorant: 2,6 vs. 1,2 (p = 0.02). False negative rate showed no difference (0.2 vs. 0.4) nor did negative predictive value. Accuracy to staging (True neg+ true pos./total) was higher for technecium (90.3% vs. 75% (p = 0.001) and so happenned with percentage of technical success (total- no migration): 92.3% vs. 75% (0.001). Conclusions: Colorant did no add any information concerning axillary status. More nodes had to be excised, and bigger incisions were made to achieve direct visualization. Accuracy to stage the lesion and percentage of technical success were higher with radioisotope after the learning curve is achieved and blue injection can be spared(AU)

Study of external root resorption during orthodontic treatment in root filled teeth compared with their contralateral teeth with vital pulps.

AIM: To determine whether root filled teeth and those with vital pulps exhibit a similar degree of external root resorption (ERR) as a consequence of orthodontic treatment. METHODOLOGY: The study sample consisted of 77 patients, with a mean age of 32.7 +/- 10.7 years, who had one root filled tooth before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the root filled tooth and that in its contralateral tooth with a vital pulp. The student's t-test, anova and logistic regression analysis were used to determine statistical significance. RESULTS: The mean PRR was 1.00 +/- 0.13, indicating that, in the total sample, there were no significant differences in root resorption in the root filled teeth and their contralateral teeth with vital pulps. Multivariate logistic regression analysis suggested that PRR was significantly greater in incisors (P = 0.0014; odds ratio = 6.2885, C.I. 95% = 2.0-19.4), compared to other teeth, and in women (P = 0.0255; odds ratio = 4.2, C.I. 95% = 1.2-14.6), compared to men. CONCLUSIONS: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root filled teeth and their contralateral teeth with vital pulps.

Pattern of antibiotic prescription in the management of endodontic infections amongst Spanish oral surgeons.

AIM: To identify antibiotic prescription practices in the treatment of endodontic infections amongst Spanish oral surgeons. METHODOLOGY: Members of the Spanish Oral Surgery Society (SECIB) were surveyed on antibiotic prescription on six different pulpal and periapical diagnoses. A total of 200 questionnaires were delivered with 127 returned (64%). RESULTS: The average duration of antibiotic therapy was 7.0 +/- 1.0 days. Ninety five percent of respondents selected amoxicillin as the first choice antibiotic in patients with no medical allergies, alone (34%) or associated to clavulanate (61%). The first drug of choice for patients with an allergy to penicillins was clindamycin 300 mg (65%), followed by azithromycin (15%) and metronidazole-spiramycin (13%). For cases of irreversible pulpitis, 86% of respondents prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis and no swelling, 71% prescribed antibiotics. Almost 60% of respondents prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract; in this clinical situation, odontologists prescribed more frequently antibiotics compared to stomatologists (P = 0.0080; odds ratio = 8.0; C. I. 95% = 1.7-37.1). CONCLUSIONS: The majority of the members of the SECIB were selecting the appropriate antibiotic for use in endodontic infections, but there are still many who are prescribing antibiotics inappropriately. The use of antibiotics for minor infections, or in some cases in patients without infections, could be a major contributor to the world problem of antimicrobial resistance.