Saliva Decreases Sucrose-Induced Cariogenicity in an Experimental Biological Caries Model.

OBJECTIVE: Whether a minimum quantity of saliva inhibit the caries process remains uncertain. This study aimed to investigate the impact of saliva dilutions on an in vitro caries model using Streptococcus mutans (S. mutans) biofilms. METHODS: S. mutans biofilms were cultivated on enamel and root dentin slabs, in culture media containing different proportions of saliva (v/v): 0%, 5%, 10%, 25%, 50%, 75%, and 100% saliva, and exposed to a 10% sucrose solution (5 min, 3x/day), with appropriate controls. After 5 (enamel) and 4 (dentin) days, demineralization, biomass, viable bacteria, and polysaccharide formation were analyzed. The acidogenicity of the spent media was monitored overtime. Each assay was performed in triplicate across two independent experiments (n = 6). RESULTS: In both enamel and dentin, an inverse relationship was observed between acidogenicity, demineralization, and the proportion of saliva. Even small quantities of saliva incorporated into the media led to a noticeable reduction in enamel and dentin demineralization. Saliva presence resulted in significant reductions in biomass, viable S. mutans cells, and polysaccharides, with the effects being concentration-dependent for both tissues. CONCLUSIONS: High quantities of saliva can almost completely inhibit sucrose-induced cariogenicity, while even small amounts exhibit a dose-dependent caries-protective effect.

Therapeutic variability in infants admitted to Latin-American pediatric intensive units due to acute bronchiolitis. / Variabilidad terapéutica en lactantes con bronquiolitis hospitalizados en unidades de cuidados intensivos latinoamericanas.

The objective of this study was to describe the management of infants with acute bronchiolitis admit ted to 20 pediatric intensive care units (PICU) members of LARed in 5 Latin American countries. Pa tients and Method: Retrospective, multicenter, observational study of data from the Latin American Registry of Acute Pediatric Respiratory Failure. We included children under 2 years of age admitted to the PICU due to community-based acute bronchiolitis between May and September 2017. Demo graphic and clinical data, respiratory support, therapies used, and clinical results were collected. A subgroup analysis was carried out according to geographical location (Atlantic v/s Pacific), type of insurance (Public v/s Private), and Academic v/s non-Academic centers. Results: 1,155 patients were included in the registry which present acute respiratory failure and 6 were excluded due to the lack of information in their record form. Out of the 1,147 patients, 908 were under 2 years of age, and out of those, 467 (51.4%) were diagnosed with acute bronchiolitis, which was the main cause of admission to the PICU due to acute respiratory failure. The demographic and severity characteristics among the centers were similar. The most frequent maximum ventilatory support was the high-flow nasal can nula (47%), followed by non-invasive ventilation (26%) and invasive mechanical ventilation (17%), with a wide coefficient of variation (CV) between centers. There was a great dispersion in the use of treatments, where the use of bronchodilators, antibiotics, and corticosteroids, representing a CV up to 400%. There were significant differences in subgroup analysis regarding respiratory support and treatments used. One patient of this cohort passed away. Conclusion: we detected wide variability in respiratory support and treatments among Latin American PICUs. This variability was not explained by demographic or clinical differences. The heterogeneity of treatments should encourage collabora tive initiatives to reduce the gap between scientific evidence and practice.

Variabilidad terapéutica en lactantes con bronquiolitis hospitalizados en unidades de cuidados intensivos latinoamericanas / Therapeutic variability in infants admitted to Latin-American pediatric intensive units due to acute bronchiolitis

Resumen: Objetivo: describir las terapias utilizadas en lactantes con bronquiolitis aguda admitidos en 20 Uni dades de Cuidados Intensivos (UCI) pediátricos miembros de LARed en 5 países latinoamerica nos. Pacientes y Método: Estudio observacional retrospectivo, multicéntrico, de datos del Registro Latinoamericano de Falla Respiratoria Aguda Pediátrica. Se incluyeron niños menores de 2 años ingresados a UCI pediátrica por bronquiolitis aguda comunitaria entre mayo-septiembre 2017. Se recolectaron datos demográficos, clínicos, soporte respiratorio, terapias utilizadas y resultados clí nicos. Se realizó análisis de subgrupos según ubicación geográfica, tipo financiación y presencia de academia. Resultados: Ingresaron al registro 1155 pacientes con falla respiratoria aguda. Seis casos fueron excluidos por no tener formulario completo. De los 1147 pacientes, 908 eran menores de 2 años. De ellos, 467 tuvieron diagnóstico de bronquiolitis aguda, correspondiendo a la principal causa de ingreso a UCI pediátrica por falla respiratoria aguda (51,4%). Las características demográficas y de gravedad entre los centros fueron similares. El soporte máximo respiratorio más frecuente fue cánula nasal de alto flujo (47%), seguido por ventilación mecánica no invasiva (26%) y ventilación mecánica invasiva (17%), con un coeficiente de variación (CV) amplio entre los centros. Hubo una gran dispersión en uso de terapias, siendo frecuente el uso de broncodilatadores, antibióticos y corticoides, con CV hasta 400%. El análisis de subgrupos mostró diferencias significativas en soporte respiratorio y tratamientos utilizados. Un paciente falleció en esta cohorte. Conclusión: Detectamos gran variabilidad en el soporte respiratorio y tratamientos entre UCI pediátricas latinoamericanas. Esta variabilidad no es explicada por disparidades demográficas ni clínicas. Esta heterogeneidad de tratamientos debería promover iniciativas colaborativas para disminuir la brecha entre la evidencia científica y la práctica asistencial.

Abstract: The objective of this study was to describe the management of infants with acute bronchiolitis admit ted to 20 pediatric intensive care units (PICU) members of LARed in 5 Latin American countries. Pa tients and Method: Retrospective, multicenter, observational study of data from the Latin American Registry of Acute Pediatric Respiratory Failure. We included children under 2 years of age admitted to the PICU due to community-based acute bronchiolitis between May and September 2017. Demo graphic and clinical data, respiratory support, therapies used, and clinical results were collected. A subgroup analysis was carried out according to geographical location (Atlantic v/s Pacific), type of insurance (Public v/s Private), and Academic v/s non-Academic centers. Results: 1,155 patients were included in the registry which present acute respiratory failure and 6 were excluded due to the lack of information in their record form. Out of the 1,147 patients, 908 were under 2 years of age, and out of those, 467 (51.4%) were diagnosed with acute bronchiolitis, which was the main cause of admission to the PICU due to acute respiratory failure. The demographic and severity characteristics among the centers were similar. The most frequent maximum ventilatory support was the high-flow nasal can nula (47%), followed by non-invasive ventilation (26%) and invasive mechanical ventilation (17%), with a wide coefficient of variation (CV) between centers. There was a great dispersion in the use of treatments, where the use of bronchodilators, antibiotics, and corticosteroids, representing a CV up to 400%. There were significant differences in subgroup analysis regarding respiratory support and treatments used. One patient of this cohort passed away. Conclusion: we detected wide variability in respiratory support and treatments among Latin American PICUs. This variability was not explained by demographic or clinical differences. The heterogeneity of treatments should encourage collabora tive initiatives to reduce the gap between scientific evidence and practice.

Woody vegetation dynamics in the tropical and subtropical Andes from 2001 to 2014: Satellite image interpretation and expert validation.

The interactions between climate and land-use change are dictating the distribution of flora and fauna and reshuffling biotic community composition around the world. Tropical mountains are particularly sensitive because they often have a high human population density, a long history of agriculture, range-restricted species, and high-beta diversity due to a steep elevation gradient. Here we evaluated the change in distribution of woody vegetation in the tropical Andes of South America for the period 2001-2014. For the analyses we created annual land-cover/land-use maps using MODIS satellite data at 250 m pixel resolution, calculated the cover of woody vegetation (trees and shrubs) in 9,274 hexagons of 115.47 km2 , and then determined if there was a statistically significant (p < 0.05) 14 year linear trend (positive-forest gain, negative-forest loss) within each hexagon. Of the 1,308 hexagons with significant trends, 36.6% (n = 479) lost forests and 63.4% (n = 829) gained forests. We estimated an overall net gain of ~500,000 ha in woody vegetation. Forest loss dominated the 1,000-1,499 m elevation zone and forest gain dominated above 1,500 m. The most important transitions were forest loss at lower elevations for pastures and croplands, forest gain in abandoned pastures and cropland in mid-elevation areas, and shrub encroachment into highland grasslands. Expert validation confirmed the observed trends, but some areas of apparent forest gain were associated with new shade coffee, pine, or eucalypt plantations. In addition, after controlling for elevation and country, forest gain was associated with a decline in the rural population. Although we document an overall gain in forest cover, the recent reversal of forest gains in Colombia demonstrates that these coupled natural-human systems are highly dynamic and there is an urgent need of a regional real-time land-use, biodiversity, and ecosystem services monitoring network.

Implementation of preemptive fluid strategy as a bundle to prevent fluid overload in children with acute respiratory distress syndrome and sepsis.

BACKGROUND: Fluid overload (FO) is associated with unfavorable outcomes in critically ill children. Clinicians are encouraged to avoid FO; however, strategies to avoid FO are not well-described in pediatrics. Our aim was to implement a bundle strategy to prevent FO in children with sepsis and pARDS and to compare the outcomes with a historical cohort. METHODS: A quality improvement initiative, known as preemptive fluid strategy (PFS) was implemented to prevent early FO, in a 12-bed general PICU. Infants on mechanical ventilation (MV) fulfilling pARDS and sepsis criteria were prospectively recruited. For comparison, data from a historical cohort from 2015, with the same inclusion and exclusion criteria, was retrospectively reviewed. The PFS bundle consisted of 1. maintenance of intravenous fluids (MIVF) at 50% of requirements; 2. drug volume reduction; 3. dynamic monitoring of preload markers to determine the need for fluid bolus administration; 4. early use of diuretics; and 5. early initiation of enteral feeds. The historical cohort treatment, the standard fluid strategy (SFS), were based on physician preferences. Peak fluid overload (PFO) was the primary outcome. PFO was defined as the highest FO during the first 72 h. FO was calculated as (cumulative fluid input - cumulative output)/kg*100. Fluid input/output were registered every 12 h for 72 h. RESULTS: Thirty-seven patients were included in the PFS group (54% male, 6 mo (IQR 2,11)) and 39 with SFS (64%male, 3 mo (IQR1,7)). PFO was lower in PFS (6.31% [IQR4.4-10]) compared to SFS (12% [IQR8.4-15.8]). FO was lower in PFS compared to CFS as early as 12 h after admission [2.4(1.4,3.7) v/s 4.3(1.5,5.5), p < 0.01] and maintained during the study. These differences were due to less fluid input (MIVF and fluid boluses). There were no differences in the renal function test. PRBC requirements were lower during the first 24 h in the PFS (5%) compared to SFS (28%, p < 0.05). MV duration was 81 h (58,98) in PFS and 118 h (85154) in SFS(p < 0.05). PICU LOS in PFS was 5 (4, 7) and in SFS was 8 (6, 10) days. CONCLUSION: Implementation of a bundle to prevent FO in children on MV with pARDS and sepsis resulted in less PFO. We observed a decrease in MV duration and PICU LOS. Future studies are needed to address if PFS might have a positive impact on health outcomes.

Health and Ecological Aspects of Stray Cats in Old San Juan, Puerto Rico: Baseline Information to Develop an Effective Control Program.

The overpopulation of stray cats in urban areas represents a potential risk for humans, as stray cats may carry diseases, such as toxoplasmosis, and virus such as rabies, the feline immunodeficiency, and the feline leukemia. In Old San Juan, a historic neighborhood and one of the most touristic places in Puerto Rico, there is an overpopulation of stray cats. In this study, we generated baseline information fundamental to developing a successful control program by estimating the stray cat population size, density, and spatial distribution. Furthermore, we quantified the number of neutered cats and developed a spatial database to include information about the external physical condition of each individual. We estimated a population of 178 (±21) cats, with a density of 3.6 cats/ha. Overall, we observed 209 cats, from which 149 (71%) were identified as new and 60 (29%) were recaptured. We found stray cats had a significant non-random and clustered spatial distribution (z-score = -19.39 SD; ratio = 0.29; p<0.0001), with an observable larger abundance in residential zones where food was provided. A total of 105 (70%) cats were neutered, and 32 (21%) individuals exhibited very poor physical conditions, including skin problems, scars, underweight, and blindness. We concluded that the ecological and descriptive data generated in this study are essential for an effective control of stray cats and their potential impacts on humans living in this neighborhood.

Patterns of doramectin tissue residue depletion in parasitized vs nonparasitized lambs.

The effect of gastrointestinal parasitism on patterns of edible tissue depletion of doramectin was studied in greyface Suffolk lambs. Twelve weight-matched pairs of lambs were allocated into group I (nonparasitized, pretreated with three administrations of 5 mg/kg fenbendazole) and group II (parasitized, did not receive anthelmintic treatment). Both groups were maintained together under similar conditions for 70 days, when they were treated with a subcutaneous dose of 0.2 mg/kg bw doramectin. At 7, 14, 21, and 28 days after doramectin administration, three lambs from each group were slaughtered and samples of liver, kidney, muscle, and fat were obtained. Pre-treatment with fenbendazole significantly reduced the nematode fecal egg count and significantly increased lamb body weight compared to the parasitized group. Doramectin was detected in all of the tissues up to 28 days post-treatment. Significantly higher and more persistent doramectin concentrations were found in the nonparasitized lambs compared to the parasitized animals. Considering the EMEA maximum residue limits for doramectin in fat, the calculated withdrawal period for the healthy lambs (43 days) was significantly higher than that for the parasitized animals (26 days).

Validación de un método analítico y determinación de residuos de invermectina en tejidos de ovino / Validation of an analytical method and determination of invermectin residues in sheep tissues

Se realizó un estudio con el objetivo de validar un método analítico sensible y confiable para la detección de residuos de ivermectina (IVM) en muestras de hígados, riñón, músculo y grasa, junto con determinar las concentraciones del fármaco en tejidos de ovinos tratados por vía subcutánea. Muestras de tejidos libres de fármaco fueron sobrecargadas con concentraciones de IVM entre 1 y 50 ng/g (hígado, riñón y músculo); 5 a 200 ng/g (grasa), luego fueron sometidas a extracción en fase sólida y analizados por cromatografía líquida de alta eficiencia (HPLC). Para el estudio de residuos se utilizaron 12 ovinos Suffolk Down de 27,8 ± 1,3 kg de peso, los que fueron tratados con 0,2 mg/kg de IVM vía subcutánea, luego se sacrificaron grupos de 3 animales a los 1,5; 7; 14 y 21 días post tratamiento. La ausencia de interferencias y una adecuada simetría de los cromatogramas indica una buena especificidad del método analítico empleado para la detección de IVM en los tejidos analizados. Los porcentajes de recuperación fluctuaron entre 70 a 93,2 por ciento. El límite de cuantificación se estableció en hígado: 0,48 ng/g; riñón: 1,02 ng/g; músculo:0,18ng/g y grasa: 2,65ng/g. La validación de la metodología analítica demostró adecuados valores de sensibilidad, presición y axactitud que permiten obtener resultados confiables para la detección y cuantificación de residuos de IVM en tejidos de ovinos. En los ovinos tratados con IVM, las mayores concentraciones de residuos fueron observadas a los 1,5 días post tratamiento en hígado (281,7 ± 116,95 ng/g) y grasa (248,67 ± 90,85 ng/g), los que persistieron hasta el día 21 con concentraciones de 0,63 ± 0,2 ng/g y 4,07 ± 2,25 ng/g, respectivamente. Las menores concentraciones de residuos de IVM fueron observadas en las muestras de músculo.

A study was undertaken in order to validate a precise and reliable analytical method for the detection of ivermectin’s (IVM) tissue residues in sheep, and to know the patterns of the drug concentrations depletion in edible tissues such as liver, kidney, muscle and fat, from treated animals by subcutaneous route. Drug free tissue samples were fortified with increasing concentrations of IVM (1 to 50 ng IVM/g for liver, kidney and muscle; and 5 to 200 ng IVM/g for adipose tissue) and then were subjected to solid phase extraction and analyzed by high performance liquid chromatography (HPLC). Twelve sheep weighing 27.8 ± 1.3 kg, were treated with 0.2 mg/kg of IVM by subcutaneous route, and then were slaughtered in groups of three animals at 1.5, 7.0, 14.0, and 21.0 days post treatment. The specificity of the method was demonstrated by the absence of interferences and the adequate symmetry of chromatograms. The percentage of recovery ranged from 70 to 93.2% for all tissues analyzed and different drug concentrations. The limit of quantification of the method was established in 0.48 ng/g for liver; 1.02 ng/g for kidney; 0.18 ng/g for muscle and 2.65 ng/g for adipose tissue. The validated analytical methodology showed satisfactory results of sensitivity, precision and accuracy that allow it use for the detection and quantification of tissue residues of IVM in sheep. From the tissues samples of sheep treated with IVM, the higher concentrations were found in liver (281.7 ± 116.95 ng/g) and adipose tissue (248.67 ± 90.85 ng/g) at 1.5 days, and the drug concentrations in both tissues were maintained for a period of 21 days post treatment with 0.63 ± 0.2 ng/g and 4.07 ± 2.25 ng/g respectively. The lowest concentrations of IVM in tissues were observed in muscle samples.

Separation and HPLC-MS identification of phenolic antioxidants from agricultural residues: almond hulls and grape pomace.

Almond hulls and grape pomace are residues abundantly generated by agricultural industries, which could be processed to obtain bioactive products. To this purpose, crude ethanol extracts from both agricultural byproducts were attained and subsequently fractionated in order to obtain an organic/water fraction (FOW). Extracts and fractions were analyzed for antioxidant power and their phenolic components tentatively identified by HPLC-MS. Chromatographic peaks of almond hull extracts showed the occurrence of hydroxybenzoic and cinnamic acid derivatives, with minor presence of flavan-3-ols (ECG, EGCG), whereas the FOW fraction offered the additional presence of epicatechin (EC) and glycosylated flavonols. In the composition for extracts of white and red grape pomace several of these compounds were also detected but basically consisted of glycosylated flavonols (quercetin, kaempferol). As a difference between both grape pomaces, myricetin glycosyde was found in that from the red variety, whereas flavan-3-ols (EC, afzelechin) were only identified in white pomace. When their FOW fractions were analyzed, gallic acid and some hydroxybenzoic acids were additionally detected. Antioxidant activity was assessed by DPPH and TBARS assays. Almond hulls showed inhibition percentages lower than 50% in both assays, while the inhibition percentage ranged from 80% to 90% in pomace extracts. Red grape pomace extract was the most efficient antioxidant, with an EC50 value of 0.91 g/L for TBARS and 0.20 g/L for DPPH. Even appearing as two quite different vegetal matrixes, the composition of phenolics in grape pomace and almond hulls is quite similar, the main difference being the major occurrence of flavonols in grape pomace. This fact could presumably explain the lower antiradical activity of hull extracts.

Tissue accretion and milk content of docosahexaenoic acid in female rats after supplementation with different docosahexaenoic acid sources.

BACKGROUND: Docosahexaenoic acid (DHA) is highly concentrated in the mammalian nervous and visual system. The fatty acid, which is required by the fetus and the newborn, is supplied by the mother from their tissue reservoirs. It has been suggested that mother's supplementation with DHA during pregnancy and even before pregnancy. Different sources of DHA are available for supplementation such as: single-cell algae triglycerides (TG), egg's yolk phospholipids (PL), DHA ethyl esther (EE), and sn-2 DHA monoacylglyceride (MG). We evaluated comparatively the effectiveness of these different DHA sources to produce tissue DHA accretion and to increase milk DHA content. METHODS: Female Wistar rats fed a diet which provided no DHA, were daily supplemented by 40 days before mating (BM) and during the pregnancy with either TG, PL, EE, or MG to an amount which provided 8 mg/kg b.w. of DHA. Samples of blood plasma, erythrocytes, hepatic and adipose tissue were obtained from rats at the BM condition and after the delivery (AD), and milk samples were also obtained from the gastric content of the pups nursed by the rats at day 3, 11 and 20 of suckling. Samples were processed to assess DHA and arachidonic acid (AA) content by gas-chromatography. RESULTS: TG, PL, EE, and MG supplementation produced a similar intestinal absorption of DHA as estimated from the plasma DHA at the BM condition. However, PL and MG supplementation produced a higher accretion of DHA into erythrocytes, hepatic, and adipose tissue than TG and EE supplementation at the BM condition. AA content was not modified by the different supplementing oils. A reduction of the DHA content of plasma, erythrocytes, hepatic and adipose tissue at the AD condition was observed, and a reduction of AA for the hepatic and adipose tissues was also observed, suggesting the importance of these tissues as DHA and AA reservoirs. Milk secretion from PL and MG supplemented rats showed a higher DHA content than secretion from TG- and EE-supplemented rats. CONCLUSIONS: We conclude that PL and MG supplementation provides higher tissue DHA accretion and higher milk DHA content than TG and EE supplementation. However, we were not able to visualize the comparative advantages derived from PL vs. MG supplementation.