Serum and Urine Metabolomic Profiling of Newly Diagnosed Treatment-Naïve Inflammatory Bowel Disease Patients.

BACKGROUND AND AIMS: Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease associated with profound metabolic changes. The discovery of novel molecular indicators for unraveling IBD etiopathogenesis and the diagnosis and prognosis of IBD is therefore pivotal. We sought to determine the distinctive metabolic signatures from the different IBD subgroups before treatment initiation. METHODS: Serum and urine samples from newly diagnosed treatment-naïve IBD patients and age and sex-matched healthy control (HC) individuals were investigated using proton nuclear magnetic resonance spectroscopy. Metabolic differences were identified based on univariate and multivariate statistical analyses. RESULTS: A total of 137 Crohn's disease patients, 202 ulcerative colitis patients, and 338 HC individuals were included. In the IBD cohort, several distinguishable metabolites were detected within each subgroup comparison. Most of the differences revealed alterations in energy and amino acid metabolism in IBD patients, with an increased demand of the body for energy mainly through the ketone bodies. As compared with HC individuals, differences in metabolites were more marked and numerous in Crohn's disease than in ulcerative colitis patients, and in serum than in urine. In addition, clustering analysis revealed 3 distinct patient profiles with notable differences among them based on the analysis of their clinical, anthropometric, and metabolomic variables. However, relevant phenotypical differences were not found among these 3 clusters. CONCLUSIONS: This study highlights the molecular alterations present within the different subgroups of newly diagnosed treatment-naïve IBD patients. The metabolomic profile of these patients may provide further understanding of pathogenic mechanisms of IBD subgroups. Serum metabotype seemed to be especially sensitive to the onset of IBD.

Determinación del abordaje clínico restaurativo de dientes tratados con endodoncia (Clínicas Facultad de Odontología de la Universidad de El Salvador) / Determination of the restorative clinical approach of teeth treated with endodontics (Clinics Faculty of Dentistry of the University of El Salvador)

Objetivo principal: de esta investigación fue sondear la preferencia en la restauración de dientes que han recibido tratamiento de endodoncia entre docentes-tutores y estudiantes del Área de Restaurativa de la Facultad de Odontología de la Universidad de El Salvador. Metodología: La técnica de recolección de datos utilizada para esta investigación fue la entrevista y como instrumento fue utilizado el cuestionario el cual fue contestado por 12 docentes tutores y 19 estudiantes de IX y X ciclo respectivamente programados en el Área de Restaurativa de esta Facultad; para la obtención de los datos el grupo investigador se dividió los instrumentos (cuestionario) en partes iguales de la siguiente manera: encuestador 1: 17 instrumentos, encuestador 2: 17 instrumentos y encuestador 3: 16 instrumentos; el proceso de recolección de datos se realizo dentro de las Clínicas de Restaurativa de esta Facultad, durante el turno de 7:00am a 9:00am (turno de restaurativa de IX ciclo) y de 1:00pm a 3:00pm (turno de restaurativa de X ciclo); solicitándole permiso al docente encargado del Área de Restaurativa. Una vez obtenida toda la información necesaria para realizar la investigación se procedió a revisa r todos y cada uno de los instrumentos utilizados en la recolección de los datos. Para la tabulación de los instrumentos fue necesaria la elaboración de una hoja tabular general (Anexo 2). Posteriormente se realizó el vaciado de los mismos por medio de hojas electrónicas de Excel para efectuar sumas y promedios a través de filtros que nos proporciona este programa. El resumen de los resultados obtenidos se presentó a través de gráficos de barra. Resultados: un 91.67% de docentes tutores y un 94.74 % estudiantes encuestados concuerdan al manifestar que la estructura dental remanente es el parámetro que mas toman en cuenta para decidir si se coloca o no un poste para la reconstrucción de dientes tratados con endodoncia. Tanto docentes como estudiantes coinciden respecto a que la reconstrucción con resina es el tratamiento restaurador indicado en el caso de dientes que cuentan con cuatro paredes dentales remanentes posterior al tratamiento de endodoncia, ya que un 91.67% de docentes y un 73.68% de estudiantes eligió esta alternativa como primera opción. En dientes que han perdido una o dos paredes dentarias remanentes un 50% de los docentes y un 52.63% respondieron que reconstruyen estos dientes con poste mas resina; un 41.67% de los docentes encuestados manifestaron indicar una corona en este caso; y solamente un 23.68% de estudiantes manifestaron reconstruir con resina este tipo de dientes. Cuando solo resta una pared de estructura dentaria remanente un 91.67% docentes y un 71.05% de estudiantes respondieron que colocan poste colado, y un 28.95% de alumnos colocaría una corona en este tipo de dientes. Reconstrucción con poste mas resina según los resultados de este estudio es el tratamiento restaurador que se realiza con mayor frecuencia dentro de la Facultad ya que tanto docentes (83.33%), como estudiantes (73.68%) coincidieron en la apreciación que tienen al respecto. El 33.33% de los docentes y el 36.84% de los alumnos respondieron que si se basan en una guía al momento de decidir el tratamiento restaurador en dientes tratados con endodoncia dentro de esta Facultad y el 66.67% de los docentes y un 63.16% de los alumnos estudiantes respondieron que no se basan en ninguna guía. Al sondear entre docentes y estudiantes si consideran que dentro de la Facultad de Odontología de la Universidad de El Salvador se unifican criterios entre los docentes tutores del Área de Restaurativa al momento de seleccionar el tratamiento restaurador de dientes que han recibido previamente tratamiento de endodoncia, un 66.67% de docentes respondió que algunas veces y un 33.33% respondió que casi siempre. En cuanto a los estudiantes encuestados un 52.63% respondió que algunas veces y un 28.65% respondió que nunca. El 50% de docentes y el 50% de alumnos coincidieron al responder que si conocen una guía que les facilite la selección del tratamiento restaurador en dientes tratados con endodoncia de igual manera un 50% de los docentes y el 50% de los alumnos concordaron al responder que desconocen una guía. Conclusiones: Según los docentes y alumnos encuestados el parámetro que mas toman en cuenta para la selección de los diversos tratamientos en dientes tratados con endodoncia es la cantidad de estructura dentaria remanente. La apreciación de los docentes y alumnos encuestados es que el tratamiento restaurador que se realiza con mayor frecuencia en dientes tratados con endodoncia dentro de la Facultad de Odontología de la Universidad de El Salvador es poste mas resina.

Main objective: of this research was to probe the preference in the restoration of teeth that have received endodontic treatment among teachers-tutors and students of the Restorative Area of ​​the Faculty of Dentistry of the University of El Salvador. Methodology: The data collection technique used for this research was the interview and the questionnaire was used as an instrument, which was answered by 12 tutors and 19 students of the IX and X cycle respectively programmed in the Restorative Area of ​​this Faculty; To obtain the data, the research group divided the instruments (questionnaire) into equal parts as follows: surveyor 1: 17 instruments, surveyor 2: 17 instruments and surveyor 3: 16 instruments; The data collection process was carried out within the Restorative Clinics of this Faculty, during the shift from 7:00 am to 9:00 am (restorative shift of IX cycle) and from 1:00 pm to 3:00 pm (restorative shift of X cycle); requesting permission from the teacher in charge of the Restorative Area. Once all the information necessary to carry out the research had been obtained, each and every one of the instruments used in data collection was reviewed. For the tabulation of the instruments, it was necessary to prepare a general tabular sheet (Annex 2). Subsequently, they were emptied by means of electronic Excel sheets to make sums and averages through filters provided by this program. The summary of the results obtained was presented through bar graphs. Results: 91.67% of tutors teachers and 94.74% surveyed students agree when stating that the remaining dental structure is the parameter that they most take into account when deciding whether or not to place a post for the reconstruction of teeth treated with endodontics. Both teachers and students agree that resin reconstruction is the restorative treatment indicated in the case of teeth that have four remaining dental walls after endodontic treatment, since 91.67% of teachers and 73.68% of students chose this alternative as first choice. In teeth that have lost one or two remaining dental walls, 50% of the teachers and 52.63% responded that they reconstruct these teeth with a post plus resin; 41.67% of the teachers surveyed stated that they indicated a crown in this case; and only 23.68% of students stated that they reconstruct this type of teeth with resin. When only one wall of remaining tooth structure remains, 91.67% teachers and 71.05% of students answered that they place a cast post, and 28.95% of students would place a crown on this type of teeth. Reconstruction with a post plus resin, according to the results of this study, is the restorative treatment that is performed most frequently within the Faculty since both teachers (83.33%) and students (73.68%) agreed in their appreciation in this regard. 33.33% of the teachers and 36.84% of the students answered that if they are based on a guide when deciding the restorative treatment in teeth treated with endodontics within this Faculty and 66.67% of the teachers and 63.16% of the student students responded that they are not based on any guideline. When probing among teachers and students if they consider that within the Faculty of Dentistry of the University of El Salvador criteria are unified among the tutors of the Restorative Area when selecting the restorative treatment of teeth that have previously received endodontic treatment, a 66.67% of teachers answered that sometimes and 33.33% answered that almost always. As for the students surveyed, 52.63% answered that sometimes and 28.65% answered that never. 50% of teachers and 50% of students agreed when answering that if they know a guide that facilitates the selection of restorative treatment in teeth treated with endodontics, in the same way, 50% of teachers and 50% of students agreed to the answer that they do not know a guide. Conclusions: According to the teachers and students surveyed, the parameter that they most take into account for the selection of the various treatments in teeth treated with endodontics is the amount of remaining tooth structure. The assessment of the teachers and students surveyed is that the restorative treatment that is most frequently performed on teeth treated with endodontics within the Faculty of Dentistry of the University of El Salvador is post plus resin.