Comment on Sallam, M. ChatGPT Utility in Healthcare Education, Research, and Practice: Systematic Review on the Promising Perspectives and Valid Concerns. Healthcare 2023, 11, 887.

We read with great interest and applaud the recently published review paper regarding ChatGPT and its implications in research and education [...].

Cleft Lip and Palate Midfacial Hypoplasia: Criteria to Choose the Treatment.

ABSTRACT: A series of skeletal and dentoalveolar/occlusal criteria were proposed for choosing the treatment modality for the management of midface hypoplasia in cleft lip/palate patients, focusing on functional improvement, aesthetics, and minimizing the risk of recurrence and secondary alterations. For which, 42 patients with nonsyndromic cleft lip/palate, all with previous primary lip/palate surgeries and without previous osteotomies, were analyzed. Orthognathic surgery (OS) (n = 24) and maxillary distraction osteogenesis (n = 18) with anterior segmental osteotomies (segmental distraction osteogenesis [SD]), alveolar transport disc (TD), and midface total distraction osteogenesis (TDO) by modified Le Fort III osteotomy was done.The average of maxillary advancement for OS was 5.58 ±â€Š0.83 mm, for SD 9.4 ±â€Š0.89 mm, for TD 8.00 ±â€Š1.00 mm, and for TDO was 8.13 ±â€Š1.55 mm.In the presence of infraorbital and/or zygomatic hypoplasia, TDO was performed using skeletal anchorage, with the requirement of occlusal stability in dental cast in occlusion. In short maxillary arch without dental cast feasibility in occlusion, hypodontia/agenesis or absence of premaxilla, TD and SD was performed. There was only 1 mm of recurrence in 1 patient of each group. Changes in speech were detected in 2 patients in the OS group (8.3%). Orthognathic surgery can be indicated for advancements ≤7 mm not requiring orbito-zygomatic advancement, whereas distraction osteogenesis can be indicated for advances >8 mm with or without the need for orbito-zygomatic advancement, in addition with other dentoalveolar factors and velopharyngeal function.

Intraspecific variation in sensitivity to food availability and temperature-induced phenotypic plasticity in the rotifer Keratella cochlearis.

Organisms with wide environmentally induced morphological plasticity and cosmopolitan distribution, e.g. the common freshwater rotifer Keratella cochlearis, are ideal models to study the evolution of plastic polymorphisms and the capacity of zooplankton to adapt to local selection conditions. We investigated population-level differences (population-by-environment interaction) in sensitivity to food availability and temperature-induced phenotypic plasticity between two clones of K. cochlearis isolated from neighboring populations in Ruidera Natural Park (Spain) with different trophic statuses: Tinaja lake (mesotrophic) and Cueva Morenilla lake (eutrophic). Using common-garden experiments, each clone proved to have a different sensitivity to food availability, with substantial phenotypic differences between them. When rotifers grew at moderate temperature (15.6°C), low food levels were more efficiently used by the Tinaja versus Cueva Morenilla clone, whereas high food levels were more efficiently used by the Cueva Morenilla versus Tinaja clone. The posterior spine was much longer and the lorica wider in the Tinaja versus Cueva Morenilla clone, with no difference in lorica length. Phylogenetic analysis based on cytochrome c oxidase subunit I (COI) gene sequences showed that the two populations have the same haplotype. This is the first study to show possible local adaptation by a rotifer species to habitats that consistently differ in food availability. We also detected an intriguing deviation from the expected negative relationship between posterior spine length and temperature. Our experimental results indicate that intermediate temperatures may activate the gene responsible for spine elongation in K. cochlearis This suggests that rotifers in nature could use water temperature as proxy signal of a change in predation risk before defense is needed.

Barcoding rotifer biodiversity in Mediterranean ponds using diapausing egg banks.

The biodiversity of Mediterranean freshwater bodies is among the most threatened worldwide; therefore, its accurate estimation is an urgent issue. However, traditional methods are likely to underestimate freshwater zooplankton biodiversity due to its high species seasonality and cryptic diversity. We test the value of applying DNA barcoding to diapausing egg banks, in combination with the creation of a reference collection of DNA barcodes using adult individual samples, to characterize rotifer communities. We use monogonont rotifers from two lakes in Doñana National Park and one from Ruidera Natural Park in Spain as models to create a reference collection of DNA barcodes for taxonomically diagnosed adult individuals sampled from the water column, to compare with the sequences obtained from individual eggs from the diapausing egg banks. We apply two different approaches to carry out DNA taxonomy analyses, the generalized mixed Yule coalescent method (GMYC) and the Automatic Barcode Gap Discovery (ABGD), to the obtained sequences and to publicly available rotifer sequences. We obtained a total of 210 new rotifer COI sequences from all three locations (151 diapausing eggs and 59 adults). Both GMYC and ABGD generated the same 35 operational taxonomic units (OTUs), revealing four potential cryptic species. Most sequences obtained from diapausing eggs (85%) clustered with sequences obtained from morphologically diagnosed adults. Our approach, based on a single sediment sample, retrieved estimates of rotifer biodiversity higher than or similar to those of previous studies based on a number of seasonal samples. This study shows that DNA barcoding of diapausing egg banks is an effective aid to characterize rotifer diversity in Mediterranean freshwater bodies.

Quiste folicular inflamatorio en posición atípica: Revisión de la literatura a propósito de un caso / Follicular inflammatory cyst in atypical location: Case report and literature review

Objetivos: Mostrar la importancia de la histopatología en el diagnóstico del quiste folicular inflamatorio para un correcto tratamiento y la relevancia de una nomenclatura precisa. Material y Métodos: Búsqueda en Pubmed, ScienceDirect, EBSCO-host de «odontogenic-cysts¼, «dentigerous cyst of inflammatory origin¼ y "follicular inflammatory-cyst¼ como key-words, full-text en inglés o español de los últimos 10 años. Resultados: Paciente 10 años de edad, presenta tumoración vestibular de zona de diente 5.3, de consistencia dura, asintomático y cubierto por mucosa normal. Diente asociado sin lesiones cariosas. La radiografía evidenció una extensa área radiolúcida bien definida, rodeando la corona del diente 1.3, desplazando y reteniéndolo. Tras evaluación radiográfica, los diagnósticos diferenciales fueron tumor-odontogénico-adenomatoide, queratoquiste y QD. La histopatología confirmó QFI. Originándose la lesión a partir de la pieza 5.4 con tratamiento pulpar. Conclusiones: Se debe considerar al QFI como una lesión similar a otros quistes inflamatorios (paradentales o radiculares). Se sugiere considerar en dentición mixta, que QFI y quiste radicular del diente temporal son la misma lesión y las diferencias en su aspecto clínico dependerán del tiempo de evolución y la relación de proximidad entre folículo y proceso inflamatorio del diente temporal.

Objectives: To show the importance of histopathology in the diagnosis of follicular inflammatory cyst for a correct treatment and the relevance of a precise nomenclature. Material and Methods: Pubmed search, ScienceDirect, EBSCO-host "odontogenic cysts", "inflammatory dentigerous cyst" and "follicular inflammatory cyst" as keywords, full text in English or Spanish for the last 10 years. Results: A 10-year-old patient presented vestibular tumor of the tooth area 5.3, with a hard consistency, asymptomatic and covered by normal mucosa. Associated tooth without carious lesions. The radiograph evidenced a radiolucent area with well-defined limits, around the crown of the tooth 1.3, displacing and retaining it. After radiographic evaluation, the differential diagnoses were tumor-odontogenic-adenomatoid, keratocyst and QD. Histopathology confirmed QFI. Originating the lesion from piece 5.4 with pulp treatment. Conclusions: The QFI should be considered as an similar to other inflammatory (paradental or root) cysts. It is suggested to consider in mixed dentition, that QFI and radicular cyst of the temporal tooth are the same lesion and the differences in their clinical aspect will depend on the evolution time and the proximity relation between follicle and inflammatory process of temporal temporal.

Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium.

The Dementia with Lewy Bodies (DLB) Consortium has refined its recommendations about the clinical and pathologic diagnosis of DLB, updating the previous report, which has been in widespread use for the last decade. The revised DLB consensus criteria now distinguish clearly between clinical features and diagnostic biomarkers, and give guidance about optimal methods to establish and interpret these. Substantial new information has been incorporated about previously reported aspects of DLB, with increased diagnostic weighting given to REM sleep behavior disorder and 123iodine-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. The diagnostic role of other neuroimaging, electrophysiologic, and laboratory investigations is also described. Minor modifications to pathologic methods and criteria are recommended to take account of Alzheimer disease neuropathologic change, to add previously omitted Lewy-related pathology categories, and to include assessments for substantia nigra neuronal loss. Recommendations about clinical management are largely based upon expert opinion since randomized controlled trials in DLB are few. Substantial progress has been made since the previous report in the detection and recognition of DLB as a common and important clinical disorder. During that period it has been incorporated into DSM-5, as major neurocognitive disorder with Lewy bodies. There remains a pressing need to understand the underlying neurobiology and pathophysiology of DLB, to develop and deliver clinical trials with both symptomatic and disease-modifying agents, and to help patients and carers worldwide to inform themselves about the disease, its prognosis, best available treatments, ongoing research, and how to get adequate support.

Evolution of clinical features in possible DLB depending on FP-CIT SPECT result.

OBJECTIVE: To test the hypothesis that core and suggestive features in possible dementia with Lewy bodies (DLB) would vary in their ability to predict an abnormal dopamine transporter scan and therefore a follow-up diagnosis of probable DLB. A further objective was to assess the evolution of core and suggestive features in patients with possible DLB over time depending on the (123)I-FP-CIT SPECT scan result. METHODS: A total of 187 patients with possible DLB (dementia plus one core or one suggestive feature) were randomized to have dopamine transporter imaging or to follow-up without scan. DLB features were compared at baseline and at 6-month follow-up according to imaging results and follow-up diagnosis. RESULTS: For the whole cohort, the baseline frequency of parkinsonism was 30%, fluctuations 29%, visual hallucinations 24%, and REM sleep behavior disorder 17%. Clinician-rated presence of parkinsonism at baseline was significantly (p = 0.001) more frequent and Unified Parkinson's Disease Rating Scale (UPDRS) score at baseline was significantly higher (p = 0.02) in patients with abnormal imaging. There was a significant increase in UPDRS score in the abnormal scan group over time (p < 0.01). There was relatively little evolution of the rest of the DLB features regardless of the imaging result. CONCLUSIONS: In patients with possible DLB, apart from UPDRS score, there was no difference in the evolution of DLB clinical features over 6 months between cases with normal and abnormal imaging. Only parkinsonism and dopamine transporter imaging helped to differentiate DLB from non-DLB dementia.

Neumonía por broncoaspiración, derivación y tratamiento definitivo / Aspiration pneumonia, referral and definitive treatment

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Clinical usefulness of dopamine transporter SPECT imaging with 123I-FP-CIT in patients with possible dementia with Lewy bodies: randomised study.

BACKGROUND: Dementia with Lewy bodies (DLB) is underrecognised in clinical settings. AIMS: To investigate whether performing a (123)I-ioflupane injection ((123)I-FP-CIT also called DaTSCAN™) single photon emission computed tomography (SPECT) scan in patients with possible DLB would lead to a more certain diagnosis (probable DLB or non-DLB dementia). METHOD: We randomised 187 patients with possible DLB 2:1 to have a scan or not (control group). The outcome measure was a change in diagnosis to probable DLB or non-DLB. RESULTS: There were 56 controls and 114 scanned patients, of whom 43% had an abnormal scan. More patients in the imaging group had a change in diagnosis compared with controls at 8 and 24 weeks (61% (n = 70) v. 4% (n = 2) and 71% (n = 77) v. 16% (n = 9); both P<0.0001). Clinicians were more likely to change the diagnosis if the scan was abnormal (82%) than if it was normal (46%). CONCLUSIONS: Imaging significantly contributed to a more certain diagnosis, proving to be a useful adjunct in the work-up of patients with possible DLB.

Breast augmentation with anatomic implants: a method based on the breast implantation base.

UNLABELLED: Currently, aesthetic and reconstructive surgery of the breast should be considered in terms of contouring, and hence in terms of dimensions. Based on experience performing more than 5,000 breast augmentations with highly cohesive anatomic implants, the authors explore the aesthetic anatomy of the (augmented) breast and explain the importance of the breast implantation base (BIB), the aesthetic proportions of the lower breast pole, and the patient's somatotype in the implant selection for a natural-appearing breast augmentation. A method is described for transferring all these concepts and proportions to the preoperative marking of the individual patient. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Selecting the implant height in breast augmentation with anatomical prosthesis: the "number Y".

BACKGROUND: Selecting the appropriate implant is one of the most important and demanding decisions in breast augmentation with anatomical implants, because different widths, heights, and projections can be found for a given volume. Most of the related literature and surgeons' concern have focused on width and projection. Implant height selection, however, has remained deeply overlooked, and it has been assumed that it depended on the suprasternal notch-to-nipple distance and, to a large extent, on the patient's height. METHODS: With more than 5123 breast augmentations performed over the past 15 years, the authors performed an analysis of the breast and implant height with consequences in aesthetic augmentation of the breast. Two concepts--breast implantation base (or breast footprint) and somatotype--were explored. Their influence in the selection of the appropriate anatomical implant height is investigated. RESULTS: Selection of implant height should follow the patient's breast implantation base, which is highly influenced by her somatotype. With this assumption, a "number Y" is proposed that correlates the suprasternal notch-to-nipple distance with the thoracic perimeter and unveils the shape of the breast implantation base in the particular patient. CONCLUSIONS: Adjusting the implant shape/footprint to the breast implantation base/breast footprint gives the surgeon control over the upper pole of the breast and allows a predictable postoperative result. The number Y rationalizes the selection of the implant height in breast augmentation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Reducing teachers’ psychological distress through a mindfulness training program

Teachers constitute one of the professional collectives most affected by psychological problems. The purpose of this quasi-experimental study is to examine the efficacy of a mindfulness training programme to reduce psychological distress in a group of teachers. The sample comprised 68 teachers of Secondary School Education, from various public schools; half of them formed the experimental group, and the another half the control group. The levels of psychological distress were measured, in both groups, by the Symptom Checklist-90-R (SCL-90-R) before and after the application of the programme. Statistical analysis shows the significant reduction of three general measures of psychological distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total), as well in all its dimensions (somatization, obsessive-compulsive, interpersonal sensibility, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism), in the experimental group compared with the control group. Follow-up measures show that these results were maintained for four months after termination of the intervention in the experimental group (AU)

Los docentes constituyen uno de los colectivos profesionales más afectados por problemas de tipo psicológico. El objetivo de este estudio cuasi-experimental es examinar la eficacia de un programa de entrenamiento en mindfulness para reducir el malestar psicológico en un grupo de docentes. La muestra estuvo constituida por 68 profesores de Educación Secundaria, de varios centros públicos; la mitad de ellos formaron el grupo control, y la otra mitad el grupo experimental. Los niveles de malestar psicológico fueron evaluados, en ambos grupos, mediante el Symptom Checklist-90-R (SCL- 90-R) antes y después de aplicación del programa. Los análisis estadísticos muestran la reducción significativa en las tres medidas generales de malestar psicológico (Índice de Severidad Global, Índice de Distrés de Síntomas Positivos y Total de Síntomas Positivos), así como en todas sus dimensiones (somatización, obsesión-compulsión, sensibilidad interpersonal, depresión, ansiedad, hostilidad, ansiedad fóbica, ideación paranoide y psicoticismo), en el grupo experimental en comparación con el grupo control. Medidas de seguimiento mostraron que estos resultados se mantuvieron transcurridos cuatro meses tras la finalización de la intervención en el grupo experimental (AU)

Reducing teachers' psychological distress through a mindfulness training program.

Teachers constitute one of the professional collectives most affected by psychological problems. The purpose of this quasi-experimental study is to examine the efficacy of a mindfulness training programme to reduce psychological distress in a group of teachers. The sample comprised 68 teachers of Secondary School Education, from various public schools; half of them formed the experimental group, and the another half the control group. The levels of psychological distress were measured, in both groups, by the Symptom Checklist-90-R (SCL-90-R) before and after the application of the programme. Statistical analysis shows the significant reduction of three general measures of psychological distress (Global Severity Index, Positive Symptom Distress Index, and Positive Symptom Total), as well in all its dimensions (somatization, obsessive-compulsive, interpersonal sensibility, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism), in the experimental group compared with the control group. Follow-up measures show that these results were maintained for four months after termination of the intervention in the experimental group.

Neoplasia papilar intraductal mucinosa de páncreas / Intraductal papillary mucinous carcinoma of the pancreas

La neoplasia papilar intraductal de páncreas es una entidad poco frecuente, raramente invasiva, de bajo potencial de malignización, de presentación poco típica y, generalmente, asintomática, que afecta la cola o el cuerpo pancreático y en muchas oportunidades es un hallazgo incidental en estudios de imágenes, como la ecografía abdominal y la tomografía.El estudio de la lesión puede realizarse de diferentes maneras, como la tomografía o la colangiografía endoscópica para estudio imaginológico y la aspiración del líquido pancreático para el estudio citológico y de marcadores tumorales. La ultrasonografía endoscópica y la colangiorresonancia permiten obtener datos más aproximados para el diagnóstico de esta lesión y para la definición del manejo, el cual en la mayoría de los casos consiste en la realización de resección quirúrgica con biopsia intraoperatoria por congelación.Se presenta el caso de un paciente con cáncer papilar intraductal de páncreas y se hace una revisión sobre este tema.

Accuracy of DaTSCAN (123I-Ioflupane) SPECT in diagnosis of patients with clinically uncertain parkinsonism: 2-year follow-up of an open-label study.

We previously reported on the role of dopamine transporter (DAT) SPECT in the workup of patients with clinically uncertain parkinsonian syndromes (CUPS). The findings of that study supported the use of SPECT imaging with DaTSCAN ((123)I-Ioflupane) for accurate diagnosis in this population. We report here the 2-year follow-up of the CUPS study, which aimed to validate the results of DaTSCAN imaging and to ascertain whether a second scan could minimize any residual diagnostic uncertainty among those with an inconclusive diagnosis. Eighty-five of 118 patients (72%) were available at follow-up. In 8 of 85 patients the neurologist was unable to provide a definite diagnosis (named as inconclusive). At follow-up, clinical diagnosis agreed with initial DaTSCAN SPECT results in 69 of 77 patients (90%) in whom a specific diagnosis was established. A second SPECT scan was performed if clinical diagnosis at follow-up differed to that suggested by the initial scan (n = 8) or was inconclusive (n = 8). Among 8 patients whose clinical diagnosis differed to DaTSCAN images, a second scan was performed in 6 (2 refused) and the results supported the final clinical diagnosis in 4. Follow-up DaTSCAN SPECT helped to establish a diagnosis in 7 of 8 patients (87.5%) with a previously inconclusive diagnosis. DaTSCAN imaging shows a high rate of agreement with clinical diagnosis after 2-years follow-up. A second scan at 2 years follow-up can reduce remaining diagnostic uncertainty that is present even after a prolonged period of observation.

Evaluación del patrón de conducta tipo C y su relación con la cognición hacia la enfermedad en pacientes colostomizados con diagnóstico de cáncer colorrectal / Evaluation of tipe C behavior and its relationshipwith cognition towars disease in colostomized patients whit colorectal

El objetivo de la siguiente investigación fue evaluar las dimensiones del patrón de conducta Tipo C y su relación con la cognición hacia la enfermedad en 58 pacientes colostomizados, diagnosticados de cáncer colorrectal, de ambos sexos, seis meses después del tratamiento médico-quirúrgico. Como instrumentos de medida se utilizaron tres de las escalas del Cuestionario de Patrón de Conducta Tipo C (López Martínez, Ramírez Maestre, Esteve Zarazaga & Anarte, 2002) y el Cuestionario de Cognición hacia la Enfermedad (ICQ), adaptado a partir de la versión holandesa de Evers et al. (2001). La fiabilidad de ambos cuestionarios, a partir del cálculo del coeficiente alpha, arroja resultados satisfactorios en ambos casos. Los resultados indican que existe una clara relación entre las respuestas a ambos instrumentos: concretamente, puntuaciones elevadas en Racionalidad se asocian a una mayor capacidad por parte de los pacientes para adaptarse a su enfermedad; por el contrario, puntuaciones elevadas en Comprensión y Represión emocional están asociadas a mayores dificultades para aceptar el estado de salud.

Hábitos básicos de salud y creencias sobre salud y enfermedad en adolescentes de España, Colombia y México / Basic habits and beliefs about health and illness among adolescents from Spain, Colombia and Mexico

En el presente estudio se han analizado los hábitos de alimentación y actividad física y las creencias sobre salud y enfermedad de una muestra de 954 adolescentes de ambos sexos (promedio 12,36±2,06 años) de España (321), Colombia (401) y México (232), empleando un cuestionario sobre hábitos de salud y creencias sobre salud y enfermedad. Los resultados indican que el 58 por ciento de los participantes muestra un perfil de riesgo en alimentación, y el 62,9 por ciento presenta un perfil de riesgo en actividad física. Las comparaciones entre países indican peores perfiles de hábitos de alimentación para la muestra colombiana frente a la mexicana y la española, y peores perfiles de hábitos de actividad física para la muestra española en comparación con las de los otros países. Los resultados confirman que la adolescencia es un momento clave en la formación de las creencias sobre salud y enfermedad con el 61 por ciento de los sujetos mostrando un patrón indefinido de creencias sobre salud y el 54 por ciento un perfil indefinido de creencias sobre la enfermedad, con diferencias significativas entre las muestras de los distintos países