Effectiveness of intraoral splints in the treatment of migraine and tension-type headache: A systematic review.

OBJECTIVES: The main objective of this systematic review was to assess the effectiveness of intraoral splints in treating migraine and tension-type headaches. MATERIAL AND METHODS: The article search was conducted within seven electronic databases (Medline, PubMed, Embase, CINAHL PLUS with full text, Cochrane Library Trials, Web of Science, and Scopus) with no date limits or language restrictions up to June 12, 2022. Strict inclusion and exclusion criteria were set for article selection. At the same time as data extraction, each study's risk of bias (RoB) was evaluated using the Cochrane tool to assess their RoB. Subsequently, the Cochrane Grading of Recommendations Assessment Development and Evaluation was used to evaluate the certainty of the evidence. RESULTS: Four controlled clinical trials were included. These trials were heterogeneous in terms of (1) diagnosis, (2) design of the intraoral splints, and (3) tools for reporting the results, which made it difficult to compile the data as well as evaluate its quality. Trials reported a reduction in the frequency of headache and pain intensity when using intraoral splints; however, this therapy was not superior to medications. CONCLUSIONS: The evidence is very low for the use of oral splints as a therapeutic alternative to medication in the treatment of migraine and/or tension-type headache.

Estudo comparativo para avaliação da eficácia cicatrizante de formulações tópicas contendo Triticum aestivum L. (sinônimo Triticum vulgare) em modelo de pele humana nativa / Comparative study to evaluate the wound healing efficacy of topical formulations containing Triticum aestivum L. (Triticum vulgare) in a native human skin model

Introdução: extratos vegetais e ativos derivados de plantas tem sido desenvolvidos com o objetivo de melhorar e potencializar o processo de cicatrização cutânea, dentre eles, o Triticum aestivum L. (sinônimo Triticum vulgare). Objetivo: avaliar o efeito do extrato de grão inteiro (EGTA-PR) e extrato aquoso (EATA-FI) de Triticum aestivum L. na cicatrização cutânea em pele humana ex vivo. Métodos: fragmentos de pele obtidos de cirurgia plástica eletiva foram submetidos a lesões teciduais e tratados com os extratos durante oito dias para avaliação histológica da reepitelização e marcação proteica do fator de crescimento epidérmico (EGF). Resultados: EGTA-PR e EATA-FI aceleraram o processo de reepitelização em cultura de pele humana submetida a lesão tecidual. Adicionalmente, foi observado um aumento da marcação proteica de EGF após o tratamento com EGTA-PR. Conclusão: EGTA-PR apresentou um melhor desempenho na reepitelização quando comparado ao EATA-FI, pois apresentou uma maior marcação proteica para EGF em cultura de pele humana. Da mesma forma, os resultados histológicos mostraram que a redensificação dérmica obtida com o EGTA-PR foi visualmente superior à observada com EATA-FI. Os resultados obtidos são promissores e corroboram as diversas ações biológicas já reportadas na literatura para extrato de Triticum aestivum L. nas etapas da cicatrização tecidual.

Introduction: Plant extracts and actives derived from plants were developed to improve and enhance the skin healing process including Triticum aestivum L. (Triticum vulgare). Purpose: To evaluate the effect of whole grain extract (EGTA-PR) and aqueous extract (EATA-FI) of Triticum aestivum L., on ex vivo skin healing. Methods: Skin fragments obtained from elective plastic surgery were subjected to tissue damage and treated with extracts for eight days for histological evaluation of re-epithelialization and immunofluorescence for epidermal growth factor (EGF). Results: EGTA-PR and EATA-FI accelerated the re-epithelialization process in human skin culture submitted to tissue injury. Additionally, we observed increased EGF protein labeling after treatment with EGTA-PR. Conclusion: EGTA-PR showed a better performance in re-epithelialization when compared to EATA-FI, as it presented a higher protein labeling for EGF in human skin culture. Likewise, the histological results showed that the dermal redensification obtained with EGTA-PR was visually superior to that observed with EATA-FI. The results obtained are promising and corroborate the several biological actions already reported in the literature for Triticum aestivum L. extract in tissue healing stages

Efficacy of botulinum toxin type A in the management of masticatory myofascial pain: A retrospective clinical study.

BACKGROUND: Muscular pain is the main cause of disability worldwide. Myofascial pain of orofacial origin is a frequent condition, the treatment of which is not always accomplished with traditional treatment. Botulinum toxin type A (BTA) is being studied for the treatment of this type of pain with contradicting results. Thus, the objective of this study was to assess the efficacy of BTA in the therapeutic management of masticatory myofascial pain (MFP). CASE DESCRIPTION: A retrospective study of 100 patients with a diagnosis of MFP was conducted. The control group (50 patients) received conventional treatment (prescription of a muscle relaxant and craniocervical physical therapy). The BTA group (50 patients) received this same treatment and the infiltration of 100 units of BTA in the masticatory musculature. Subjective and objective pain ratings and range of mandibular movements were recorded before and after the treatment. No differences were found between groups in the baseline values. Statistically significant improvements were found in both groups compared with baseline values in all studied parameters. Moreover, BTA improved the subjective pain ratings compared with the control group. The administration of BTA added to the conventional treatment does not seem to improve objective pain ratings and functional measurements, but it improves the subjective pain ratings. PRACTICAL IMPLICATIONS: The addition of BTA could be beneficial in the treatment of MFP in addition to conventional treatment, but further studies are needed to elucidate the mechanisms underlying this positive effect.

Hereditary hemorrhagic telangiectasia diagnosed by enteroscopy: a case report.

Hereditary hemorrhagic telangiectasia (HHT) is a very rare autosomal dominant multisystemic disease. Patients with this disease usually present with punctate mucocutaneous telangiectasias and arteriovenous malformations. The diagnostic criteria currently in use are the Curaçao criteria. HHT is considered a clinical diagnosis; thus, no imaging or preclinical laboratory is mandatory, and diagnosis and management are performed according to the experience of the treating team. We herein describe a 58-year-old man with no significant medical history who presented with a 15-day history of intermittent hematochezia. He was admitted to the hospital and underwent a series of laboratory tests, including colonoscopy, which showed normal results. Therefore, the patient was discharged with a diagnosis of gastrointestinal bleeding. During his second visit to the emergency room, the doctors requested video capsule endoscopy because of the patient's history, and a diagnosis of HHT was made. The entire approach and treatment were completed with antegrade double-balloon enteroscopy. This case highlights the importance of endoscopic methods for timely diagnosis and proper management.

Perinatal outcomes associated with the diagnosis of gestational diabetes: Systematic review and meta-analysis.

OBJECTIVE: To compare perinatal outcomes in pregnant women diagnosed with gestational diabetes using the one-step and the two-step test. METHODS: Meta-analysis of observational studies pregnancies women with gestational diabetes from January 2014 to February 2019. The outcomes studied were induction of labor and delivery, preterm delivery, fetal macrosomia, neonatal hypoglycemia, hyperbilirubinemia, low birth weight, and admission to the neonatal intensive care unit. RESULTS: Eight studies were included with a population of 108,609 pregnancies. Statistical differences were obtained for fetal macrosomia RR0.9 (95%CI0.85-0.97; I20%) and neonatal hypoglycemia RR1.1 (95%CI1.01-1.40; I248.5%). CONCLUSION: Neonatal macrosomia appears to be less present when the one-step diagnostic test is used and neonatal hypoglycemia was lower with the two-step test. Register PROSPERO CRD42020215062.

Nefrolitotomía percutánea ambulatoria: serie de casos y revisión de la literatura / Percutaneous Nephrolithotomy Ambulatory: Case Series and Literature Review

La nefrolitotomía percutánea (PCNL), es un procedimiento mínimamente invasivo, considerado como el tratamiento de elección para el manejo de los cálculos renales de gran tamaño o de formación compleja. Esa técnica fue introducida en la urología desde hace más de 30 años. Inicialmente fue Goodwin en 1955 quien realizó el primer abordaje percutáneo en un riñón.1 Posteriormente en 1976 Fernstórm y Johansson, efectuaron la primera extracción de un cálculo renal por vía percutánea2; permitiendo así el inicio y desarrollo de una nueva técnica mínimamente invasiva para el manejo de la litiasis renal. Aquella técnica, si bien presenta menor morbilidad que la cirugía abierta, no es un procedimiento libre de complicaciones, por lo cual se han realizado una seria de modificaciones de la técnica inicial.

Percutaneous nephrolithotomy (PCNL) is a procedure minimally invasive, considered to be the treatment of choice for the handling of large kidney stones size or complex formation. This technique was introduced into urology over 30 years ago. Initially it was Goodwin in 1955 who made the first percutaneous approach in a kidney.1 Subsequently in 1976 Fernstórm and Johansson, carried out the first extraction of the a percutaneous renal stone2; thus allowing the initiation and development of a new technique minimally invasive for the management of renal lithiasis. This technique, although it presents less morbidity than the open surgery, it is not a procedure free of complications, for which a series of tests have been carried out. modifications to the initial technique

Diez años de experiencia en la realización de biopsias por saturación / 10-Year experience in performing saturation prostate biopsy

Objetivo: Identificar la tasa de detección de cáncer de próstata en pacientes en quienes se realizaron biopsias por saturación en el Hospital Universitario San Ignacio desde enero del 2005 hasta febrero del 2015. Métodos: En el Hospital Universitario San Ignacio se han realizado 114 biopsias por saturación. Para este estudio se llevó a cabo un análisis univariado de las variables a estudio. Se obtuvo la asociación por medio del T-test y del test de Wilcoxon con una significancia de 0,05. Por último, se corrió un modelo de regresión para predecir un resultado positivo para cáncer de próstata. Resultados: La tasa de detección de cáncer de próstata fue del 16,7 %, y de estos el 84 % fueron categorizados como significativos. En promedio, se obtuvieron 19 muestras de tejido. El número de biopsias previas, el número de muestras, el volumen de la próstata y la densidad del PSA presentaron valores estadísticamente significativos. Conclusiones: La biopsia por saturación en Colombia presenta una tasa de detección de cáncer de próstata del 16,7 %, de las cuales el 84 % fueron significativas.

Objective: Identify the prostate cancer detection rate in patients in whom underwent a saturation prostate biopsy as a rebiopsy from January 2005 to February 2015 at San Ignacio Hospital. Materials and methods: In San Ignacio hospital were performed from January 2005 to February 2015, 114 saturation biopsies. The investigators made a univariate analysis of the variables. The association between the variable was evaluated based on the T-test and Wilcoxon test. P < 0.05 was considered statistically significant. Finally, a regression model was performed to predict significant variables for prostate cancer. Results: The cancer detection rate using saturation prostate biopsy was 16.7% of which 84% were categorized as significant. A mean of 19 cores were obtained. There were statistically significant differences between patients with prostate cancer and healthy patients in the number of previous biopsies, number of samples, prostate volume and PSA density. Conclusion: Saturation prostate biopsy in our study has a prostate cancer detection rate of 16.7% and 84% of them were significant in this cohort of patients.

Prognosis and management of acute coronary syndrome in Spain in 2012: the DIOCLES study.

INTRODUCTION AND OBJECTIVES: To identify the current mortality and management of patients admitted for suspected acute coronary syndrome in Spain. The last available registry (2004-2005) reported an in-hospital mortality of 5.7%. METHODS: The study included patients consecutively admitted between January and June 2012 at 44 hospitals selected at random. Information was collected on clinical course at admission and on events at 6 months. RESULTS: A total of 2557 patients admitted with suspected acute coronary syndrome were included: 788 (30.8%) with ST-segment elevation, 1602 (62.7%) without ST-segment elevation, and 167 (6.5%) with unclassified acute coronary syndrome. In-hospital mortality was 4.1% (6.6%, 2.4%, and 7.8% respectively), significantly lower than that observed for 2004-2005. Reperfusion treatment (most commonly, primary percutaneous coronary intervention) was administered to 85.7% of patients with ST-segment elevation attended within 12h. The median time from first medical contact to thrombolysis was 40 min and to balloon inflation, 120 min. Among patients without ST-segment elevation, coronary angiography was performed in 80.6%, percutaneous intervention in 52.0%, and surgery was indicated in 6.4%. Secondary prevention treatments at discharge was prescribed more often than in earlier registries. In patients alive at discharge (follow-up available for 97.1%), 6-month mortality was 3.8%. CONCLUSIONS: Mortality among patients with acute coronary syndrome in Spain was lower than that reported in the most recent published studies, in parallel with a more frequent use of the main treatments recommended.

Sleep bruxism: review and update for the restorative dentist.

Sleep bruxism (SB) is a parafunctional oromotor activity that can sometimes pose a threat to the integrity of the structures of the masticatory system if the magnitude and direction of the forces exerted exceed the system's adaptive capacity. Over the years science has tried to provide a consistent explanation of the etiopathogenesis and physiopathology of SB, although the pathophysiological mechanisms are, even now, not fully understood yet. There is at present no specific, effective treatment to permanently eliminate the habit of SB. There are only palliative therapeutic alternatives steered at preventing the pathological effects of SB on the stomatognathic system and alleviating the negative clinical consequences of the habit. The aim of this paper is to review and update the fundamental scientific concepts of SB based on the scientific literature and to furnish an approach to the main types of therapy available, in an attempt to assist the general and restorative dentist to manage those clinical situations in which SB is a significant risk factor for the oral health and/or dental treatment of the patient.

Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: The aim of this study is to perform a qualitative and quantitative analysis of the scientific literature regarding the use of acupuncture in the treatment of pain associated with temporomandibular disorders (TMDs). METHODS: By using electronic databases, the goal was to search and evaluate all the randomized controlled trials (RCTs) in which acupuncture was used in the management of pain attributed to these clinical entities. For the meta-analysis, an adequate description of the results' statistical data was required along with a comparison of the treatment with a control group using a placebo or sham. Two independent reviewers evaluated the quality of the studies using the Jadad scale. RESULTS: A total of 8 RCTs were selected, and the quality of only 4 was considered acceptable. These 4 studies showed positive results such as reducing pain, improving masticatory function, and increasing maximum interincisal opening. By combining the studies (n=96) and analyzing the results, it was concluded that acupuncture is more effective than placebo in reducing pain intensity in TMD (standardized mean difference 0.83; 95% confidence interval, 0.41-1.25; P=0.00012). DISCUSSION: The results of this meta-analysis suggest that acupuncture is a reasonable adjunctive treatment for producing a short-term analgesic effect in patients with painful TMD symptoms. Although the results described are positive, the relevance of these results was limited by the fact that substantial bias was present. These findings must be confirmed by future RCTs that improve the methodologic deficiencies of the studies evaluated in this meta-analysis.

Heart rupture predictors in Spanish myocardial infarction patients: evaluation using propensity score analysis.

BACKGROUND: The aim was to evaluate factors associated with the development of heart rupture in a Spanish registry of acute myocardial infarction (AMI) patients. MATERIAL/METHODS: This was a retrospective study of cohorts, including all patients diagnosed with AMI included in the ARIAM Spanish multicenter registry. The study period was from June 1996 to December 2005. The follow-up period was limited to the time of stay in intensive care or coronary care units. Multivariate logistic regression was used to study the factors associated with the development of heart rupture. A propensity score analysis was also performed to determine the involvement of beta blockers, ACE inhibitors, and fibrinolytics in the development of heart rupture. RESULTS: 16,815 AMI patients were included. Heart rupture occurred in 477 (2.8%). Heart rupture was associated with female gender, older age, the absence of previous infarct, and the administration of thrombolysis, while ACE inhibitors and beta blockers acted as protective variables. The propensity score analysis showed that fibrinolysis was a variable associated with heart rupture except in the younger subgroup and in the subgroup with less delay in administration. It was also found that beta blockers and ACE inhibitors are variables providing protection against heart rupture. CONCLUSIONS: Heart rupture is associated with older age, female gender, absence of previous infarct, and the administration of thrombolysis, while ACE inhibitors and beta blockers seem to prevent this complication.

Effectiveness of acupuncture in the treatment of temporomandibular disorders of muscular origin: a systematic review of the last decade.

OBJECTIVE: The purpose of this review is to evaluate the effectiveness of using acupuncture treatment for temporomandibular disorders (TMD) of muscular origin according to research published in the last decade. METHODS: The information was gathered using the MEDLINE, EMBASE, CINAHL, and CISCOM databases. The inclusion criteria for selecting the studies were the following: (1) only randomized controlled trials (RCTs) were selected; (2) studies had to be carried out on patients with TMD of muscular origin; (3) studies had to use acupuncture treatment; and (4) studies had to be published in scientific journals between 1997 and 2008. Two (2) independent reviewers analyzed the methodological quality of the studies using the Delphi list. A total of four RCTs were chosen once the methodological quality was judged as being acceptable. All of the studies included in the review compared the acupuncture treatment with a placebo treatment. All of them described results that were statistically significant in relation to short-term improvement of TMD signs and symptoms of a muscular origin, except one of the analyzed studies that found no significant difference between acupuncture and sham acupuncture. CONCLUSIONS: In the authors' opinion, research into the long-term effects of acupuncture in the treatment of TMD is needed. We also recommend larger samples sizes for future studies, so the results will be more reliable.

Estudio sobre algunas características epidemiológicas y sociales de los accidentes en los niños y adolescentes / Some epidemiologic and social characteristics in children and adolescents

Se hace un estudio sobre algunas características epidemiológicas y sociales de los accidentes en niños y adolescentes, tomando como base la información ofrecida por los familiares o acompañantes de los lesionados que concurrieron durante un mes al cuerpo de guardia del hospital provincial pediátrico de Camagüey. Se excluyeron los accidentes del tránsito. Se comprueba la magnitud de los accidentes domésticos, así como el peso de los ocurridos teniendo como marco la escuela. Se comentan los resultados y las conclusiones y recomendaciones dirigidas a un trabajo educativo preventivo

Estudio sobre algunas características epidemiológicas y sociales de los accidentes en los niños y adolescentes / Soe epidemiologic and social characteristics in children and adolescents

Se hace un estudio sobre algunas características epidemiológicas y sociales de los accidentes en niños y adolescentes, tomando como base la información ofrecida por los familiares o acompañantes de los lesionados que concurrieron durante un mes al cuerpo de guardia del hospital provincial pediátrico de Camagüey. Se excluyeron los accidentes del tránsito. Se comprueba la magnitud de los accidentes domésticos, así como el peso de los ocurridos teniendo como marco la escuela. Se comentan los resultados y las conclusiones y recomendaciones dirigidas a un trabajo educativo preventivo (AU)