Thinking about the next generation: The case for a mentalization-informed approach to perinatal and intergenerational mental health.

BACKGROUND: There has been substantial progress made across multiple disciplines to emphasize the importance of perinatal mental health both for parents and offspring. This focuses on what has been termed the 'First 1000 Days' from conception to the child's second birthday. We argue that our understanding of this issue can go further to create an intergenerational approach to mental health. Despite the existence of theoretical frameworks and practical approaches to implementation, there are gaps in the understanding of perinatal and intergenerational mental health including which psychological mechanisms are implicated in the transmission of risk and resilience within the perinatal period; and how to leverage these into treatment approaches. AIMS AND METHODS: In this paper, we explore the potential for mentalization as a candidate psychological approach to intergenerational mental health. RESULTS: We contextualize this issue in terms of the points of contact between mentalization and broader theoretical models such as the social determinants of health and the Developmental Origins of Health and Disease (DoHaD) model. Further, we provide an overview of the existing evidence base for the relevance of mentalization to perinatal mental health. DISCUSSION: Finally, we sketch out an outline model for integrating mentalization into perinatal and intergenerational mental health, highlighting several areas of opportunity to develop research and practice from diverse geographies and demographics. Here, we suggest that integration of mentalization with other conceptual frameworks such as DoHaD can mutually enrich the understanding of each model, pointing the way towards more effective early and preventative interventions.

Gingival crevicular fluid as Biomarker's source for alzheimer's disease / Fluido crevicular gingival como biomarcador de enfermedad de Alzheimer

Abstract Periodontitis is a low-grade inflammatory disease caused by a subgingival dysbiotic microbiota. Multiple studies have determined the higher prevalence of tooth loss and poor oral hygiene in patients with Alzheimer's disease (AD). However, the periodontal diagnosis, periodontal bacteria or mediators has not been measured to date. Aim: To determine the periodontal status, the pro-inflammatory mediators, Porphyromonas gingivalis load, and Apoliporpotein E (ApoE) in patients with AD. A complete dental examination was performed on 30 patients, and cognitive status was determined by the Montreal Cognitive Assessment (MoCA). Subgingival microbiota and GCF samples were then taken from all patients from the deepest sites. Total DNA was isolated from the microbiota samples for the quantification of the 16S ribosomal subunit. Pro-inflammatory mediators and ApoE were quantified from the gingival crevicular fluid (GCF). Patients with AD had periodontitis stage III-IV in 80%, a higher concentration of pro-inflammatory and ApoE mediators, and a higher P. gingivalis load compared to healthy subjects. The pro-inflammatory mediators, P. gingivalis load had a negative correlation with the MoCA test scores. Finally, a ROC curve was performed to assess the specificity and sensitivity of ApoE levels, detecting an area of 84.9%. In AD patients, we found a more severe periodontitis, a higher levels of pro-inflammatory mediators, and higher bacterial load. In addition, there is an increase in ApoE that allows to clearly determine patients with health, periodontitis and periodontitis and AD.

Resumen La periodontitis es una enfermedad crónica no transmisible que se caracteriza por generar una inflamación sistémica de bajo grado causada por una microbiota disbiótica subgingival. Múltiples estudios han determinado la mayor prevalencia de pérdida de dientes y mala higiene bucal en pacientes con enfermedad de Alzheimer (EA). Sin embargo, el diagnóstico periodontal, bacterias periodontales o mediadores pro-inflamatorio no se ha medido hasta la fecha. Determinar el estado periodontal, los mediadores pro-inflamatorios, la carga de Porphyromonas gingivalis y la apoliporpoteína E (ApoE) en pacientes con EA. Se realizó un examen odontológico completo en 30 pacientes y el estado cognitivo se determinó mediante la Evaluación Cognitiva de Montreal (MoCA). Luego, se tomaron muestras de microbiota subgingival y FCG de todos los pacientes de los sitios más profundos. Se aisló el DNA total de las muestras de microbiota para la cuantificación de la subunidad ribosómica 16S. Los mediadores pro-inflamatorios y la ApoE se cuantificaron a partir del líquido crevicular gingival (GCF). Los pacientes con EA tenían periodontitis en estadio III-IV en 80%, una mayor concentración de mediadores pro-inflamatorios y ApoE, y una mayor carga de P. gingivalis en comparación con los sujetos sanos. Los mediadores pro-inflamatorios y la carga de P. gingivalis tuvieron una correlación negativa con las puntuaciones de la prueba MoCA. Finalmente, se realizó una curva ROC para evaluar la especificidad y sensibilidad de los niveles de ApoE, detectando un área del 84,9%. En los pacientes con EA encontramos una periodontitis más severa, mayores niveles de mediadores pro-inflamatorios y mayor carga bacteriana. Además, un aumento de ApoE que permite determinar claramente a los pacientes con salud, periodontitis y periodontitis y EA.

Desinfección de Alicates de Ortodoncia. Actualización de Recomendaciones en Contexto de COVID- 19. Revisión de la Literatura

RESUMEN: El adecuado conocimiento de definiciones, normas, procedimientos, uso de antisépticos y desinfectantes, permite contar con las herramientas para evitar la diseminación de agentes infecciosos y proporcionar el conocimiento para el uso racional de estos. El objetivo de este trabajo es presentar de manera estructurada y ordenada la información disponible respecto de la desinfección de alicates de ortodoncia y proporcionar una guía para el control óptimo de infecciones. Se realizó una búsqueda mediante PubMed, MEDLINE y Google Scholar, sin importar idioma, desde el año 2000 a abril 2021. Se establecieron los desinfectantes más recomendados para la desinfección de alicates de ortodoncia y las consideraciones en su uso. Además, se determinaron los riesgos de corrosión y recomendaciones para evitarlas. Es importante contar con información actualizada que se pueda utilizar para desarrollar un programa óptimo de asepsia, sobre todo en el contexto actual de pandemía.

ABSTRACT: Adequate knowledge of definitions, norms, procedures, use of antiseptics and disinfectants, allows to avoid the spread of infectious agents and provides knowledge for proper use of these aides. The objective of this study is to present the information available regarding the disinfection of orthodontic pliers in a structured and organized manner, and to provide a guide for optimal infection control. A search was carried out using PubMed, MEDLINE and Google Scholar, regardless of language, from the year 2000 to April 2021. The most recommended disinfectants for the disinfection of orthodontic pliers and the considerations in their use were established. In addition, risks of corrosion and recommendations to avoid them were determined. It is important to have up-to-date information that can be used to develop an optimal asepsis program, especially in the present context of a pandemic.

Frecuencia, severidad y ubicación de erupciones acneiformes en hombres y mujeres tras una cirugía ortognática: estudio descriptivo longitudinal / Frequency, severity and location of acneiform eruptions in men and women after orthognathic surgery: longitudinal descriptive study

Describir la frecuencia de erupciones acneiformes y/o exacerbaciones de un acné previo tras una cirugía ortognática. La muestra consta de 57 pacientes (n=57) de ambos sexos, sometidos a una cirugía ortognática, los cuales fueron evaluados en: el preoperatorio (0-7 días previos); en distintas etapas de la cirugía; postoperatorio inmediato (7 ­ 15 días post cirugía) y postoperatorio mediato (30 ­ 40 días postquirúrgicos). En todos los controles clínicos mencionados se determinó la presencia/ausencia, ubicación, severidad y diagnóstico de las erupciones acneiformes. El 52,6 % de los pacientes sometidos a cirugía ortognática presentaron erupciones acneiformes, siendo mayores en las mujeres en comparación con los hombres. La severidad de las erupciones acneiformes es mayor en el postoperatorio inmediato en comparación al preoperatorio y postoperatorio mediato. La ubicación más frecuente del acné corresponde a la región frontal, tanto en el preoperatorio (22,8 %) como en el postoperatorio inmediato (31,6 %). En el postoperatorio mediato la zona más frecuente es la geniana (39 %). La frecuencia de acné post cirugía ortognática es elevada, siendo mayor en mujeres que en hombres. La severidad de este acné es mayor en el postoperatorio inmediato. La región frontal corresponde a la zona más frecuente de aparición de las erupciones acneiformes en el postoperatorio inmediato y la zona geniana en el postoperatorio mediato. El diagnóstico de estas erupciones acneiformes corresponde a un acné esteroidal, por lo que se puede sugerir un posible plan de tratamiento, con el fin de mejorar el postoperatorio de las pacientes y evitar, en lo posible, futuras manifestaciones en nuevas pacientes sometidas a este tipo de cirugía.

Describe the frequency of acneiform eruptions and / or exacerbations of a previous acne after orthognathic surgery. The sample consisted of 57 patients (n = 57) of both genders, undergoing orthognathic surgery, who were evaluated with a follow-up of 2 postoperative months, at different stages of surgery; Preoperative (0-7 days), immediate postoperative (7-15 days) and mediate postoperative (30-40 days). The presence / absence, location, severity and diagnosis of acneiform eruptions were determined in all clinical controls. The frequency of acneiform eruptions corresponds to 52.6 % of patients undergoing orthognathic surgery, being higher in women compared to men in relation to the presence of acneiform eruptions and / or exacerbations of a previous acne after the intervention. The severity of acneiform eruptions is greater in the immediate postoperative period compared to the preoperative and mediate postoperative period. The most frequent location to be found in the facial region is in the frontal area, both in the preoperative (22.8 %) and in the immediate postoperative period (31.6 %). In the postoperative period, the most frequent is the genial area (39 %). The appearance of acneiform eruptions corresponds to steroidal acne. The frequency of acne post orthognathic surgery is high, being higher in women than in men. The severity of this acne is greater in the immediate postoperative period. The frontal region corresponds to the most frequent area of onset of acneiform eruptions in the immediate postoperative period and the genial area in the postoperative period. The diagnosis of these acneiform eruptions corresponds to a steroidal acne, so it is possible to suggest a possible treatment plan, in order to improve the postoperative of the patients and to avoid, as far as possible, future manifestations in new patients undergoing this type of surgery.

Avances en el Estudio de la Diversidad Bacteriana Oral Asociada a Caries Dental Mediante el Estudio Genómico / Advances in the Study of Oral Bacterial Diversity Associated with Dental Caries by Genomic Study

La caries es una enfermedad infecciosa, transmisible y multifactorial, que conduce a la pérdida de minerales reversible o irreversible de los tejidos duros susceptibles del diente, por acción de productos ácidos provenientes de la fermentación de los hidratos de carbono de la dieta por la actividad metabólica del biofilm adherido a la superficie dentaria. Aunque tradicionalmente se ha considerado al Streptococcus mutans como el responsable de la enfermedad, actualmente otras bacterias, denominadas no mutans, se han asociado con el inicio, progresión y actividad de la enfermedad en esmalte, dentina y cemento radicular. Para profundizar el estudio de la diversidad bacteriana oral asociada a caries dental se han aplicado diversas metodologías, dentro de las cuales destaca el estudio del metagenoma oral. Este nos permite estudiar comunidades bacterianas completas mediante el análisis del DNA, en un determinado ambiente sin necesidad de aislar y cultivar las especies, entregando información sobre la diversidad taxonómica y filogenética de estas comunidades. Existen diferentes métodos de análisis de la diversidad bactariana, entre los que tenemos el análisis del ARNr 16S mediante electroforésis, PCR, microarreglos, secuenciamiento de última generación, entre otros. El estudio del metagenoma oral ha permitido identificar especies que no han podido ser aisladas por métodos convencionales, además de identificar su presencia o ausencia en las distintas etapas del desarrollo de la enfermedad de caries dental, permitiendo un mejor conocimiento del desarrollo de esta patología. El estudio basado en el metagenoma ha dado a conocer una diversidad microbiana oral inesperada, dando información relevante para la actualización de los conocimientos y así identificar nuevos objetivos terapéuticos. El propósito de esta revisión bibliográfica es exponer los principales resultados que ha aportado el estudio del metagenoma sobre la diversidad microbiana, aplicado específicamente a la comunidad bacteriana oral.

Dental caries is an infectious, transmissible and multifactorial disease, which leads towards a reversible and irreversible loss of minerals found in hard tissues of a tooth, caused by acids from carbohydrates fermentation due to metabolic activity of the biofilm attached to the tooth surface. Although Streptococcus mutans has been thought to be responsible for tooth decay, another bacterium named no mutans has been linked to the beginning, progression and activity of the disease in the enamel, dentine and cement. One of the methodologies put into practice to deepen the study of oral bacteria diversity related to carious cavities is oral metagenome. This methodology allows the study of whole bacterial groups by the analysis of DNA in a particular environment without the need of isolating and cultivating species, providing information about the taxonomical and phylogenetic diversity of these groups. There are different methods to study the bacterial diversity, including 16 S rRNA analysis through electrophoresis, PCR, microarrays, next generation sequence (NGS). The metagenome tool permits to recognize species that have not been able to be isolated by conventional methods. As well as identify its presence or absence in the different stages of the dental caries development, which allows a better understanding of development of the disease. The metagenome-based study has revealed an unexpected oral microbial diversity, giving information relevant to the updating of knowledge and identifies new therapeutic targets. The purpose of this review is to present the main results has brought the study of the metagenome on microbial diversity, applied specifically to the oral bacterial community in health and caries disease.

Comparison of the Formula of PSA, Age, Prostate Volume and Race Versus PSA Density and the Detection of Primary Malignant Circulating Prostate Cells in Predicting a Positive Initial Prostate Biopsy in Chilean Men with Suspicion of Prostate Cancer.

BACKGROUND: Combining risk factors for prostate cancer into a predictive tool may improve the detection of prostate cancer while decreasing the number of benign biopsies. We compare one such tool, age multiplied by prostate volume divided by total serum PSA (PSA-AV) with PSA density and detection of primary malignant circulating prostate cells (CPCs) in a Chilean prostate cancer screening program. The objectives were not only to determine the predictive values of each, but to determine the number of clinically significant cancers that would have been detected or missed. MATERIALS AND METHODS: A prospective study was conducted of all men undergoing 12 core ultrasound guided prostate biopsy for suspicion of cancer attending the Hospital DIPRECA and Hospital de Carabineros de Chile. Total serum PSA was registered, prostate volumecalculated at the moment of biopsy, and an 8 ml blood simple taken immediately before the biopsy procedure. Mononuclear cells were obtained from the blood simple using differential gel centrifugation and CPCs identified using immunocytchemistry with anti- PSA and anti-P504S. Biopsy results were classed as positive or negative for cancer and if positive the Gleason score, number of positive cores and percent infiltration recorded. RESULTS: A total of 664 men participated, of whom 234 (35.2%) had cancer detected. They were older, had higher mean PSA, PSA density and lower PSA-AV. Detection of CPCs had high predictive score, sensitivity, sensibility and positive and negative predictive values, PSA-AV was not significantly different from PSA density in this population. The use of CPC detection avoided more biopsies and missed fewer significant cancers. CONCLUSIONS: In this screening population the use of CPC detection predicted the presence of clinically significant prostate cancer better than the other parameters. The high negative predictive value would allow men CPC negative to avoid biopsy but remain in follow up. The formula PSA-AV did not add to the predictive performance using PSA density.

Rearmemos la vida de los niños y niñas: Guía para la familia

Ante la pérdida de un ser querido, de la casa y objetos apreciados, los niños y las niñas vivirán un duelo. La tarea de los adultos en este proceso es ser buenos acompañantes y saber darles el tiempo para recuperarse. Este documento brinda recomendaciones y consejos acerca de cómo se debe conversar y como se deben atender los niños y las niñas después de haber vivido una experiencia de este tipo.