Role of Leptin in Non-Alcoholic Fatty Liver Disease.

Non-alcoholic fatty liver disease (NAFLD), which affects about a quarter of the global population, poses a substantial health and economic burden in all countries, yet there is no approved pharmacotherapy to treat this entity, nor well-established strategies for its diagnosis. Its prevalence has been rapidly driven by increased physical inactivity, in addition to excessive calorie intake compared to energy expenditure, affecting both adults and children. The increase in the number of cases, together with the higher morbimortality that this disease entails with respect to the general population, makes NAFLD a serious public health problem. Closely related to the development of this disease, there is a hormone derived from adipocytes, leptin, which is involved in energy homeostasis and lipid metabolism. Numerous studies have verified the relationship between persistent hyperleptinemia and the development of steatosis, fibrinogenesis and liver carcinogenesis. Therefore, further studies of the role of leptin in the NAFLD spectrum could represent an advance in the management of this set of diseases.

Incidencia y mortalidad de la osteomielitis en España según el conjunto mínimo básico de datos / Incidence and mortality of osteomielitis in Spain according to the basic minimum data set

Fundamento y objetivos: Conocer la incidencia y mortalidad de pacientes hospitalizados por osteomielitis en España. Material y método: Se realizó un estudio observacional de población ingresada con diagnóstico principal de osteomielitis en hospitales españoles según el conjunto mínimo de datos al alta hospitalaria, entre 1997-2014 (29.290 casos). Resultados: La incidencia de ingresos por osteomielitis fue de 3,85 (IC 99%: 3,79-3,91) casos/100.000 habitantes y año. El riesgo relativo de los hombres fue de 2,02. La mortalidad intrahospitalaria fue del 1,72% (IC 99%: 1,4 -1,93). La mortalidad de la osteomielitis asociada a septicemia alcanzó el 27,12% (IC 99%: 20,5-35), la de la infección por Staphylococcus aureus resistente a meticilina (MRSA) el 5,5% (IC 99%: 2,18-13,2) y la de mayores de 64 años el 4,65% (IC 99%: 3,89-5,0). En el análisis multivariante la mortalidad se asoció de forma independiente a los diagnósticos de septicemia, osteomielitis aguda, ingresos urgentes, infección por MRSA, mayores de 64 años, comorbilidad y mujeres (p<0,001). Conclusiones: La incidencia de hospitalizaciones por osteomielitis en España es sustancial. La sepsis, la edad superior a los 64 años e infección por MRSA son factores importantes de riesgo de muerte

Background and objectives: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. Material and method: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. Results: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. Conclusions: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death

Incidence and mortality of osteomielitis in Spain according to the basic minimum data set. / Incidencia y mortalidad de la osteomielitis en España según el conjunto mínimo básico de datos.

BACKGROUND AND OBJECTIVES: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. MATERIAL AND METHOD: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. RESULTS: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. CONCLUSIONS: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death.

Particulated, Extracted Human Teeth Characterization by SEM⁻EDX Evaluation as a Biomaterial for Socket Preservation: An in vitro Study.

The aim of the study was to evaluate the chemical composition of crushed, extracted human teeth and the quantity of biomaterial that can be obtained from this process. A total of 100 human teeth, extracted due to trauma, decay, or periodontal disease, were analyzed. After extraction, all the teeth were classified, measured, and weighed on a microscale. The human teeth were crushed immediately using the Smart Dentin Grinder machine (KometaBio Inc., Cresskill, NJ, USA), a device specially designed for this procedure. The human tooth particles obtained were of 300⁻1200 microns, obtained by sieving through a special sorting filter, which divided the material into two compartments. The crushed teeth were weighed on a microscale, and scanning electron microscopy (SEM) evaluation was performed. After processing, 0.25 gr of human teeth produced 1.0 cc of biomaterial. Significant differences in tooth weight were found between the first and second upper molars compared with the lower molars. The chemical composition of the particulate was clearly similar to natural bone. Scanning electron microscopy⁻energy dispersive X-ray (SEM⁻EDX) analysis of the tooth particles obtained mean results of Ca% 23.42 0.34 and P% 9.51 0.11. Pore size distribution curves expressed the interparticle pore range as one small peak at 0.0053 µm. This result is in accordance with helium gas pycnometer findings; the augmented porosity corresponded to interparticle spaces and only 2.533% corresponded to intraparticle porosity. Autogenous tooth particulate biomaterial made from human extracted teeth may be considered a potential material for bone regeneration due to its chemical composition and the quantity obtained. After grinding the teeth, the resulting material increases in quantity by up to three times its original volume, such that two extracted mandibular lateral incisors teeth will provide a sufficient amount of material to fill four empty mandibular alveoli. The tooth particles present intra and extra pores up to 44.48% after pycnometer evaluation in order to increase the blood supply and support slow resorption of the grafted material, which supports healing and replacement resorption to achieve lamellar bone. After SEM⁻EDX evaluation, it appears that calcium and phosphates are still present within the collagen components even after the particle cleaning procedures that are conducted before use.

What advice should we give our patients to preserve their fertility and avoid needing oocyte donation in the future? - A Social Fertility Preservation program.

OBJECTIVE: To describe our fertility preservation program focusing on the number of oocytes vitrified by age. METHODS: From January 2015 to December 2016, 686 oocyte vitrification cycles were performed in our units for the social fertility preservation program. In total, 288 were donors who donated their oocytes for our oocyte-banking program, and 398 were patients who underwent elective fertility preservation. RESULTS: The mean numbers of COCs retrieved and vitrified oocytes were similar among the donor cycles (women under 30 years). In those patients over 36 years of age the mean numbers of COCs retrieved and vitrified oocytes were significantly lower. We also estimated the association between age and cancelation rates. Odd ratios (OR) for total cancelation was calculated between patients of 31-35 years and 41-45 years; the OR was 5.17 (95% CI 1.89 - 14.17) and increased up to 25.67 (95% CI 5.01 - 131.42) between patients 31-35 y and those older than 45 years. No differences were found between patients of 31-35 years and 36-40 years. The OR for total cancellation increased 3.83 (95% CI 2.06 - 7.11) and 19.00 (95% CI 4.56 - 79.11) between women 36-40 years and 41-45 years, and those older than 45 years, respectively. Finally, the oocyte survival rate in patients under 36 years of age was similar to that of our donor program (94% vs. 95%). CONCLUSIONS: Based on this study, we encouraged our patients under than 36 years of age to preserve their fertility for the future.

A new procedure for processing extracted teeth for immediate grafting in post-extraction sockets. An experimental study in American Fox Hound dogs.

OBJECTIVES: To investigate freshly extracted dental particulate used to graft post-extraction sockets in dogs, comparing new bone formation at experimental and control sites. MATERIALS AND METHODS: Bilateral premolars P2, P3, P4 and first mandibular molars were extracted atraumatically from six American Fox Hound dogs. The teeth were ground immediately using a 'Smart Dentin Grinder'. The dentin particulate was sieved to ensure a grain size of 300-1200µm and immersed in an alcohol cleanser to dissolve organic debris and bacteria, followed by washing in sterile saline buffer solution. The animals were divided into two groups randomly: group 'A' (control) samples were left to heal without any extraction socket grafting procedure; group 'B' (experimental) sockets were filled with the autogenous dentin particulate graft. The rate of tissue healing and the quantity of bone formation were evaluated using histological and histomorphometric analyses at 60 and 90 days post-grafting. The type of bone generated was categorized as woven (immature bone) or lamellar bone (mature bone). RESULTS: Substantially more bone formation was found in Group B (experimental) than Group A (control) at 60 and 90 days (p<0.05). Less immature bone was identified in the dentin grafted group (25.7%) than the control group (55.9%) [corrected]. Similar differences were also observed at 90 days post grafting. CONCLUSION: Autogenous dentin particulate grafted immediately after extractions may be considered a useful biomaterial for socket preservation, protecting both buccal and lingual plates, generating large amounts of new woven bone formation after 60 days, and small amounts of lamellar bone after 90 days healing.