Estimation of the age of majority through radiographic evaluation of the third molar maturation degree.

BACKGROUND: Although the third molar is the tooth with the greatest anatomical and developmental variability, some authors consider it important to estimate whether a subject is of legal age or not. The Demirjian's technique is the most widely used tool to estimate dental age and was therefore used in our study to assess possible correlation between the age of majority and the maturational degree of the lower third molars, evaluated through radiographic images. MATERIAL AND METHODS: This observational transversal study was conducted on 180 panoramic radiographs from consecutive patients. The degree of maturation of the lower third molar was independently classified by two observers, according to the Demirjian´s maturational stage method. RESULTS: A total of 180 patients - 65 men (36.12%) and 115 women (63.88%) - were included (mean age 21.6 years; standard deviation 5.2). The age range of our subjects corresponded to maturational stages D to H in the Demirjian's classification. A logistic regression analysis showed that subjects classified into the highest maturational stage H had a significantly higher probability of being considered of legal age by both observers, as compared with subjects in the lowest stage D. Inter-observer agreement was very high. Gender predictive capacity was not observed. CONCLUSIONS: Our results showed that subjects with the lower third molars in the highest maturational stage could be estimated to be older than 18 years and therefore considered of legal age, a finding also reported by other authorsThe Demirjian´s tooth maturational stage method, applied to the lower third molars, can be reliably used to estimate whether an individual is of legal age (18 years or older). High concordance between different observers using this method can be expected.

Estado cualitativo y cuantitativo óseo generalizado enla osteonecrosis de maxilares. Efecto de los bifosfonatos / Qualitative and quantitative status of general bonein osteonecrosis of the jaws. Effect of bisphosphonates

OBJETIVO: La osteonecrosis de maxilares (ONM) es una enfermedad recientemente descrita cuya etiopatogenia es desconocida, aunque se ha atribuido, entre otras causas, al tratamiento prolongado con bifosfonatos. Sin embargo, mientras que la ONM es una patología localizada, la acción de los bifosfonatos es generalizada, es decir, afecta a todos los huesos. No hay estudios que muestren el estado óseo general de los pacientes con ONM. Con este trabajo hemos querido estudiar en pacientes afectos de ONM dicho estado general mediante medidas cuantitativas y estimaciones cualitativas del hueso por medio de la densidad mineral ósea (DMO) y el trabecular bone score (TBS) y los parámetros ultrasonográficos en el calcáneo (QUS), además de la presencia de otras enfermedades y la toma de fármacos (especialmente los bifosfonatos) en los pacientes con ONM que pudieran participar en su etiopatogenia. MATERIAL Y MÉTODO: Estudio observacional y transversal de casos y controles, realizado en 304 pacientes de ambos sexos, en los que el grupo de casos (grupo I) estaba formado por 24 pacientes que habían sufrido una ONM, mientras que el grupo control (grupo II) estaba formado por 280 pacientes que no presentaban ONM y que recibían bifosfonatos desde un mínimo de 5 años por causas diversas. A todos ellos se les realizó una densitometría ósea (DXA, Hologic 4500 Discovery®) en la columna lumbar y en la extremidad proximal del fémur. Además, se les realizó mediciones del TBS en la columna lumbar, así como de los parámetros ultrasonográficos en el calcáneo (Hologic, Sahara®) en el pie dominante (QUS). RESULTADOS: Los pacientes afectos de ONM tenían una mayor comorbilidad que los controles, con una mayor prevalencia de las siguientes enfermedades: diabetes mellitus, cáncer, artritis reumatoide, hipertiroidismo, cardiopatía, arritmias, insuficiencia cardíaca e hipercolesterolemia. Por ello, el consumo de corticoides, (orales e inhalados), anticoagulantes, hipnóticos, bifosfonatos i.v. (zoledronato), y quimioterapia antineoplásica fue también mayor entre los pacientes afectos de ONM que los pacientes controles. Sin embargo, entre los pacientes con ONM el porcentaje que tomaba bifosfonatos orales fue menor. Los valores densitométricos (DMO medida en la columna lumbar L2-L4, cuello femoral y total de cadera) fueron más elevados en los pacientes con ONM en comparación con los de los controles. El TBS no mostró diferencias estadísticamente significativas entre ambos grupos, y los ultrasonidos presentaron valores más elevados de QUI y SOS en los pacientes con ONM que en los controles. La prevalencia de fracturas por fragilidad fue similar en ambos grupos. CONCLUSIONES: Nuestros pacientes afectos de ONM mostraron una mayor comorbilidad y un mayor consumo de fármacos que los pacientes del grupo control, a excepción de bifosfonatos orales. Por otro lado, tanto la DMO como los parámetros ultrasonográficos mostraron valores más elevados en los pacientes con ONM que los controles. Si consideramos la DXA como una técnica medidora de la cantidad de masa ósea, y el TBS y la ultrasonografía de calcáneo técnicas estimadoras de aspectos cualitativos del hueso, podemos suponer que ni la cantidad ni la calidad óseas en general parecen estar afectadas en la ONM, siendo probablemente otro su mecanismo etiopatogénico. Los bifosfonatos orales no parecen estar entre los fármacos que participen en la etiología de la ONM, aunque sí los bifosfonatos más potentes que se administran por vía intravenosa, si bien no pueden considerarse independientemente de la patología subyacente para la cual se administran

OBJECTIVE: Osteonecrosis of the jaw (ONJ) is a recently reported disease whose origin and development are unknown, although prolonged bisphosphonate treatment has been attributed, among other causes. While ONJ is a localized condition, the action of bisphosphonates is widespread and affects all bones. No studies show the general bone status of patients with ONJ. Our study examines the general condition in patients with ONJ using quantitative measurements and qualitative estimates of bone by means of bone mineral density (BMD) and trabecular bone score (TBS) and ultrasound parameters in the calcaneus (QUS), along with other diseases and the taking of drugs (especially bisphosphonates) in patients with ONJ who may be involved in the pathogenesis. MATERIAL AND METHOD: Observational and cross-sectional study of cases and controls, conducted in 304 patients of both sexes, in which the case group (group I) was formed by 24 patients who had suffered ONJ. The control group (group II) contained 280 patients who did not present ONJ and who received bisphosphonates over at least 5 years for various reasons. All of them underwent bone densitometry (DXA, Hologic 4500 Discovery®) in the lumbar spine and proximal femur. In addition, TBS measurements were made in the lumbar spine, as well as ultrasound parameters in the calcaneus (Hologic, Sahara®) in the dominant foot (QUS). RESULTS: Patients suffering ONJ presented greater comorbidity than controls, with a higher prevalence of diabetes mellitus, cancer, rheumatoid arthritis, hyperthyroidism, heart disease, arrhythmias, heart failure and hypercholesterolemia. Therefore, the consumption of corticosteroids, (oral and inhaled), anticoagulants, hypnotics, bisphosphonates i.v. (zoledronate), and antineoplastic chemotherapy was also higher among patients with ONJ than control patients. However, among the patients with ONJ the percentage taking oral bisphosphonates was lower. Densitometric values (BMD measured in lumbar spine L2-L4, femoral neck and total hip) were higher in patients with ONJ compared to those in controls. The TBS showed no statistically significant differences between the two groups, and the ultrasound showed higher values of QUI and SOS in patients with ONJ than in controls. The prevalence of fragility fractures was similar in both groups. CONCLUSIONS: Patients with ONJ in our study presented greater comorbidity and a higher consumption of drugs than the patients in the control group, except for oral bisphosphonates. On the other hand, both BMD and ultrasound showed higher values in patients with ONJ than in controls. If we consider DXA as a technique for measuring the amount of bone mass, and TBS and calcaneal ultrasound estimating qualitative aspects of bone, we could assume that neither bone quantity nor quality in general seems to be affected in ONJ, and that its etiopathogenic mechanism is probably another. Oral bisphosphonates do not appear to be among the drugs involved in ONJ's origin and development, but the most potent and intravenously administered bisphosphonates are, although they cannot be considered independently of the underlying disease for which they are administered

¿Cuál es el nivel de contaminación del cepillo de dientes almacenado en diferentes entornos sanitarios? / What is the level of toothbrush contamination stored in different sanitary settings?

Introducción: Los cepillos pueden albergar una amplia variedad de microorganismos, incluyendo bacterias hongos y virus, pudiendo así facilitar la translocación de especies en un mismo individuo y la transmisión de especies entre individuos. Métodos: Estudio de la contaminación bacteriana de los cepillos de dientes de cien voluntarios con la cumplimentación de un cuestionario (lugar de almacenamiento, tipo de cepillo, utilización de estuche de almacenamiento y meses de uso). Resultados: Se estudiaron un total de 100 muestras. El 33% guardaba el cepillo fuera del baño, un 20% lo guardaba en el cajón del baño y un 47% sobre el lavabo del baño. El 92% de las muestras estaban contaminadas como mínimo con un grupo de microorganismos Conclusión: El lugar de almacenamiento del cepillo de dientes es fundamental en la reducción de la contaminación. Se debe guardar en un lugar seco, lejos del inodoro y sin estuche

Introduction: Brushes can house a wide variety of microorganisms, including fungal bacteria and viruses, which can facilitate the translocation of species in the same individual and the transmission of species between individuals. Methods: Study of the bacterial contamination of toothbrushes of one hundred volunteers with the completion of a questionnaire (place of storage, type of brush, use of storage case and months of use). Results: A total of 100 samples were studied. 33% kept the brush outside the bathroom, 20% kept it in the bathroom drawer and 47% on the bathroom sink. 92% of the samples were contaminated with at least one group of microorganisms. Conclusion: The storage place of the toothbrush is fundamental in the reduction of contamination. It should be stored in a dry place, away from the toilet and without a box

Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants.

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years. There were 33 men and 90 women and they all recovered. The IAN was mobilised by one of two procedures, one that involves the nerve directly (transposition) and one that does not (lateralisation). During lateralisation the nerve is deflected laterally through a mandibular osteotomy, while the mental nerve and mental foramen are not manipulated. The resulting hypoaesthetic area was drawn on a graph to assess its extension. Although different techniques are available for placing implants in atrophic jaws, mobilisation of the IAN is indicated in certain cases in which other techniques are not feasible or have a high risk of complications.

Technical aspects and complications in the surgical treatment of poliomyelitis-affected lower limb fractures. / Aspectos técnicos y complicaciones en el tratamiento de las fracturas de los miembros inferiores con secuelas de poliomielitis.

OBJECTIVE: Post-polio patients present problems such as small and deformed bones, with narrow intramedullary canal and osteoporosis, affecting surgical treatment. The aim of this article is to describe the main preoperative and intraoperative complications of the surgical treatment of fractures in this population. MATERIAL AND METHODS: A retrospective analysis was conducted between 1995 and 2014. Data obtained from the medical records included patient age, fracture pattern (AO/OTA), device used, technical aspects of the surgery that changed compared to a standard procedure, and the presence of intraoperative skeletal complications. RESULTS: Sixty-four patients with 78 fractures were included in the study. Forty-seven percent of the fractures were at the proximal femur. The main complications of hip arthroplasty (14 patients) were absent hip abductors and intraoperative instability (3), bad cup fixation (3) and intraoperative periprosthetic fracture (2). The main problems of intramedullary nailing were due to a narrow canal and previous bone deformity. Main problems reported when plating included difficulty to fit a precontoured plate, and oversized hardware. CONCLUSION: Given the large number of intraoperative complications, in preoperative planning we must include nails of small diameter and length, locking plates and external fixators, and, in the case of hip arthroplasty, long and thin stems and restrictive or dual mobility acetabular systems.

Categorisation of air quality monitoring stations by evaluation of PM(10) variability.

Air Quality Monitoring Networks (AQMNs) are composed by a number of stations, which are typically classified as urban, suburban or rural, and background, industrial or traffic, depending on the location and the influence of the immediate surroundings. These categories are not necessarily homogeneous and distinct from one another, regarding the levels of the monitored pollutants. A classification providing groups with these features is of interest for air quality management and research purposes, and therefore, other classification criteria should be explored. In this work, the variations of PM10 concentrations in 43 stations in the AQMN of the Basque Country in the period 2005-2012 have been studied to group them according to common characteristics. The characteristic variations in time are synthesised by the autocorrelation function (ACF), with both daily and hourly data, and by the average diurnal evolution pattern of the normalised concentrations on a seasonal basis (Evol-P). A methodology based on k-means clustering of these features is proposed. Each classification gives a different piece of information that has been phenomenologically related with specific dispersion and emission dynamics. The classification based on Evol-Ps is found to be the most influential one when comparing PM10 levels between groups. A combination of these categorisations provides 5 groups with significantly different levels of PM10, improving the discrimination of the conventional classification. Our results indicate that the time series of the pollutant concentrations contain enough information to provide an objective classification of the monitoring stations in an AQMN.

Radioprotección en quirófanos de traumatología: ¿en qué situación estamos? / Radiation safety in orthopaedic operating theatres. what is the current situation?

Objetivo. Analizar la exposición a radiaciones ionizantes por parte de dos cirujanos ortopédicos en su práctica diaria y revisar las principales recomendaciones nacionales e internacionales al respecto. Material y método. Se efectúo un estudio retrospectivo de la actividad quirúrgica con uso de fluoroscopia realizado por dos cirujanos ortopédicos en un año. Se calculó la radiación recibida basándose en mediciones por procesos publicados en la bilbliografía. Revisión bibliográfica de recomendaciones y normativas internacionales. Resultado. La radiación recibida en un año por los dos cirujanos ortopédicos no sobrepasó el límite de la legislación actual ni el de las nuevas recomendaciones europeas e internacionales. La exposición fue asimétrica, siendo las manos la zona más radiada. Las nuevas recomendaciones rebajan los niveles permitidos de radiación en ojos. Discusión. La estimación de radiación recibida hace necesario proteger y vigilar especialmente las manos y los ojos. Son necesarios conocimientos del funcionamiento del fluoroscopio y de las medidas de radioprotección (AU)

Objective. To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. Material and methods. A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. Results. The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. Discussion. The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential (AU)

[Radiation safety in orthopaedic operating theatres. What is the current situation?]. / Radioprotección en quirófanos de traumatología: ¿en qué situación estamos?

OBJECTIVE: To analyse the exposure of two Orthopaedic Surgeons to ionizing radiations in their daily work, and to review the main national and international recommendations on this subject. MATERIAL AND METHODS: A retrospective study was conducted on the surgical treatments that use fluoroscopy performed by two Orthopaedic Surgeons during a one year period. An evaluation was made of the radiation received, based on measurements of the processes published in the bibliography section. A literature review of international recommendations and regulations is also presented. RESULTS: The radiation received by the two Orthopaedic Surgeons during one year did not exceed the limits of present-day legislation or the new European and international recommendations. The exposure was asymmetrical, with the hands being the most radiated part. The new recommendations reduce the permitted level of radiation on eyes. DISCUSSION: The evaluation of the radiation received demonstrates the need for radiation protection, paying particular attention to the hands and eyes. Good knowledge of operating a fluoroscope and radiation safety measures are also essential.

Effect of the inhibitors phenylalanine arginyl ß-naphthylamide (PAßN) and 1-(1-naphthylmethyl)-piperazine (NMP) on expression of genes in multidrug efflux systems of Escherichia coli isolates from bovine mastitis.

The multidrug efflux system in bacteria can reduce antibiotic concentration inside the cell, leading to failure in the treatment of bacterial diseases. This study evaluated the influence of two efflux pump inhibitors (EPIs), phenylalanine arginyl ß-naphthylamide (PAßN) and 1-(1-naphthylmethyl)-piperazine (NMP), on the gene expression of three multidrug efflux systems, AcrAB, AcrEF and EmrAB in Escherichia coli bovine mastitis isolates resistant to ampicillin and sulfamethoxazole/trimethoprim simultaneously. Each isolate had at least three multidrug efflux system genes. The acrA and acrB had the lowest expression levels in all treatments, while the emrA or emrB showed the highest expression levels in the presence of ampicillin, sulfamethoxazole/trimethoprim, PAßN and NMP. EPIs also contributed to the decrease in arcF expression when used in combination with ampicillin treatment. Since PAßN showed stronger effects than NMP, it may serve as an alternative to assist in the antimicrobial therapy of mastitis.

Sclerotherapy of face and oral cavity low flow vascular malformations: our experience.

We have reviewed our experience (15 patients during the period 2008-2012) in the treatment of low flow vascular malformations (LFVMs) of the face and oral cavity with polidocanol foam sclerotherapy. They were diagnosed clinically and with the help of Doppler ultrasound and magnetic resonance imaging. The maximum dose recommended for each session was 20mg/day and the minimum interval between sessions was 4 weeks. Embolisation was repeated as many times as needed until the size of the lesions and the symptoms had been reduced sufficiently. Patients were followed up 1, 6, and 12 months after treatment had finished, and the size of the lesions was assessed objectively. The 8 men and 7 women were aged between 18 and 71 (mean 44) years. The lesions had reduced and symptoms had improved in all cases. During the follow-up period, one patient relapsed and developed further symptoms. The pain and postoperative inflammation were successfully controlled with an analgesic and an anti-inflammatory drug. There was only one complication (superficial necrosis), which healed completely by second intention. Direct puncture and sclerosis with polidocanol foam are an effective treatment for LFVM of the face and oral cavity.

Use of platelet-rich plasma in the treatment of bisphosphonate-related osteonecrosis of the jaw.

Platelet-rich plasma is a concentrate of growth factors and osteoconductive proteins, which can play a major role in bone biology by accelerating and enhancing bone repair and regeneration. This paper describes the results of using platelet-rich plasma in the management of bisphosphonate-associated necrosis of the jaw. Eight patients with a diagnosis of bisphosphonate-associated necrosis of the jaw were surgically treated for debridement and removal of necrotic bone, followed by application of autologous platelet concentrate enriched with growth factors and primary suture of the wound. Patients underwent periodic clinical and radiological follow-up examinations. All patients showed clinical improvement and oral lesions resolved 2-4 weeks after treatment. After an average 14-month follow up period, patients remained asymptomatic. Although not conclusive, the combination of necrotic-bone curettage and platelet-rich-plasma to treat refractory osteonecrosis of the jaw yielded promising results.

Oxidative effects of chronic ethanol consumption on the functions of heart and kidney: folic acid supplementation.

AIMS: The principal aim of this study was to investigate the oxidative effects of chronic ethanol consumption on the functions of the heart and the kidney and the possible modification of this effect by folic acid supplementation. Moreover, in order to find whether this oxidative profile affects cardiovascular function, parameters such as heart rate and glomerular filtration rate were also assessed. METHODS: Four experimental groups of rats were used: control, ethanol-exposed, control supplemented with folic acid and ethanol-exposed plus folic acid. Ethanol-exposed rats were subjected to a chronic ethanol treatment (2 months), in which the level of alcohol reaches 30% v/v. Diet and ethanol solution were provided ad libitum, and folic acid supplementation was 8 vs. 2 ppm. Energy intake, creatinine clearance and heart rate were determined. Antioxidant enzyme activity and lipid and protein peroxidation of the kidney and the heart were measured by the spectrophotometric method. RESULTS: Ethanol increases heart size and catalase (CAT) activity and decreases lipid peroxidation in heart without changing heart rate. However, in the kidney, ethanol decreases CAT activity, increases lipid peroxidation and decreases glomerular filtration rate. Folic acid supplementation avoids these situations; it does not, however, improve glomerular function. CONCLUSION: Chronic ethanol consumption has many effects on the antioxidant enzymatic activity of the heart and the kidney, leading to increased renal lipid peroxidation prevented by folic acid supplementation.

The effects of ethanol upon hydric balance and arterial pressure in rats: folic acid as a possible hypotensor.

AIMS: Chronic alcohol intake is related to hypertension. There are, however, few studies concerning the effect of ethanol upon hydric balance in relation to arterial pressure. Folic acid intake has beneficial effects upon the cardiovascular system decreasing hyperhomocysteinemia, however, more studies imply that it is related with other mechanisms. Therefore, we have studied the effects of chronic alcohol intake (30% v/v) upon hydric-saline balance and hypertension and have found that dietary supplementation with folic acid (8 mg/kg) improves the above parameters. MAIN METHODS: Our study used four experimental groups of rats: control, alcohol, alcohol with folic acid and control with folic acid. In all cases we measured the clearance of Na(+), K(+) and aldosterone; osmolarity in urine, liquid and solid ingestion; homocysteine levels in serum; cardiac frequency and arterial blood pressure. KEY FINDINGS: The alcohol intake increases serum aldosterone and homocysteine, which is reflected in an increase in arterial blood pressure. In addition, we have found that alcohol intake reduces both liquid and solid ingestion (causing a malnourishment status), the clearance of creatinine, aldosterone, Na(+) and K(+), and the ratio ClNa(+)/ClCr; it also increases urine osmolarity. Folic acid supplementation increases the clearance of Na(+) and the ratio ClNa(+)/ClCr. SIGNIFICANCE: Folic acid intake improves the hypertension provoked by alcohol by increasing the aldosterone clearance, drastically reducing the serum levels of this hormone and thus its hypertensor effect.

Bisfosfonatos en atención primaria. Estudio epidemiológico de la administración y repercusión de bisfosfonatos en pacientes que acuden a consultas de odontología del Servicio Canario de Salud / Bisphosphonates in primary attention. Study epidemiologist of administration and repercussion of bisphosphonates in patientes who they go to consultations of odontology of the Canary Service of Health

Objetivos: Hemos realizado un estudio en tres consultas de Odontología de Las Palmas de Gran Canaria para conocer el porcentaje de pacientes que acude a las mismas en tratamiento con bisfosfonatos (BF), qué características tienen, qué prestaciones solicitan y si estos fármacos condicionan los tratamientos dentales. Igualmente, queremos saber el grado de información sobre los posibles efectos secundarios de la administración de BF en relación a la salud bucodental y si se llevaron a cabo revisiones previas a dicho tratamiento. Diseño del estudio: Se realizaron encuestas durante 40 días laborales (entre los meses Junio y Julio de 2007) a todos los pacientes de 50 años o más, que acudieron con cita previa a las Consultas de Odontología de tres Centros de Salud, del Servicio Canario de Salud en Las Palmas de Gran Canaria. Resultados: De los 501 pacientes, 25 (5%) estaban en tratamiento con BF. El risedronato y el alendronato eran los BF más utilizados. Se encontró menor frecuencia de exodoncias respecto a la esperada en estos pacientes y un aumento de las prescripciones medicamentosas. Conclusiones: Ningún paciente había acudido para una revisión dental antes de iniciar un tratamiento con BF. Los pacientes en tratamiento con BF vía oral no están debidamente informados de la posibilidad de osteonecrosis maxilar tras alguna manipulación dentaria (AU)

Objetives: We have realized a study in three consutations of Odontology of Las Palmas of Gran Canaria, to know the percentage patients that goes to the same in tratment with bisphosphonates (BF), what characteristic has, what benefits they request and if these medicaments determine the dental treatments. Equally, we want to know the degree of information about the possible side effects of the administration of BF in relation to the oral health and if previous revisions were carried out to this treatment. Design of the study: Surveys were realised during 40 labour days (between the months June and July, 2007) to all the 50-year-old patients o more, that they came with appointment before the Consultations of Odontology of three Centers of Health, of the Canary Service of Health in Las Palmas of Gran Canaria. Results: Of 501patients, 25 (5%) was in treatment with BF. The risedronato and the alendronato were the most used BF. One found minor frequency of exodoncias with regard to waited in these patients and an increase of the medicinal prescriptions. Conclusions: No patient had come for dental review before initiating a treatment with BF. The patientes in treatment with BF oral route are not properly informed about the possibility of osteonecrosis maxillary after any dental manipulation (AU)

Dietary selenium plus folic acid as an antioxidant therapy for ethanol-exposed pups.

BACKGROUND: Nutrients such as folic acid and selenium are decreased in dams exposed to ethanol during gestation and lactation, affecting their metabolism, antioxidant balance, and the future health of their progeny. We will study whether the supplementation of the maternal diet with folate and selenium can prevent ethanol-induced oxidative liver disorders in the offspring. METHODS: Dams were randomised into four groups: control, alcohol, alcohol+folic acid+Se, and control+folic acid+Se. We determined selenium by graphite-furnace atomic absorption and antioxidant enzyme activities, lipid peroxidation, and protein carbonyl by spectrophotometry in the offspring. RESULTS: Alcohol increased serum Se levels and glutathione peroxidase (GPx) activity. However, in the liver of pups from ethanol-exposed dams a decrease in selenium was provoked and GPx activity increased with the double supplementation. Glutathione reductase (GR) and catalase (CAT) activities increased with ethanol, while double supplementation significantly decreased the GR activity. The supplemented diet reduced the protein peroxidation found in ethanol pups. CONCLUSIONS: These results suggest that folic acid+Se could be effective in neutralising the damage of ethanol consumption in pups since it prevents peroxidation protein products.

Importancia del cepillado antes de acostarse en la prevención de la caries. Estudio en una población infantil / The importance of night tooth brushing before sleeping in the prevention of dental caries. Study on childhood population

En el presente trabajo nos planteamos si sería imprescindible el cepillado tres veces al día y, en caso contrario, en qué momento del día sería más importante la eliminación mecánica de la placa. Para ello, se planteó un estudio transversal correspondiente a 214 escolares de 6-12 años en el periodo comprendido en el curso 2004-5. A cada niño se le practicó el “Examen parcial o tipo III” recomendado por la Federación Dental Internacional, como procedimiento estándar para un estudio de prevalencia de caries. Hemos obtenido los siguientes resultados: 1. El cepillado de dientes antes de acostarse es un factor protector de la presencia de caries, siendo el correspondiente odd-ratio ajustado de 0.339 (intervalo de confianza al 95% [0.159; 0.722]). 2. El consumir azúcar más de una vez una vez al día tiene más riesgo de aparición de caries que si consumen una vez al día, siendo el correspondiente odd-ratio ajustado de 1.998 (intervalo de confianza al 95% [1.090; 3.665]). 3. Los niños que acuden a un colegio público tienen más riesgo de presentar caries que los que asisten a un colegio privado. Siendo el correspondiente odd-ratio ajustado de 2.019 (intervalo de confianza al 95% [1.105; 3.691]). 4. Se cumplen en la población estudiada los objetivos marcados sobre caries dental por la OMS para el año 2000 (AU)

In the present study we are questioning if the three time a day tooth brushing is really essential and if it is the opposite case, what time of the day would be most important for mechanical elimination of dental plaque. For this purpose we have planed a transversal study on 214 pupils aged 6 to 12 years in the period of 2004-05 scheduled school coarse. On each of them was applied the “Partial Exam type III” which is recommended from International Dental Federation and which is considered as standard procedure on prevalence of dental caries study. We obtained following results: 1. Tooth brushing by night before sleeping is a favourable protection factor from dental caries, being correspondent odd-ratio adjusted on 0.339 (interval of confidence is 95% [0.159; 0.722]). 2. Consuming the sugar more than one time a day causes higher risk for dental caries apparition than one time a day consumption of sugar, being correspondent odd-ratio adjusted on 1.998 (interval of confidence is 95% [1.090;3.665]). 3. The children attending public schools have higher risk of dental caries presence than the children attending private schools being correspondent odd-ratio adjusted on 2.019 (interval of confidence is 95% [1.105;3.691]). 4. The objectives on dental caries marked from WHO are carried out on the studied population (AU)

Limitación a la tolerancia al ejercicio en pacientes con EPOC a la altura de Bogotá (2.640 m). Patrón respiratorio y gasometría arterial en reposo y en ejercicio pico / Exercise limitation in patients with chronic obstructive pulmonary disease at the altitude of Bogota (2640 m). Breathing pattern and arterial gases at rest and peak exercise

OBJETIVO: Describir la respuesta al ejercicio en sujetos normales y en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) en Bogotá (altura: 2.640 m; presión atmosférica: 560 mmHg) y establecer diferencias con los datos publicados de pacientes con dicha enfermedad a nivel del mar. Las personas sanas a esta altura aumentan la ventilación alveolar para atenuar la hipoxemia (presión arterial de CO2: 30 mmHg; presión arterial de O2: 63 mmHg). MATERIAL Y MÉTODO: Se realizó un estudio descriptivo en pacientes con EPOC y en sujetos sanos. La capacidad de ejercicio se determinó con una prueba incremental en un cicloergómetro. RESULTADOS: Se incluyó en el estudio a 16 sujetos sanos y 25 pacientes con EPOC (volumen espiratorio forzado en el primer segundo del 43,3 ñ 13 por ciento). En comparación con los sujetos sanos, en los pacientes con EPOC se observó un aumento de la ventilación minuto en reposo que no se mantuvo adecuadamente en el ejercicio, así como disminución del consumo de oxígeno pico (53,0 ñ 15 por ciento). En ejercicio pico la capacidad inspiratoria disminuyó (-0,62 ñ 0,34 l), la relación ventilación minuto/ventilación voluntaria máxima aumentó y hubo una intensa hipoxemia (presión arterial de O2 de 49,9 ñ 9,9 mmHg). Esta hipoxemia se correlacionó significativamente con el porcentaje del valor predicho del consumo de oxígeno pico (r = 0,60), la fatiga de los miembros inferiores (r = -0,62), el porcentaje predicho de la capacidad inspiratoria pico (r = 0,61) y el porcentaje predicho del volumen corriente pico (r = 0,49). En comparación con los datos publicados a nivel del mar, en los pacientes con EPOC la ventilación minuto en reposo fue mayor, hubo una mayor disminución de la capacidad inspiratoria durante el ejercicio y la hipoxemia fue más grave tanto en reposo como en ejercicio. CONCLUSIONES: En los pacientes con EPOC residentes en Bogotá demostramos intolerancia al ejercicio determinada por limitación ventilatoria e hipoxemia severa. El aumento de la ventilación minuto en reposo, la mayor disminución de la capacidad inspiratoria y la gravedad de la hipoxemia durante el ejercicio fueron las principales diferencias con la EPOC a nivel del mar (AU)

[Exercise limitation in patients with chronic obstructive pulmonary disease at the altitude of Bogota (2640 m). Breathing pattern and arterial gases at rest and peak exercise]. / Limitación a la tolerancia al ejercicio en pacientes con EPOC a la altura de Bogotá (2.640m). Patrón respiratorio y gasometría arterial en reposo y en ejercicio pico.

OBJECTIVE: To describe the response to exercise of normal subjects and patients with chronic obstructive pulmonary disease (COPD) in Bogota, Colombia (altitude: 2640 m; atmospheric pressure: 560 mm Hg) and compare it with data published on COPD patients at sea level. Healthy people increase their minute ventilation to attenuate hypoxemia (PaCO2: 30 mm Hg; PaO2: 63 mm Hg). MATERIAL AND METHOD: A descriptive study was carried out on healthy subjects and COPD patients. Exercise limitation was determined by an incremental test on a cycle ergometer. RESULTS: The study enrolled 16 healthy subjects and 25 COPD patients (forced expiratory volume in 1 second: 43.3% [SD 13%]). Minute ventilation at rest was greater in COPD patients compared with healthy subjects, it was not adequately sustained during exercise, and there was a reduction in peak oxygen uptake (53.0% [15%]). At peak exercise, inspiratory capacity decreased (-0.62 [0.34] L), the ratio of minute ventilation to maximal voluntary ventilation increased, and severe hypoxemia occurred (PaO2: 49.9 [9.9] mm Hg). There was significant correlation between hypoxemia and the percentage of predicted peak oxygen uptake (r=0.60), leg fatigue (r=-0.62), percentage of predicted peak inspiratory capacity (r=0.61), and the percentage of predicted peak tidal volume (r=0.49). Minute ventilation at rest was shown to be higher, there was a greater reduction in the inspiratory capacity during exercise, and hypoxemia was more severe at rest and during exercise for patients with COPD in Bogota, compared with those at sea level. CONCLUSIONS: Patients with COPD living in Bogota were shown to have lower tolerance to exercise evidenced by ventilatory limitation and severe hypoxemia. Increased minute ventilation at rest, greater reduction in inspiratory capacity, and severity of hypoxemia during exercise were the main differences between COPD in Bogota and at sea level.

El proteinograma en medicina clínica

Las proteínas constituyen un tipo de biomoléculas formadas por cadenas de aminoácidos unidos por el enlace peptídico, con gran variedad estructural y una enorme diversidad de funciones biológicas.Diversas enfermedades cursan con alteraciones cualitativas o cuantitativas de la sangre, orina o líquido cefalorraquídeo u otros líquidos biológicos.Aprovechando sus características fisicoquímicas, pueden separarse distintas fracciones que se comportan análogamente frente a la electroforesis, pero con funciones biológicas muy diferentes. A pesar de ello, las alteraciones de las distintas fracciones reconocidas en el proteinograma tienen gran interés diagnóstico.En este trabajo se describen las alteraciones más significativas de interés clínico (AU)