Salivary and Dental Plaque Composition in Disabled Children Who Require Home Care: A Cross-sectional Investigation.

Aims: The purpose of this study was to compare salivary and dental plaque (DP) composition between disabled children who require home care (DCHC) and a control group (CG) and to correlate it with oral and systemic health factors. Materials and Methods: This cross-sectional study included 15 DCHC and 15 healthy children (aged between 4 and 10 years). The caregivers answered a questionnaire on disease diagnosis, medical history, dental history, and oral hygiene routine. In addition to clinical examination, saliva and DP samples were collected and analyzed using attenuated total reflection-Fourier transform infrared spectroscopy. Data were collected between January and December 2019. Student's t and Kendall correlation tests were used. Results: Calculus (46.7%), bleeding on toothbrushing (53.3%), and gingival hyperplasia (40.0%) were prevalent in DCHC. The saliva of DCHC presented a higher amount of lipids and collagen and a lower amount of carbohydrates than that of the CG (P < 0.05). DP components were similar in DCHC and CG. Conclusion: DCHC presented oral comorbidities and changes in salivary composition, compared with the CG.

Demographic outcomes and ecosystem implications of giant tortoise reintroduction to Española Island, Galapagos.

Restoration of extirpated species via captive breeding has typically relied on population viability as the primary criterion for evaluating success. This criterion is inadequate when species reintroduction is undertaken to restore ecological functions and interactions. Herein we report on the demographic and ecological outcomes of a five-decade-long population restoration program for a critically endangered species of "ecosystem engineer": the endemic Española giant Galapagos tortoise (Chelonoidis hoodensis). Our analysis of complementary datasets on tortoise demography and movement, tortoise-plant interactions and Española Island's vegetation history indicated that the repatriated tortoise population is secure from a strictly demographic perspective: about half of tortoises released on the island since 1975 were still alive in 2007, in situ reproduction is now significant, and future extinction risk is low with or without continued repatriation. Declining survival rates, somatic growth rates, and body condition of repatriates suggests, however, that resources for continued population growth are increasingly limited. Soil stable carbon isotope analyses indicated a pronounced shift toward woody plants in the recent history of the island's plant community, likely a legacy of changes in competitive relations between woody and herbaceous plants induced by now-eradicated feral goats and prolonged absence of tortoises. Woody plants are of concern because they block tortoise movement and hinder recruitment of cactus--a critical resource for tortoises. Tortoises restrict themselves to remnant cactus patches and areas of low woody plant density in the center of the island despite an apparent capacity to colonize a far greater range, likely because of a lack of cactus elsewhere on the island. We conclude that ecosystem-level criteria for success of species reintroduction efforts take much longer to achieve than population-level criteria; moreover, reinstatement of endangered species as fully functioning ecosystem engineers may often require large-scale habitat restoration efforts in concert with population restoration.

Accounting for the impact of conservation on human well-being.

Conservationists are increasingly engaging with the concept of human well-being to improve the design and evaluation of their interventions. Since the convening of the influential Sarkozy Commission in 2009, development researchers have been refining conceptualizations and frameworks to understand and measure human well-being and are starting to converge on a common understanding of how best to do this. In conservation, the term human well-being is in widespread use, but there is a need for guidance on operationalizing it to measure the impacts of conservation interventions on people. We present a framework for understanding human well-being, which could be particularly useful in conservation. The framework includes 3 conditions; meeting needs, pursuing goals, and experiencing a satisfactory quality of life. We outline some of the complexities involved in evaluating the well-being effects of conservation interventions, with the understanding that well-being varies between people and over time and with the priorities of the evaluator. Key challenges for research into the well-being impacts of conservation interventions include the need to build up a collection of case studies so as to draw out generalizable lessons; harness the potential of modern technology to support well-being research; and contextualize evaluations of conservation impacts on well-being spatially and temporally within the wider landscape of social change. Pathways through the smog of confusion around the term well-being exist, and existing frameworks such as the Well-being in Developing Countries approach can help conservationists negotiate the challenges of operationalizing the concept. Conservationists have the opportunity to benefit from the recent flurry of research in the development field so as to carry out more nuanced and locally relevant evaluations of the effects of their interventions on human well-being.

The effect of formulation on the penetration of coated and uncoated zinc oxide nanoparticles into the viable epidermis of human skin in vivo.

The use of nanoparticulate zinc oxide (ZnO-NP) in sunscreens and other cosmetic products has raised public health concerns. The two key issues are the extent of exposure to ZnO-NP and the likely hazard after the application of ZnO-NP in sunscreen and cosmetic products to humans in vivo. Our aims were to assess exposure by the extent of ZnO-NP penetration into the viable epidermis and hazard by changes in the viable epidermal redox state for a number of topical products. Of particular interest is the role of the particle coating, formulation used, and the presence of any enhancers. Multiphoton tomography with fluorescence lifetime imaging microscopy (MPT-FLIM) was used to simultaneously observe ZnO-NP penetration and potential metabolic changes within the viable epidermis of human volunteers after topical application of various ZnO-NP products. Coated and uncoated ZnO-NP remained in the superficial layers of the SC and in the skin furrows. We observed limited penetration of coated ZnO-NP dispersed in a water-in-oil emulsion formulation, which was predominantly localized adjacent to the skin furrow. However, the presence of ZnO-NP in the viable epidermis did not alter the metabolic state or morphology of the cells. In summary, our data suggest that some limited penetration of coated and uncoated ZnO-NP may occur into viable stratum granulosum epidermis adjacent to furrows, but that the extent is not sufficient to affect the redox state of those viable cells.

Hipertensión arterial: hechos esenciales / Hypertension: essential facts

La hipertensión arterial (HTA) es una afección de alta prevalencia y elevada morbimortalidad. Su manejo debe ser individualizado según el riesgo cardiovascular total de cada paciente. Se han formulado recomendaciones para el uso dediferentes métodos de toma de la presión arterial (PA) (consultorio, domicilio, MAPA) con objetivos tanto diagnósticos como pronósticos y de orientación terapéutica. Hay acuerdo en iniciar un cambio de estilo de vida en todo paciente hipertenso o con PA normal alta. El momento de inicio de tratamiento farmacológico así como las metas de PA a alcanzarson puntos controvertidos aunque se formulan recomendaciones específicas. El mayor beneficio logrado en términosde reducción de eventos adversos en el tratamiento de la HTA depende de la magnitud del descenso de las cifras tensionales logrado. Hay, sin embargo, indicaciones y contraindicaciones definidas para el uso de ciertos tipos de fármacos antihipertensivos en situaciones clínicas particulares. Creemos que el concepto más importante a transmitir sobre el tratamiento de la HTA es muy simple: descendamos las cifras tensionales del paciente, si es posible, hasta llegar a las metas, pero aunque no logremos llegar a las mismas,igualmente estaremos disminuyendo en forma marcada su riesgo.

Quantum dot penetration into viable human skin.

Systematic studies probing the effects of nanoparticle surface modification and formulation pH are important in nanotoxicology and nanomedicine. In this study, we use laser-scanning fluorescence confocal microscopy to evaluate nanoparticle penetration in viable excised human skin that was intact or tape-stripped. Quantum dot (QD) fluorescent nanoparticles with three surface modifications: Polyethylene glycol (PEG), PEG-amine (PEG-NH2) and PEG-carboxyl (PEG-COOH) were evaluated for human skin penetration from aqueous solutions at pH 7.0 and at pHs of solutions provided by the QD manufacturer: 8.3 (PEG, PEG-NH2) and 9.0 (PEG-COOH). There was some penetration into intact viable epidermis of skin for the PEG-QD at pH 8.3, but not at pH 7.0 nor for any other QD at the pHs used. Upon tape stripping 30 strips of stratum corneum, all QDs penetrated through the viable epidermis and into the upper dermis within 24 h.

Characterization of optical properties of ZnO nanoparticles for quantitative imaging of transdermal transport.

Widespread applications of ZnO nanoparticles (NP) in sun-blocking cosmetic products have raised safety concerns related to their potential transdermal penetration and resultant cytotoxicity. Nonlinear optical microscopy provides means for high-contrast imaging of ZnO NPs lending in vitro and in vivo assessment of the nanoparticle uptake in skin, provided their nonlinear optical properties are characterized. We report on this characterization using ZnO NP commercial product, Zinclear, mean-sized 21 nm. Two-photon action cross-section of this bandgap material (E(bg) = 3.37 eV, λ(bg) = 370 nm) measured by two techniques yielded consistent results of [Formula: see text] = 6.2 ± 0.8 µGM at 795 nm, and 32 ± 6 µGM at 770 nm per unit ZnO crystal cell, with the quantum efficiency of [Formula: see text] = (0.9 ± 0.2) %. In order to demonstrate the quantitative imaging, nonlinear optical microscopy images of the excised human skin topically treated with Zinclear were acquired and processed using [Formula: see text] and [Formula: see text]values yielding nanoparticle concentration map in skin. Accumulations of Zinclear ZnO nanoparticles were detected only on the skin surface and in skin folds reaching concentrations of 800 NPs per µm(3).

Sinopsis de las especies arbóreas del santuario histórico de Machu Picchu y su zona de amortiguamiento / Synopsis of tree species historic sanctuary of Machu Picchu and its buffer zone

We estimate that the tree and woody flora of the Machu Picchu Historical Sanctuary has more than 550 species: in the core area and buffer zone. Field work and the density of such collections are all studying the Andean forests, except that in this investigation, increases the number of species. The Torontoy Canyon which crosses the Sanctuary boundaries from southeast to northwest between Chillca and Collpani and the presence of the Urubamba and Vilcabamba mountain ranges with is complex of glaciers in the area are the determining factors for high tree diversity. The study results reported over 550 tree species distributed in 74 families and 192 genera. The lack of interest in long-term research affects the risk of misuse and little knowledge of the tree flota that applies to biological convervation in the country.

Estimamos que la flora arbórea y leñosa del Santuario Histórico de Machu Picchu tiene más de 550 especies: en el área núcleo y la Zona de Amortiguamiento. El trabajo de campo y la densidad de colecciones son semejantes a todos los que estudian las selvas andinas, execpto que en esta investigación, se incementa el número de especies. El Cañon del Torontoy que atraviesa el Santuario de sus límites sureste a noreste entre Chillca a Collpani y la presencia de las Cordilleras de Urubamba y Vilcabamba con su complejo de glaciares en el área son los factores determinantes para la alta diversidad de árboles. Los resultados del estudio reportan sobre 550 especies arbóreas distribuidas en 74 familias y 192 géneros. La escasez de interés en investigar a largo plazo afecta el mal uso y peligro de no conocer bien la flora arbórea que se aplica a la conservación biológica del país.

Analysis of the metabolic deterioration of ex vivo skin from ischemic necrosis through the imaging of intracellular NAD(P)H by multiphoton tomography and fluorescence lifetime imaging microscopy.

Ex vivo human skin has been used extensively for cosmeceutical and drug delivery studies, transplantable skin allografts, or skin flaps. However, it has a half-life of a few days due to ischemic necrosis. Traditional methods of assessing viability can be time-consuming and provide limited metabolic information. Using multiphoton tomography and fluorescence lifetime imaging (MPT-FLIM) we assess ischemic necrosis of ex vivo skin by NAD(P)H autofluorescence intensity and fluorescence lifetime. Ex vivo skin is stored in the presence and absence of nutrient media (Dulbecco Modified Eagle Medium) at -20, 4, and 37 degrees C and room temperature over a 7-day time course to establish different rates of metabolic deterioration. At higher temperatures we observe a decrease in NAD(P)H autofluorescence, higher image noise, and a significant increase in the average fluorescence lifetime (tau(m)) from approximately 1000 to 2000 ps. Additionally, significant distortions in NAD(P)H fluorescence lifetime histograms correspond to the reduction in autofluorescence. Skin kept at 4 degrees C, with or without media, showed the least change. Our findings suggest that MPT-FLIM enables useful noninvasive optical biopsies to monitor the metabolic state and deterioration of human skin for research and clinical purposes.

Tratamiento antitrombótico en la fibrilación auricular crónica / Antithrombotic therapy in chronic atrial fibrillation

La fibrilación auricular crónica es la arritmia sostenida más frecuente en la práctica clínica. Su presencia se asocia con un aumento de la morbilidad y de la mortalidad. La embolia arterial, sobre todo encefálica, es una de sus complicaciones más temibles. La warfarina es altamente efectiva para prevenirla, si bien su uso puede aumentar el riesgo de sangrado. Se han pautado niveles óptimos de anticoagulación y se han descrito factores de riesgo de sangrado con anticoagulantes orales. La aspirina tiene una efectividad mucho menor, aunque suficiente en algunos casos. El riesgo embólico no es uniforme en la población de sujetos portadores de fibrilación auricular crónica. Se han sugerido esquemas de estratificación de riesgo que tienen particular importancia a la hora de elegir el tratamiento antitrombótico más adecuado para un paciente dado

Displasia arritmogénica del ventrículo derecho: presentación de tres casos / Arrhythmogenic right ventricular dysplasia

La displasia arritmogénica del ventrículo derecho es una afección bien definida con manifestaciones predominantemente arrítmicas. Se analizan los tres casos diagnosticados por nuestro grupo. Estos casos se presentaron como taquicardia ventricular con morfología de bloqueo de rama izquierda, presentando uno de ellos una muerte súbita abortada en la evolución. El electrocardiograma basal y la promediación de señales fueron anormales en dos de los tres casos, al igual que el ecocardiograma. El estudio electrofisiológico logró inducir en los tres pacientes taquicardia ventricular monomorfica sostenida con morfología de bloqueo de rama izquierda. El diagnóstico definitivo se hizo por ventriculografía derecha en dos casos y por resonancia nuclear magnética en el otro. El tratamiento incluyó fármacos antiarrítmicos en los tres casos y la colocación de un cardiodesfibrilador automático en el que sobrevivió a una muerte súbita

Sudden cardiac death in familial hypertrophic cardiomyopathy: are "benign" mutations really benign?

Familial hypertrophic cardiomyopathy (FHC) is an autosomal dominant disorder characterised predominantly by left ventricular hypertrophy and sudden cardiac death. Mutations in the cardiac beta-myosin heavy chain gene have been identified in several families and designated as "benign" or "malignant". We describe a family (family L) with a "benign" mutation in which early sudden cardiac death has occurred. The family was studied by clinical, electrocardiographic and echocardiographic assessment. DNA analysis involved screening for the six most common cardiac beta-myosin heavy chain gene mutations using allele specific oligonucleotide probes and restriction enzyme analysis. The Val606Met missense mutation was found. This mutation has been described in four families as being "benign" since it was associated with low penetrance and a near normal life span. Sudden cardiac death was an infrequent finding. In contrast, family L has a more malignant clinical picture with one sudden death in three affected individuals. The proband died suddenly at age 14 years during exercise. Designating gene mutations in FHC as benign or malignant has major clinical implications. As these mutations have only been described in a limited number of families, caution needs to be taken when interpreting genotype-phenotype correlations in this disorder.

A comparison of the properties of the binary and ternary complexes formed by calmodulin and troponin C with two regulatory peptides of phosphorylase kinase.

The regulatory peptides Phk13 (301-327) and a modified form of Phk5 (342-367) from the gamma-subunit of glycogen phosphorylase kinase form binary and ternary complexes with both calmodulin and the related muscle protein troponin C. Neither peptide appears to affect to a major extent a fluorescent probe linked to Cys-27 of wheat germ calmodulin. Phk13, but not Phk5, significantly modifies the properties of a probe joined to Cys-98 of troponin C. A comparison by means of radiationless energy transfer of the average separations of Trp-16 of Phk5 from specific groups in the N- and C-terminal halves of calmodulin and troponin C indicate significant changes upon going from the 1:1 binary complex to the 1:1:1 ternary complex with Phk13. A comparison of the effects of addition of Phk13 to calmodulin, troponin C, and their binary complexes with Phk5 suggests that the conformation of Phk13 is similar in the binary and ternary complexes.

Treatment of chronic atrial fibrillation in the elderly, assessed by ambulatory electrocardiographic monitoring.

This study concerns 8 elderly patients with age-related chronic atrial fibrillation that required control of the ventricular response. The effects of oral administration of placebo, pindolol, verapamil, digoxin and digoxin + pindolol were assessed (each for a week) during three daily activity and sleep sessions, over a six-week period. Cardiac rhythm was monitored by taped electrocardiograms. Either digoxin or pindolol was effective, but digoxin was the best tolerated of all the drugs. A combination of pindolol and digoxin reduced the maximum ventricular rate without further depression of the minimum ventricular rate. Digoxin seems to be well tolerated in the control of atrial fibrillation in the elderly, and beta blockade may be a useful therapeutic adjunct.

Oral pindolol in acute evolving myocardial infarction.

Pindolol was administered orally (5 mg 8th-hourly) to 30 patients 5--19 (mean = 9.0 hrs) hours after onset of acute myocardial infarction. There were no serious side effects during the acute phase of infarction, only one hospital death and two late deaths at follow-up 2--82 (mean = 37 wks) weeks after hospital discharge. In contrast to healthy volunteers, patients with acute infarction had unpredictable absorption of pindolol from the gastrointestinal tract; this was attributable in part to concurrent administration of narcotic analgesics.

Intravenous disopyramide phosphate and ventricular overdrive pacing in the termination of paroxysmal ventricular tachycardia.

Both antiarrhythmic drugs and bursts of rapid ventricular pacing provide alternatives to DC cardioversion for the treatment of paroxysmal ventricular tachycardia. This report considers the individual and combined success of burst ventricular pacing and intravenous disopyramide phosphate in the tretment of 11 examples of paroxysmal ventricular tachycardia. Rapid ventricular pacing, at a rate of up to 50 beats/min faster than the tachycardia rate terminated 7 of the tachycardias. Intravenous disopyramide resulted in increased tachycardiac cycle length (342 +/- 34 ms-385 +/- 56 ms), increased QRS complex width (147 +/- 42 ms-180 +/- 41 ms) and termination of 8 the tachycardias. The remaining 3 tachycardias could be terminated by bursts of ventricular pacing following the infusion of disopyramide. Of these, 2 could not be terminated prior to disopyramide. The use of both techniques allowed the extinction of all 11 tachycardias and prevented the need to proceed to DC conversion.

Atrial bigeminy with block associated with bradycardia and paroxysmal atrial fibrillation -- an important variant of the tachycardia-bradycardia syndrome.

Serial 2-channel 24 h dynamic ECGs in 7 patients who were referred with the "tachy-brady" syndrome for consideration for permanent cardiac pacing revealed: 1. atrial premature beats (APBs) which were conducted to the ventricles normally or aberrantly; 2. intermittent atrial bigeminy with block towards the ventricles (this rhythm mimicked sinus bradycardia with ventricular rates of 38-45 beats/min and the ectopic P waves were visible on only one of the ECG channels); 3. paroxysms of atrial fibrillation initiated by closely coupled APBs. These findings suggested that both the ventricular bradycardia and the atrial fibrillation were caused by frequent APBs and that pacing therapy was unnecessary. Disopyramide was given to 5 patients resulting in suppression of the arrhythmia and relief of symptoms. In one patient there was spontaneous resolution and one patient refused treatment. This variant of the "tachy-brady" syndrome can be successfully treated by suppression of abnormal atrial impulse formation without recourse to pacemaker implantation.