Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

Transcriptional analysis of metabolic and virulence genes associated with biofilm formation in Piscirickettsia salmonis strains.

Piscirickettsia salmonis is a facultative intracellular bacterium that generates piscirickettsiosis affecting salmonids in Chile. The bacterium has the adaptability to survive in the marine environment under multiple stressful conditions. In this sense, this work focused on the analysis of a gene battery associated with biofilm formation under different culture conditions and on the adaptability of this biofilm to different media. The results indicated that the strains LF-89, IBM-034 and IBM-040 were strong biofilm producers, evidencing adaptability to the media by increasing the amount of biofilm through successive growths. Transcript levels of six genes described in various bacteria and P. salmonis, considered to have metabolic functions, and playing a relevant role in biofilm formation, were analyzed to evaluate bacterial functionality in the biofilm. The genes mazE-mazF, implicated in biofilm and stress, were markedly overexpressed in the biofilm condition in the three strains. For its part, gene gltA, an indicator of metabolic activity and related to virulence inhibition in Salmonella typhimurium, also seems to restrain the pathogenesis process in P. salmonis by inhibiting the expression of the virulence-associated genes liso and tcf. Finally, the expression of the glnA gene suggests the use of glutamine as an essential element for the growth of the biofilm.

Characterization of a ripening-related transcription factor FcNAC1 from Fragaria chiloensis fruit.

Fragaria chiloensis is a strawberry endemic from Chile with attractive white-pink fruit, pleasant aroma and taste. However, this fruit has a limited post-harvest period due to fast softening. Several transcription factors (TFs) are involved in the regulation of fruit ripening, and members of the NAC family have been implicated in cell wall remodeling. FcNAC1 was isolated from F. chiloensis fruit, coding a protein of 332 amino acid residues and displaying a characteristic NAC domain at the N terminus. FcNAC1 protein showed nuclear localization. An increase in transcript level was observed during ripening. A sequence of 1488 bp of FcNAC1 promoter was obtained. In silico analysis identified cis elements able to respond to some hormones and Secondary wall NAC binding elements (SNBE), and responding to auxin and ABA. A structural model of FcNAC1 provided evidence for interaction with DNA sequences containing SNBE, while a dual luciferase assay confirmed the transcriptional activation by FcNAC1 of the promoter of FcPL, a gene involved in cell wall remodeling in F. chiloensis fruit. The results suggest the participation of FcNAC1 during ripening development of strawberry fruit, by regulating pectin metabolism during softening.

Immunological response of the Sub-Antarctic Notothenioid fish Eleginops maclovinus injected with two strains of Piscirickettsia salmonis.

Eleginops maclovinus is an endemic fish to Chile that lives in proximity to salmonid culture centers, feeding off of uneaten pellet and salmonid feces. Occurring in the natural environment, this interaction between native and farmed fish could result in the horizontal transmission of pathogens affecting the aquaculture industry. The aim of this study was to evaluate the innate and adaptive immune responses of E. maclovinus challenged with P. salmonis. Treatment injections (in duplicate) were as follows: control (100 µL of culture medium), wild type LF-89 strain (100 µL, 1 × 108 live bacteria), and antibiotic resistant strain Austral-005 (100 µL, 1 × 108 live bacteria). The fish were sampled at various time-points during the 35-day experimental period. The gene expression of TLRs (1, 5, and 8), NLRCs (3 and 5), C3, IL-1ß, MHCII, and IgMs were significantly modulated during the experimental period in both the spleen and gut (excepting TLR1 and TLR8 spleen expressions), with tissue-specific expression profiles and punctual differences between the injected strains. Anti-P. salmonis antibodies increased in E. maclovinus serum from day 14-28 for the LF-89 strain and from day 14-35 for the Austral-005 strain. These results suggest temporal activation of the innate and adaptive immune responses in E. maclovinus tissues when injected by distinct P. salmonis strains. The Austral-005 strain did not always cause the greatest increases/decreases in the number of transcripts, so the magnitude of the observed immune response (mRNA) may not be related to antibiotic resistance. This is the first immunological study to relate a pathogen widely studied in salmonids with a native fish.

Ectoparasite Caligus rogercresseyi modifies the lactate response in Atlantic salmon (Salmo salar) and Coho salmon (Oncorhynchus kisutch).

Although Caligus rogercresseyi negatively impacts Chilean salmon farming, the metabolic effects of infection by this sea louse have never been completely characterized. Therefore, this study analyzed lactate responses in the plasma, as well as the liver/muscle lactate dehydrogenase (LDH) activity and gene expression, in Salmo salar and Oncorhynchus kisutch infested by C. rogercresseyi. The lactate responses of Atlantic and Coho salmon were modified by the ectoparasite. Both salmon species showed increasing in plasma levels, whereas enzymatic activity increased in the muscle but decreased in the liver. Gene expression was overexpressed in both Coho salmon tissues but only in the liver for Atlantic salmon. These results suggest that salmonids need more energy to adapt to infection, resulting in increased gene expression, plasma levels, and enzyme activity in the muscles. The responses differed between both salmon species and over the course of infection, suggesting potential species-specific responses to sea-lice infection.

Correlación clínica del triage con el diagnóstico clínico de ingreso y egreso realizado en los pacientes que acuden al servicio médico de urgencias de un hospital privado / Clinical correlation of triage with clinical diagnosis at entering and discharge in patients assisting to emergency room of a private hospital

Resumen: OBJETIVO: determinar la correlación del triage por niveles de ingreso a urgencias y la reclasificación del triage de acuerdo con el diagnóstico de egreso de urgencias. MATERIAL Y MÉTODO: estudio observacional, descriptivo y transversal, realizado en el Hospital Ángeles Clínica Londres, Ciudad de México. Se incluyeron pacientes mayores de 18 años que acudieron al servicio de urgencias de la Clínica Londres de enero a febrero de 2016. RESULTADOS: se incluyeron en el estudio 144 pacientes. Respecto a la frecuencia de niveles de ingreso se reportó clasificado en color naranja a 4% de los pacientes, en amarillo a 56%, en verde a 33%, en azul a 7%. Al egreso se clasificó en color rojo a 4%, en anaranjado a 22%, en amarillo a 28%, en verde a 21% y en azul a 25%. CONCLUSIONES: no existe correlación del triage de ingreso por niveles con la reclasificación triage de egreso hospitalario, con lo que se comprueba la hipótesis nula. De acuerdo con los niveles triage de ingreso y egreso encontramos una subclasificación de 100% del nivel I (rojo), 80% del nivel II (anaranjado), 50% del nivel III (amarillo), 37% del nivel IV (verde) y 72% del nivel V (azul).

Abstract: OBJECTIVE: To determine the correlation of triage by levels at entering to emergency room and the reclassification of triage according to the diagnosis of emergency discharge. MATERIAL AND METHOD: An observational, descriptive and cross-sectional study, done at Hospital Angeles Clínica Londres, Mexico City. Patients older tan 18 years who assisted to the emergency room of Clinica Londres from January to February 2016 were included. RESULTS: There were included 144 patients. About the frequency of levels at entering 4% of patients were classified as orange color, 56% to yellow, 33 to green and 7% to blue. At discharge 4% was classified as red, 22% as orange, 28% as yellow, 21 as green and 25% as blue. CONCLUSIONS: There was no correlation of triage at entering by levels with reclassification of triage at discharge, with proves the null hypothesis. According to levels of triage at entering and discharge we found a subclassification of 100% of level I (red), 80% of level II (orange), 50% of level III (yellow), 37% of level IV (green) and 72% of level V (blue).

Factors affecting dental fluorosis in low socioeconomic status children in Mexico.

OBJECTIVE: To assess the association between dental fluorosis and maternal education in schoolchildren of medium and low socioeconomic status in a low income region of Mexico. DESIGN: Cross-sectional study. SETTINGS: Public schools in the south-central region of Oaxaca, Mexico where the mean fluoride water concentration was 1.01 mg/L (SD 0.21; range 0.71-1.40). Fluoridated salt (200mgF/kg) was available in the region. PARTICIPANTS: 794 schoolchildren. METHODS: To identify the socioeconomic status of the participants, the Bronfman index was used. Dental fluorosis was assessed applying the Thysltrup-Fejerskov Index, (TF). RESULTS: The children's mean age was 10.4 (SD1.2) years. The prevalence of dental fluorosis (TF⟩0) was high 95.7% and 45.2% of the children showed dental fluorosis of TF≥4. The percentage of children showing TF≥4 was 48.8% where their mothers' education was ⟨6 years of schooling compared to 36.7% among other children (p⟨0.001). The multinomial logistic regression model using as base outcome category TF≤2 showed that severe forms of fluorosis (TF≥4) were associated with the consumption of boiled water, (OR= 1.65, p=0.039) of fluoridated salt (OR= 2.61 p=0.001), high brushing frequency (OR=3.12, p=0.001) and lower maternal education (OR=1.71, p=0.007). CONCLUSIONS: A high prevalence of dental fluorosis was observed in the study region. An unequal burden of fluorosis in aesthetically objectionable categories was found in children exposed to several sources of fluoride and whose mother had lower educational level.

Search and analysis of genes involved in antibiotic resistance in Chilean strains of Piscirickettsia salmonis.

Piscirickettsia salmonis is the pathogen causing Piscirickettsiosis. For treatment, the industry mainly uses oxytetracycline and florfenicol, so it is essential to understand the degree of susceptibility of this pathogen to these drugs. But this is still unknown for a large number of P. salmonis strains, as are the molecular mechanisms responsible for greater or lesser susceptibility. However, genes that confer resistance to these antimicrobials have been reported and characterized for this and other bacterial species, among which are membrane proteins that take out the drug. Our results identified differences in the degree of susceptibility to both antibiotics among different Chilean isolated of these bacteria. We analysed 10 available genomes in our laboratory and identified ~140 genes likely to be involved in antibiotic resistance. We analysed six specific genes, which suggests that some of them would eventually be relevant in conferring resistance to both antibiotics, as they encode for specific transporter proteins, which increase the number of transcripts when grown in media with these antibiotics. Our results were corroborated with EtBr permeability analysis, which revealed that the LF-89 strain accumulates this compound and has a reduced capacity to expulse it compared with the field strains.

Factores contextuales que influyen en la participación comunitaria en actividades de ocio y tiempo libre en personas en situación de discapacidad física / Contextual factors affecting community participation in leisure and free time persons with disabilities physical

Se realizó un estudio cualitativo-descriptivo con el objetivo de analizar los factores contextuales que influyen en la participación comunitaria en actividades de ocio y tiempo libre en personas en situación de discapacidad de origen físico con edades comprendidas entre 30 y 59 años y que pertenecen al Departamento de la Discapacidad de Concepción, Chile. La muestra fue seleccionada a través de muestreo por conveniencia y estuvo conformada por cuatro participantes a los cuales se les realizó una entrevista abierta aplicada de manera individual, durante el período de Junio de 2016. Como conclusiones, la mayor participación comunitaria en actividades de ocio y tiempo libre de los y las entrevistados/as se encuentra en las actividades provenientes desde programas específicos para personas con discapacidad, en este caso desde el Departamento de la Discapacidad de Concepción, identificándose factores tanto ambientales como personales que influyen en la participación de estas actividades. En relación a los factores ambientales, más de la mitad de los y las entrevistados/as identificó: el espacio físico, el apoyo y relaciones y el clima, como factores influyentes en su participación en este tipo de actividades. En relación a los factores personales, más de la mitad de los y las entrevistados/as identificó: la motivación, el tiempo, los resultados de la experiencia y los factores asociados a la condiciónde salud, como factores influyentes en su participación en este tipo de actividades.

A qualitative descriptive study was conducted with the aim of analyzing the contextual factors that influence community participation in leisure activities and free time in persons with disabilities from physical aged between 30 and 59 years and belonging to the Department Disability Concepcion, Chile. The sample was selected by convenience sampling and consisted of four participants who underwent an open interview applied individually during the period of June 2016. In conclusion, the greater community participation in leisure activities and free time of respondents in the activities arising from specific programs for people with disabilities, in this case from the Department of Disability Concepcion, identifying both environmental and personal factors that influence participation of these activities. In relation to environmental factors, more than half of participants identified: physical space, support and relationships and climate, as factors influencing their participation in such activities. In relation to personal factors, more than half identified: motivation, time, results of the experience and the factors associated with the health condition as factors influencing their participation in such activities.

Iron acquisition and siderophore production in the fish pathogen Renibacterium salmoninarum.

Renibacterium salmoninarum is the causative agent of bacterial kidney disease, which significantly affects salmonid farming worldwide. Despite this impact, there is scarce data on its iron uptake ability, a factor of pathogenesis. This study investigated the iron acquisition mechanisms of R. salmoninarum and its capacity to uptake iron from different sources. Thirty-two Chilean isolates and the DSM20767T type strain grew in the presence of 2,2'-Dipyridyl at varying concentrations (250-330 µm), and all isolates positively reacted on chrome azurol S agar. Subsequently, inocula of four Chilean isolates and the type strain were prepared with or without 200 µm of 2,2'-Dipyridyl for uptake assays. Assay results revealed differences between the isolates in terms of iron acquisition. While a prior iron-limited environment was, for most isolates, not required to activate the uptake of iron (II) sulphate, ammonium iron (III) citrate or iron (III) chloride at higher concentrations (100 µm), it did facilitate growth at lower iron concentrations (10 µm and 1 µm). An exception was the H-2 isolate, which only grew with 100 µm of iron sulphide. In turn, 100 µm of haemin was toxic when isolates were grown in normal KDM-2. In silico R. salmoninarumATCC 33209T genome analysis detected various genes coding iron uptake-related proteins. This is the first study indicating two iron acquisition systems in R. salmoninarum: one involving siderophores and another involving haem group utilization. These data represent a first step towards fully elucidating this virulence factor in the pathogenic R. salmoninarum.

Primer congreso sobre la nutrición de los estratos pobres de la población: hacia una historia de la alimentación y nutrición en Chile (1931) / First congress on the nutrition of the poorer strata of the population: towards a history of feeding and nutrition in Chile (1931)

This article studies the First Congress on the nutrition of the poorer strata of the population developed in the City of Valparaiso (Chile) in 1931. It is approached in the context of a conference, the role played by the first generation of doctors concerned about the problem of nutrition and the main conclusions of meeting. We note that the First Congress is the beginning of a nutrition policy to the poorer strata of the population that will be accompanied with the creation of the National Council of Food in 1937.

En este artículo se estudia el Primer Congreso sobre la nutrición de los estratos más pobres de la población, desarrollado en la ciudad de Valparaíso (Chile) en 1931. Se aborda en el contexto de la conferencia, el papel jugado por la primera generación de médicos preocupados por el problema de la nutrición y las principales conclusiones del encuentro. Señalamos que el Primer Congreso es el inicio de una política de nutrición de los estratos más pobres de la población, lo que será acompañado con la creación del Consejo Nacional de Alimentación en 1937.

ASMA EN ADULTOS MAYORES / Asthma in older adults

El asma se ha considerado a menudo como una enfermedad cuyo inicio se produce en la infancia. Sin embargo, recientes estudios poblacionales han informado que el inicio del asma es común en las personas mayores. La carga sanitaria, personal y económica del asma puede ser más significativa en los ancianos que en sus homólogos más jóvenes, particularmente en lo que se refiere a la mortalidad, la hospitalización, los costos médicos o la calidad de vida relacionada con la salud. El asma en el Adulto Mayor (AAM) sigue siendo subdiagnosticada y subtratada. El objetivo principal de esta Revisión es identificar las necesidades no satisfechas en los campos de investigación y práctica para AAM, así como encontrar nuevas direcciones de investigación, proponer nuevas estrategias terapéuticas y mejorar los resultados para el creciente número de personas mayores con asma. El desafío de hoy es fomentar la investigación en AAM, utilizando el conocimiento existente para mejorar el diagnóstico, y los diagnósticos deferenciales, así como educar al paciente, desarrollar un enfoque terapéutico seguro y eficaz, controlar la enfermedad y, finalmente, proporcionar una mejor calidad de vida(AU)

Asthma has often been considered as a childhood disease. However, recent population studies reported that asthma is common in the elderly The burden of asthma may be more significant in the elderly than in their younger counterparts, particularly with regard to mortality, hospitalization, medical costs or health-related quality of life.Asthma in the Elderly (AIE) is still under-diagnosed and under-treated. The primary aim of this review is to identify unmet needs in the fields of research and practice for AIE. This will enable us to find new research directions, propose new therapeutic strategies, and ultimately improve outcomes for elderly people with asthma. The challenge today is to encourage new research in AIE, but to already use existing knowledge we have to make the diagnosis of AIE, educate the patient, develop a therapeutic approach to control the disease, and ultimately provide a better quality of life to our elderly patients(AU)

Effects on the metabolism, growth, digestive capacity and osmoregulation of juvenile of Sub-Antarctic Notothenioid fish Eleginops maclovinus acclimated at different salinities.

In this study we assessed the influence of three different environmental salinities (5, 15 and 31 psu during 90 days) on growth, osmoregulation, energy metabolism and digestive capacity in juveniles of the Notothenioid fish Eleginops maclovinus. At the end of experimental time samples of plasma, liver, gill, intestine, kidney, skeletal muscle, stomach and pyloric caeca were obtained. Growth, weight gain, hepatosomatic index and specific growth rate increased at 15 and 31 psu and were lower at 5 psu salinity. Gill Na(+), K(+)-ATPase (NKA) activity presented a "U-shaped" relationship respect to salinity, with its minimum rates at 15 psu, while this activity correlated negatively with salinity at both anterior and posterior intestinal portions. No significant changes in NKA activity were observed in kidney or mid intestine. Large changes in plasma, metabolite levels and enzymatic activities related to energy metabolism in liver, gill, intestine, kidney and muscle were generally found in the groups exposed to 5 and 31 psu compared to the 15 psu group. Only the pepsin activity (digestive enzymes) assessed enhanced with environmental salinity, while pyloric caeca trypsin/chymotrypsin ratio decreased. This study suggests that juvenile of E. maclovinus presents greater growth near its iso-osmotic point (15 psu) and hyperosmotic environment (31 psu). Acclimation to low salinity increased the osmoregulatory expenditure as seen by the gill and anterior intestine results, while at high salinity, branchial osmoregulatory activity was also enhanced. This requires the mobilization of lipid stores and amino acids, thereby holding the growth of fish back. The subsequent reallocation of energy sources was not sufficient to maintain the growth rate of fish exposed to 5 psu. Thus, E. maclovinus juveniles present better growth efficiencies in salinities above the iso-osmotic point and hyperosmotic environment of this species, showing their best performance at 15 psu as seen by the main osmoregulatory and energy metabolism enzymatic activities.

Effectiveness of egg yolk immunoglobulin against the intracellular salmonid pathogen Piscirickettsia salmonis.

AIMS: To produce and characterize egg yolk immunoglobulin (IgY) against the fish intracellular pathogen Piscirickettsia salmonis as well as to evaluate the antibacterial activity of IgY in vitro and the availability in the serum of fish immunized orally. METHODS AND RESULTS: Specific IgY was produced by immunizing hens with P. salmonis proteins. The IgY was obtained from egg yolks using the ammonium sulphate precipitation method and it was characterized by SDS-PAGE, Western-blot and ELISA, demonstrating that anti-P. salmonis IgY strongly reacted specifically against P. salmonis proteins. In an in vitro neutralization assay, IgY inhibited the growth of P. salmonis in liquid medium at concentrations ranging from 128 to 256 µg ml(-1) in a dose-dependent manner. Interestingly, IgY against P. salmonis also generates a strong protective effect on the infection of P. salmonis in salmon head kidney-1 cells. In addition, the bacteriostatic function of IgY appears to result possibly from agglutination by the interaction of IgY with surface components of the pathogen. Finally, to confirm this IgY as an alternative for salmonid treatment, Atlantic salmon (Salmo salar) specimens were orally inoculated with IgY. The analysis of the sera demonstrates that IgY was effectively transported by fish intestine and that this immunoglobulins maintains its properties and recognizes several proteins of P. salmonis up to 12 h after inoculation of IgY against P. salmonis. CONCLUSIONS: Specific IgY effectively inhibited the growth of P. salmonis and this immunoglobulin can be released in the Atlantic salmon sera when administered orally to fish. SIGNIFICANCE AND IMPACT OF THE STUDY: We propose that this specific IgY against this fastidious micro-organism could be a useful strategy for the treatment of piscirickettsiosis.

Cell-surface properties of Vibrio ordalii strains isolated from Atlantic salmon Salmo salar in Chilean farms.

Vibrio ordalii is the causative agent of atypical vibriosis and has the potential to cause severe losses in salmonid aquaculture, but the factors determining its virulence have not yet been elucidated. In this work, cell-surface-related properties of the isolates responsible for outbreaks in Atlantic salmon were investigated. We also briefly examined whether pathogenicity against fish varied for V. ordalii strains with differing cell-surface properties. Hydrocarbon adhesions indicated the hydrophobic character of V. ordalii, although only 4 of 18 isolates induced haemagglutination in Atlantic salmon erythrocytes. A minority of the studied isolates (6 of 18) and the type strain ATCC 33509T produced low-grade biofilm formation on polyethylene surface after 2 h post-inoculation (hpi), but no strains were slime producers. Interestingly, V. ordalii isolates showed wide differences in hydrophobicity. Therefore, we chose 3 V. ordalii isolates (Vo-LM-03, Vo-LM-18 and Vo-LM-16) as representative of each hydrophobicity group (strongly hydrophobic, relatively hydrophobic and quasi-hydrophilic, respectively) and ATCC 33509T was used in the pathogenicity studies. All tested V. ordalii strains except the type strain resisted the killing activity of Atlantic salmon mucus and serum, and could proliferate in these components. Moreover, all V. ordalii isolates adhered to SHK-1 cells, causing damage to fish cell membrane permeability after 16 hpi. Virulence testing using rainbow trout revealed that isolate Vo-LM-18 was more virulent than isolates Vo-LM-03 and Vo-LM-16, indicating some relationship between haemagglutination and virulence, but not with hydrophobicity.

Delphinol® standardized maqui berry extract reduces postprandial blood glucose increase in individuals with impaired glucose regulation by novel mechanism of sodium glucose cotransporter inhibition.

AIM: The impetus of our study was to investigate the effects of a nutritional supplement Delphinol®, an extract of maqui berries (Aristotelia chilensis) standardised to ≥25% delphinidins and ≥35% total anthocyanins, on postprandial blood glucose and insulin levels and identify the physiologic mechanism involved. METHODS: Postprandial blood glucose and insulin were investigated in double-blind, placebo-controlled, cross-over fashion in ten volunteers with moderate glucose intolerance. Longer term effects on blood sugar levels were investigated in streptozotocin-diabetic rats over a four months period. Effects of maqui berry delphinidins on sodium-glucose symport were examined in rodent jejenum of the small intestine. RESULTS: Delphinol® intake prior to rice consumption statistical significantly lowered post prandial blood glucose and insulin as compared to placebo. We identified an inhibition of Na+-dependant glucose transport by delphinidin, the principal polyphenol to which Delphinol® is standardised. In a diabetic rat model the daily oral application of Delphinol® over a period of four months significantly lowered fasting blood glucose levels and reached values indistinguishable from healthy non-diabetic rats. CONCLUSION: Our results suggest a potential use of Delphinol® for naturally controlling post-prandial blood glucose owed to inhibition of sodium glucose co-transporter in small intestine.

Dental fluorosis: concentration of fluoride in drinking water and consumption of bottled beverages in school children.

OBJECTIVE: The purpose of the study was to identify dental fluorosis prevalence and to analyze its association with tap water fluoride concentration and beverage consumption in school children from the city of Oaxaca, who were receiving fluoridated salt. STUDY DESIGN: A cross-sectional study was performed on elementary public school children. Dean's Index was applied to assess dental fluorosis. The parents of the children who were studied completed a questionnaire about socio-demographic characteristics and type of beverages consumed by their children. A total of 917 school children participated in this study. RESULTS: Dental fluorosis prevalence was 80.8%. The most frequent fluorosis category was very mild (41.0%), and 16.4% of the children were in the mild category. The mean water fluoride concentration was 0.43 ppm (±0.12). No association was detected between tap water fluoride concentration and fluorosis severity. The multinomial regression model showed an association among the mild fluorosis category and age (OR = 1.25, [95% CI 1.04, 1.50]) and better socio-economic status (OR = 1.78, [95% CI 1.21, 2.60]), controlling for fluoride concentration in water. Moderate and severe fluorosis were associated with soft drink consumption (OR = 2.26, [95% IC 1.01, 5.09]), controlling for age, socio-economic status, and water fluoride concentration. CONCLUSIONS: The prevalence of fluorosis was high. Mild fluorosis was associated with higher socio-economic status, while higher fluorosis severity was associated with soft drink consumption.

Increased exhaled breath temperature in subjects with uncontrolled asthma.

BACKGROUND: Increased vascularity of the airway mucosa in asthma potentially increases heat loss in the airways. OBJECTIVE: To determine if the inflamed airways of subjects with uncontrolled asthma show increased exhaled breath temperature (EBT). PATIENTS AND METHODS: In 100 patients with persistent asthma and 50 healthy volunteers, we measured lung function by post-bronchodilator forced spirometry, the asthma control test (ACT) and EBT. RESULTS: Patients with asthma, of whom 49 (49%) were female, with a mean (± standard error of the mean) age of 44 (±17) years and a predicted forced expiratory volume in one second of 71% (±16), had a significantly increased EBT, particularly those with uncontrolled asthma (n = 50, ACT ≤ 19, EBT 34.9 ± 0.8°C), compared to patients with controlled asthma (n = 50, ACT ≥ 20, EBT 33.7 ± 0.8°C) and healthy volunteers (n = 50, EBT 33.2 ± 0.2°C, P < 0.001). CONCLUSION: We observed a higher temperature on exhaled breath in subjects with uncontrolled asthma than in subjects with controlled asthma and healthy controls. The increase in exhaled breath temperature may be a proxy for a raised airway inflammatory state in asthma patients.