[Anterior shoulder instability with Hill-Sachs on-track. Bankart or Bankart-remplissage?] / Inestabilidad anterior de hombro con lesión de Hill-Sachs on-track. ¿Bankart o Bankart-remplissage?

INTRODUCTION: in patients with anterior glenohumeral (GH) instability together with an off-track or engaging Hill-Sachs (HS) defect, Bankart-remplissage (B-R) surgery reduces the recurrence rate when compared to Bankart (B) surgery alone. There is controversy regarding whether the recurrence rate also decreases in patients with on-track or non-engaging Hill-Sachs defects. OBJECTIVE: to compare the recurrence rate and clinical evolution of patients with anterior glenohumeral instability with 'on-track' Hill-Sachs defect treated with either B or B-R surgery. MATERIAL AND METHODS: non-randomized, retrospective, single-center cohort study of patients with anterior glenohumeral instability and on-track Hill-Sachs defect, operated between January 2010 and December 2018. Patients operated with B versus B-R were compared. Recurrence, complications and re-operation were recorded. In addition, VAS, SSV, WOSI and qDASH scores were obtained and compared in both groups. RESULTS: of the 105 patients who met the inclusion criteria, 78 (74.3%) patients had a complete follow-up (52 B and 26 B-R, 4.3 years median follow-up). There was a higher recurrence rate in group B compared to B-R, with this difference not reaching statistical significance (17.3% vs 7.7%, p = 0.21). There were no significant differences in residual pain, feeling of instability, complications or VAS, qDASH, SSV or WOSI scores between both groups. In the subgroup analysis, patients who practiced contact sports and were operated with B showed higher recurrence rates (24.1% vs 0%, p = 0.08) and complications (41.4% vs 18.2%, p = 0.16) when compared to B + R, although these differences were not significant. CONCLUSION: there were no significant differences in recurrence rates and functional evolution between patients with anterior glenohumeral instability operated with B or B-R surgery. Comparative, prospective studies should be performed to establish definitive recommendations.

INTRODUCCIÓN: en pacientes con inestabilidad glenohumeral (GH) anterior con defecto de Hill-Sachs (HS) off-track o enganchante, Bankart-remplissage (B + R) reduce tasa de recurrencia en comparación a Bankart aislado (B). Hay controversia si tasa de recurrencia también disminuye en pacientes con defecto de HS on-track o no enganchantes. OBJETIVO: comparar la tasa de recurrencia y evolución clínica entre la cirugía de B versus B-R en pacientes operados por inestabilidad glenohumeral anterior con defecto de Hill-Sachs on-track. MATERIAL Y MÉTODOS: estudio de cohorte, no randomizado, retrospectivo y unicéntrico, en pacientes operados por inestabilidad glenohumeral anterior, entre Enero 2010 y Diciembre de 2018. Se incluyen sólo pacientes con defecto de Hill-Sachs on-track. Fueron comparados pacientes operados con cirugía de B versus B + R. Se consigna recurrencia, complicación, reoperación y sensación de inestabilidad. Además, se realizan y comparan puntajes de EVA, SSV, WOSI y qDASH. RESULTADOS: de los 105 pacientes que cumplieron criterios de inclusión, 78 (74.3%) realizaron seguimiento completo (52 B y 26 B + R, 4.3 años mediana de seguimiento). Hubo mayor tasa de recurrencia en grupo B en comparación a B + R, siendo esta diferencia no significativa (17.3% versus 7.7%, p = 0.21). No hubo diferencia significativa en dolor residual, sensación de inestabilidad residual, complicaciones o puntajes de escala EVA, qDASH, SSV ni WOSI. En análisis por subgrupo, pacientes con deportes de contacto, B tienen mayor tasa de recurrencia (24.1% versus 0%, p = 0.08) y complicaciones comparadas con B + R (41.4% versus 18.2%, p = 0.16), siendo estas diferencias no significativas. CONCLUSIÓN: no hubo diferencias significativas en tasa de recurrencia y evolución funcional entre cirugía de Bankart aislado o Bankart-remplissage para inestabilidad glenohumeral anterior asociada a defecto de Hill-Sachs on-track. Estudios comparativos, prospectivos deben realizarse para establecer recomendaciones definitivas.

Análisis de los datos de monitorización del ventilador para la toma de decisiones en ventilación mecánica invasiva crónica / Analysis of ventilator monitoring data for decision-making in chronic invasive mechanical ventilation

El uso de la ventilación mecánica invasiva crónica se ha incrementado progresivamente en pediatría. Su uso tiene importantes beneficios, pero también riesgos asociados. La terapia ventilatoria debe ser supervisada en forma constante y dentro de los métodos de evaluación clínica de la ventilación se encuentra el análisis de los datos de monitorización almacenados en la memoria interna del ventilador. Estos datos contienen información almacenada durante el uso del ventilador que puede ayudarnos a tomar decisiones. Es importante considerar que la precisión de la información depende de la tecnología del ventilador y los componentes utilizados. El objetivo de esta revisión es dar a conocer la utilidad y limitaciones de la información de monitorización del ventilador mecánico en pacientes usuarios de ventilación mecánica crónica por traqueostomía, junto con describir su interpretación estructurada en forma sencilla y con ejemplos clínicos.

Long-term mechanical ventilation has increased in pediatric patients. Its use has important benefits, but also associated risks. Ventilatory therapy must be constantly monitored, and ventilator data analysis it's one of the evaluation methods. The device data contains information stored during the ventilator use and can help us with therapy decisions. The information accuracy depends on ventilator technology and the components that are used for ventilation. The objective of this review is to present the usefulness and limitations of the information on mechanical ventilator monitoring devices in patients using chronic mechanical ventilation by tracheostomy describing and structured interpretation in a simple way with the use of clinical examples.

Histopathological Analysis of Sealant Infiltration in White Spot Enamel Lesions (WSEL) / Análisis Histopatológico de Infiltración de Sellante en Lesiones de Mancha Blanca en Esmalte (LMBE)

ABSTRACT: The use of resin sealants has shown partial infiltration of White-Spot Enamel Lesions in vitro (WSEL). The aim of the present study was to perform a morphological evaluation of natural WSEL when infiltrated using a commercially available sealant (Concise, 3M- ESPE). 20 bicuspids extracted for orthodontic reasons from patients ranging 18 to 30 years old, which had WSEL, were used in this study. The patients agreed to donate their teeth by signing a written consent. Every WSEL was assessed microscopically (Stereo Zeiss Axiscop) and then photographed (ProScope HR microscope). Prior to applying the sealant the lesion was etched using phosphoric acid at 37 % (3M-ESPE, St Paul, MN, USA.) for 30 seconds, washed for 40 seconds and then air-dried. The sealant was marked with rhodamine B (1mg/ml) and was applied according to the manufacturer directions. A specimen of approximately 100 mm was obtained for every WSEL by cutting perpendicularly through the lesion (Isomet 1000, Buehler Co.) and grinding (600 grit). The specimens were evaluated using: clear camp, polarized light, and epifluorescence microscopy. Images were taken of each specimen for every microscopic evaluation using a slide film (Kodak Ektachrome film 400 ASA). The images were digitalized by scanning at 1200 dpi resolution (Epson Filmscan 200) and then saved as JPEG and TIFF files. The sealant infiltration into The WSEL was assessed by means of analysis, processing and digital superimposing using Adobe Photoshop 7.0 and Matrox Inspector 1.07. It was concluded that the sealant infiltrated the whole body zone of the lesion. The depth of penetration of sealants into White Spot Enamel Lesion plays an important role in the control of caries lesion progression.

RESUMEN: El uso de sellantes de resina ha demostrado lograr la infiltración parcial de lesiones de mancha blanca en esmalte in vitro (LMBE). El objetivo del presente estudio fue realizar una evaluación morfológica de la infiltración a LMBE naturales utilizando un sellante disponible comercialmente (Concise, 3M-ESPE). Se utilizaron en este estudio, 30 bicúspides extraídos por razones de ortodoncia en pacientes que tenían entre 18 a 30 años de edad, y presentaban LMBE. Los pacientes aceptaron donar sus dientes firmando un consentimiento informado. Cada LMBE se evaluó microscópicamente (Stereo Zeiss Axiscop) y luego se fotografió (microscopio ProScope HR). Antes de aplicar el sellante, la lesión se grabó usando ácido fosfórico al 37 % (3M-ESPE, St Paul, MN, EE. UU.) durante 20 segundos, luego se lavó durante 40 segundos y finalmente se secó con aire de jeringa triple. El sellante se marcó con rodamina B (1 mg / ml) y se aplicó siguiendo las instrucciones del fabricante. Se obtuvo una muestra de aproximadamente 100 mm para cada LMBE cortando perpendicularmente a través de la lesión (Isomet 1000, Buehler Co.) y trituración (grano 600). Las muestras se evaluaron usando: campo claro, luz polarizada y microscopía de epifluorescencia. Se tomaron imágenes de cada espécimen para la evaluación microscópica usando una película deslizante (Kodak Ektachrome film 400 ASA). Las imágenes se digitalizaron escaneando a una resolución de 1200 ppp (Epson Filmscan 200) y luego se guardaron como archivos JPEG y TIFF. La infiltración del sellante en las LMBE se evaluaron mediante análisis, procesamiento y superposición digital utilizando Adobe Photoshop 7.0 y Matrox Inspector 1.07. Se concluyó que el sellante infiltró toda la zona del cuerpo de la lesión. La capacidad de penetración en profundidad de los sellantes en Lesiones de Mancha Blanca del Esmalte desempeñan un rol importante en el control de la progresión de las lesiones de caries.

Valores de referencia de oximetría de pulso en prematuros: seguimos en deuda / Reference values of pulse oximetry in preterm infants: still a debt

Oxygen therapy is frequent in prematures to treat respiratory conditions typically associated with them. Long-term use is mainly due to Bronchopulmonary Dysplasia (BPD). However, the use of oxygen has been controversial in the last decade especially given the associated risk of hyperoxemia in these children. Pulse oximetry (SpO2) is a fundamental tool to guide oxygen therapy. Different trials have found that, in prematures born ≤28 weeks of gestational age who requires oxygen, a restrictive SpO2 target (85-89%) vs a liberal one (91-95%) may cause a higher mortality rate and enterocolitis, but less serious retinopathy. These targets are not normal SpO2 values. Studies on SpO2 reference values in preterm infants are scarce, heterogeneous and they do not necessarily use highly accurate and latest generation pulse oximeters. This contributes to the variation of oxygen therapy among different centers and reinforces the relevance of having SpO2 reference values in preterm infants to safely guide oxygen therapy.

La terapia con oxígeno es frecuente en prematuros para el tratamiento de patología respiratoria propia de su condición. En forma crónica la principal causa de su uso es Displasia Broncopulmonar (DBP). Sin embargo, el uso de oxígeno en prematuros ha sido motivo de debate en la última década fundamentalmente por los riesgos asociados a estados de hiperoxemia. La oximetría de pulso (SpO2) es una herramienta fundamental para guiar la oxigenoterapia. En prematuros que nacen ≤28 semanas de edad gestacional que requieren oxígeno, distintos estudios han demostrado que una meta de SpO2 restrictiva (85-89%) vs liberal (91-95%) tendría mayor mortalidad y enterocolitis, pero menor retinopatía grave. Estas metas no son valores normales de SpO2. Los estudios sobre valores de referencia de SpO2 en prematuros son limitados, heterogéneos y no necesariamente con oxímetros de última generación de mayor precisión. Esto contribuye a que la oxigenoterapia sea variable entre distintos centros y refuerza la relevancia de contar con valores de referencia de SpO2 en prematuros para guiar con seguridad el uso de oxígeno.

Un recorrido por la pared abdominal: evaluación de las hernias por tomografía computada multidetector / A tour of the abdominal wall: assessment of hernias by multidetector computed tomography

Si bien el diagnóstico de hernias de la pared abdominal es clínico y el estudio más indicado es la ecografía, en una gran cantidad de casos es difícil su evaluación o no se sospecha su presencia debido al biotipo del paciente, la ausencia de síntomas, la aparición de complicaciones o corresponde a algún tipo de hernia poco frecuente. Además, la debilidad de la pared abdominal generada por una cirugía predispone a la eventración de órganos, a veces poco habituales, como el hígado, la vejiga o el apéndice. La utilización de la tomografía computada multidetector (TCMD) brinda grandes ventajas cuando resulta dificultoso establecer el diagnóstico por otros métodos. También puede ser un hallazgo incidental a tener en cuenta por sus posibles complicaciones futuras. En el presente trabajo describimos los principales hallazgos por TCMD de las hernias y eventraciones de la pared abdominal (como la umbilical, epigástrica, hipogástrica, inguinal, de Spiegel, lumbar, obturatriz, intercostal e incisional) y su contenido.

Although the diagnosis of abdominal wall hernias is clinical, and the most appropriate study is ultrasound, in a lot of cases they are difficult to evaluate, or their presence is not suspected because of the biotype of the patient, the absence of symptoms, the presence of complications, or the appearance of rare hernias. Surgery weakness generated in the wall leads to organ hernia, sometimes unusual, as in the liver, bladder, or appendix. The use of multidetector computed tomography (MDCT) is a great advantage in these situations where the diagnosis can be difficult to determine with other methods. It also can be an incidental finding to consider eventual complications. In this paper, the main MDCT findings in abdominal wall hernias are described, including umbilical, epigastric, hypogastric, inguinal, Spiegel, lumbar, obturator, intercostal, and incisional, as well as their content.

Embolización portal hepática preoperatoria con lipiodol y gelatina absorbible / Preoperative hepatic portal vein embolisation with lipiodol and absorbable gelatin

Objetivo: Describir los resultados de la embolización portal hepática (EPH) preoperatoria con lipiodol y gelatina absorbible para generar hipertrofia hepática y permitir la hepatectomía derecha en pacientes con tumores hepáticos e hígado remanente futuro insuficiente. Materiales y métodos: Entre marzo de 2002 y abril de 2014, en 18 pacientes candidatos a hepatectomía derecha se realizó EPH con lipiodol y esponja de gelatina absorbible mezclada con contraste yodado. La estimación de los volúmenes hepáticos preembolización se hizo por tomografía computada con contraste endovenoso. Los pacientes fueron abordados mediante punción percutánea bajo guía ecográfica, seguida de angiografía. El control de la hipertrofia con estimación del volumen se realizó a la cuarta semana posembolización y el seguimiento se llevó a cabo ambulatoriamente o mediante historia clínica. Resultados: La mediana de edad fue de 58 años (relación hombre/mujer de 1:0,8) y el volumen hepático total estimado (mediana) de 1587,75 cm³. La estimación previa del volumen hepático y su relación con la porción futura remanente pre-EPH fue de 19,9%, mientras que el promedio absoluto de crecimiento del parénquima hepático remanente futuro pos-EPH se encontró entre los 306,2 y 475,2 cm³, con un 43,5% de aumento. La mediana de incremento de la relación volumen hepático total y la porción remanente pos-EPH fue de 8,5% (p< 0,001). Como complicaciones, se registró un hematoma y una necrosis aséptica. Conclusión: La EPH con lipiodol y esponja de gelatina absorbible es un procedimiento seguro y efectivo, que surge como alternativa a otros materiales de embolización.

Objective: To evaluate outcomes of preoperative hepatic portal vein embolisation with lipiodol and absorbable gelatin in order to generate liver hypertrophy and enable right hepatectomy in selected patients with liver tumours and future insufficient residual liver. Materials and methods: Portal vein embolisation (PVE) with lipiodol and absorbable gelatin sponge mixed with iodine based contrast was performed in 18 patient candidates for right hepatectomy between March 2002 and April 2014. The preembolisation liver volume evaluations were performed by computed tomography with intravenous contrast. Patients underwent an ultrasound-guided percutaneous puncture, followed by angiography. The controls of hypertrophy and volume estimation were performed in the 4 th week after portal embolisation. The patients were followed-up on an outpatient basis or by using their medical records. Results: The median age was 58 years, with a 1:0.8 male: female ratio. The total estimated liver volume, excluding the tumour, of all patients evaluated prior to surgery was 1587.75 cm³ (median). The previous estimated liver volume and its relation to the future remaining portion before PVE was 19.9%. The absolute median growth of future residual liver parenchyma post-PVE was 306.2 to 475.2 cm³, being an increase of 43.5%, and the mean growth of liver volume and remaining portion ratio post-PVE was 8.5% (P<.001). Complications were one haematoma and one aseptic necrosis. Conclusión: The selection of patients is of paramount importance, and PVE with lipiodol and absorbable gelatin in our environment is a safe and effective procedure.

Frecuencia de anticuerpos anti-transglutaminasa y antiendomisio en pacientes con diabetes tipo 1 / Association of type 1 diabetes mellitus with celiac disease

Background: Type 1 diabetes mellitus and celiac disease share common genetic and immunological aspects and celiac disease is more common among type 1 diabetic patients. Aim: To determine the frequency of anti endomysial and anti transglutaminase antibodies among patients with type 1 diabetes. Material and Methods: Anti endomysialantibodies determined by indirect immunofluorescence an anti transglutaminase antibodies determined by ELISA were measured in 410 serum samples of patients with type 1 diabetes. Results: Seventy one samples (17 percent) had positive anti transglutaminase antibodies. Among these, 17 had also positive anti endomysial antibodies. In 11 of these 17 patients, the presence of celiac disease was confirmed. Conclusions: Among patients with type 1 diabetes mellitus, the frequency of celiac disease is three times higher than in the general population.

Patrones imagenológicos por TCMD del linfoma renal / CTMD imaging patterns of renal lymphoma

El linfoma es una neoplasia que puede comprometer con frecuencia al sistema genitourinario,en especial a los riñones. En su mayoría son secundarios a una afectación sistémica. Describimos los hallazgos imagenológicos de los distintos patrones de presentación del linfoma renal...

Hemorragia abdominal espontánea: evaluación por imágenes / Abdominal hemorrhage spontaneous: imaging evaluation

Se define como hemorragia intraabdominal espontánea a aquella que no es de causa traumática. Su presentación clínica es inespecífica, por lo que el diagnóstico suele realizarse en base a los hallazgos imagenológicos. El estudio de imágenes cumple tres funciones básicas: realizar el diagnóstico al detectar la presencia de sangre intraabdominal, localizar el origen del sangrado y determinar la presencia o no de extravasación arterial activa. Las causas del hemoperitoneo no traumático son diversas y se pueden clasificar, según el órgano de origen, en hepáticas, esplénicas, pancreáticas, adrenales, renales, gineco-obstétricas, vasculares y de partes blandas (peritoneales y musculares)

It defines spontaneous abdominal hemorrhage that is not traumatic. Its clinical presentation is nonspecific and usually not suspected by the emergency physician, so the diagnosis is usually made based on imaging findings. The study of images serves three basic functions, which are to perform the diagnosis by detecting the presence of blood intraabdominal, locating the source of bleeding and determining the presence or absence of active arterial extravasation. The causes of non traumatic hemoperitoneum are diverse and can be classified according to the organ of origin in liver, spleen, pancreas, adrenal, kidney, obstetric-gynecology, vascular and soft tissue (peritoneal and muscular)

Hemorragia abdominal espontánea: evaluación por imágenes

Se define como hemorragia intraabdominal espontánea a aquella que no es de causa traumática. Su presentación clínica es inespecífica, por lo que el diagnóstico suele realizarse en base a los hallazgos imagenológicos. El estudio de imágenes cumple tres funciones básicas: realizar el diagnóstico al detectar la presencia de sangre intraabdominal, localizar el origen del sangrado y determinar la presencia o no de extravasación arterial activa. Las causas del hemoperitoneo no traumático son diversas y se pueden clasificar, según el órgano de origen, en hepáticas, esplénicas, pancreáticas, adrenales, renales, gineco-obstétricas, vasculares y de partes blandas (peritoneales y musculares).(AU)

It defines spontaneous abdominal hemorrhage that is not traumatic. Its clinical presentation is nonspecific and usually not suspected by the emergency physician, so the diagnosis is usually made based on imaging findings. The study of images serves three basic functions, which are to perform the diagnosis by detecting the presence of blood intraabdominal, locating the source of bleeding and determining the presence or absence of active arterial extravasation. The causes of non traumatic hemoperitoneum are diverse and can be classified according to the organ of origin in liver, spleen, pancreas, adrenal, kidney, obstetric-gynecology, vascular and soft tissue (peritoneal and muscular).(AU)

Traqueobroncomalacia / Tracheobronchomalacia

A 10-years-old girl with recurrent wheezing was diagnosed as asthmatic. Her spirometry showed variable central airway intrathoracic obstruction. The bronchoscopy confirmed the presence of bronchomalacia.

Se presenta el caso de una paciente de edad escolar, quien por sibilancias recurrentes se trataba como asmática. Al realizar espirometría forzada se detectó un compromiso variable de vía central intratorácica. La fibrobroncoscopía confirmó la presencia de broncomalacia.

Gingival wound healing: an essential response disturbed by aging?

Gingival wound healing comprises a series of sequential responses that allow the closure of breaches in the masticatory mucosa. This process is of critical importance to prevent the invasion of microbes or other agents into tissues, avoiding the establishment of a chronic infection. Wound healing may also play an important role during cell and tissue reaction to long-term injury, as it may occur during inflammatory responses and cancer. Recent experimental data have shown that gingival wound healing is severely affected by the aging process. These defects may alter distinct phases of the wound-healing process, including epithelial migration, granulation tissue formation, and tissue remodeling. The cellular and molecular defects that may explain these deficiencies include several biological responses such as an increased inflammatory response, altered integrin signaling, reduced growth factor activity, decreased cell proliferation, diminished angiogenesis, reduced collagen synthesis, augmented collagen remodeling, and deterioration of the proliferative and differentiation potential of stem cells. In this review, we explore the cellular and molecular basis of these defects and their possible clinical implications.

No nos olvidemos del bazo: el órgano huérfano / Do not forget the spleen: The orphan organ

Si bien cumple una función esencial en procesos como la filtración sanguínea y respuesta inmunitaria, el bazo es el órgano abdominal olvidado o huérfano, ya que ningún especialista (incluyendo a los radiólogos) le presta atención. No obstante, este puede verse afectado por una gran cantidad de patologías benignas y malignas, cuyas características en imágenes es importante conocer para lograr un correcto diagnóstico. En el presente artículo realizamos un ensayo iconográfico sobre las distintas entidades que pueden comprometerlo.

Even when the spleen plays a key role in processes such as blood filtration and immune response, it is the abdominal organ forgotten or orphan. The spleen can be affected by much benign and malignant disease, and is important to know the characteristics images of them to achieve a correct diagnosis. In this iconographic assay we show images of several of these diseases.

No nos olvidemos del bazo: el órgano huérfano

Si bien cumple una función esencial en procesos como la filtración sanguínea y respuesta inmunitaria, el bazo es el órgano abdominal olvidado o huérfano, ya que ningún especialista (incluyendo a los radiólogos) le presta atención. No obstante, este puede verse afectado por una gran cantidad de patologías benignas y malignas, cuyas características en imágenes es importante conocer para lograr un correcto diagnóstico. En el presente artículo realizamos un ensayo iconográfico sobre las distintas entidades que pueden comprometerlo.(AU)

Even when the spleen plays a key role in processes such as blood filtration and immune response, it is the abdominal organ forgotten or orphan. The spleen can be affected by much benign and malignant disease, and is important to know the characteristics images of them to achieve a correct diagnosis. In this iconographic assay we show images of several of these diseases.(AU)

Evaluación de un ingrediente funcional para el control glicémico en humanos / Evaluation of a functional ingredient for glycemic control in human

The prevalence of non-transmissible chronic diseases such as obesity, dyslipidemia and type 2 diabetes, among others, have increased worldwide. One way to prevent and/or control them is through bioactive food compounds that can be incorporated as functional ingredients (IF). The IF isa compound IF: apple pomace, opuntia palette, tomato pomace and rice bran. Objective: Assess the functional ingredient (IF) for glycemic control in humans. Subjects and Methods: 48 Subjects, both sexes, aged between 40 and 60. Divided into three groups: non-obese (NO), obese (OB) and diabetic (DM) with 16 subjects per group. Subjects consumed 600 g daily of nonfat yogurt with artificial sweetener. 50 percent of the subjects in each group received yogurt with IF and 50 percent without IF for 44 days. Metabolic control of capillary blood glucose was performed weekly, of nutrition every week, as well as basal metabolic control, 22 and 44 with: fasting blood glucose, lipid profile, tolerance test to glucose with 2 point sampling and calculation of HOMA-IR. All analyses were performed at the Institute of Nutrition and Food Technology (INTA), University of Chile. The statistical analysis included measures of central tendency and dispersion. They compared the effect of the intervention vs control using the Mann-Whitney U test for independent samples and the Chi2 test for categorical variables. Results:15 subjects from the DM group, 16 from OB and 10 from NO completed the experiment. Significant differences were found between the intervention group and the placebo in the obese group, in the weight variation of the basal-22 days, 22-44 and basal-44 days with p = 0.007, p = 0.001 and p = 0.001respectively, and significant differences in the NO group between the placebo and intervention groups in the variation basal-22 days for HOMA-IR (p = 0.010) and 44 -22 days for LDL (p = 0.045). Conclusion: In this study no significant differences were found for subjects stratified into...

Defective Wound-healing in Aging Gingival Tissue.

Aging may negatively affect gingival wound-healing. However, little is known about the mechanisms underlying this phenomenon. The present study examined the cellular responses associated with gingival wound-healing in aging. Primary cultures of human gingival fibroblasts were obtained from healthy young and aged donors for the analysis of cell proliferation, cell invasion, myofibroblastic differentiation, and collagen gel remodeling. Serum from young and old rats was used to stimulate cell migration. Gingival repair was evaluated in Sprague-Dawley rats of different ages. Data were analyzed by the Mann-Whitney and Kruskal-Wallis tests, with a p value of .05. Fibroblasts from aged donors showed a significant decrease in cell proliferation, migration, Rac activation, and collagen remodeling when compared with young fibroblasts. Serum from young rats induced higher cell migration when compared with serum from old rats. After TGF-beta1 stimulation, both young and old fibroblasts demonstrated increased levels of alpha-SMA. However, alpha-SMA was incorporated into actin stress fibers in young but not in old fibroblasts. After 7 days of repair, a significant delay in gingival wound-healing was observed in old rats. The present study suggests that cell migration, myofibroblastic differentiation, collagen gel remodeling, and proliferation are decreased in aged fibroblasts. In addition, altered cell migration in wound-healing may be attributable not only to cellular defects but also to changes in serum factors associated with the senescence process.

Resin penetration in artificial enamel carious lesions after using sodium hypochlorite as a deproteinization agent.

OBJECTIVES: To study the degree of penetration of an adhesive resin in artificial enamel carious lesions after using sodium hypochlorite as deproteinization agent. STUDY DESIGN: Twenty included human third-molars, extracted for surgical indication, were used. Artificial lesions were created in the buccal and lingual sides of each specimen through a cycle of demineralization-remineralization. Samples were then incubated in human saliva for 7 days at 37 ° C. After surface cleaning, lesions and the peripheral sound enamel were etched with 37% orthophosphoric acid for 20 seconds. One lesion of each specimen was treated with 5.25% sodium hypochlorite (NaOCl) for one minute. The other lesion of each specimen was used as a control. Experimental and control lesions were sealed with a fluid resin marked with Rhodamine B. Lesions were sectioned for microscopic observation by epifluorescence and polarized light. The images obtained were analyzed morphometrically. The micrometer measurements were made with ImageJ ® software. The level of significance was assessed at p<0.05. RESULTS: The average sealant depth penetration in the control group was 94.9 ± 28.6 µm versus 122.8 ± 25.3 µm in the experimental group. This represents Δ 20.1% significantly greater penetration when using sodium hypochlorite (p<0.001). CONCLUSION: The results demonstrated a significant penetration of the sealing resin when the conventional technique is complemented with the application of 5.25% sodium hypochlorite for one minute in artificial enamel carious lesions.

Monocyte chemotactic protein-3: possible involvement in apical periodontitis chemotaxis.

AIM: To study the expression of monocyte chemotactic protein-3 (MCP-3, also known as chemokine CCL-7) in tissue from apical lesions (AL) and to associate MCP-3 expression with symptomatic or asymptomatic apical periodontitis. METHODOLOGY: To determine the expression of MCP-3 in AL, biopsies obtained during tooth extraction procedures were fixed, subjected to routine processing and diagnosed as apical granuloma (AG) (n = 7) or radicular cyst (RC) (n = 5). As controls, apical periodontal ligament (PDL) specimens from healthy premolars extracted for orthodontics reasons were included (n = 7). All specimens were immunostained for MCP-3 and examined under a light microscope. In addition, homogenates from AL (n = 14) and healthy PDL samples (n = 7) were studied through immunowestern blot. Finally, periapical exudates samples were collected from root canals of teeth having diagnosis of symptomatic (n = 14) and asymptomatic apical periodontitis (n = 14) during routine endodontic treatments and analysed by immunowestern blot and densitometry. RESULTS: MCP-3 was detected in AG and RC and localized mainly to inflammatory leucocytes, whereas no expression was observed in healthy PDLs. MCP-3 was also detected in periapical exudate, and its levels were significantly higher in symptomatic than in asymptomatic apical periodontitis. CONCLUSIONS: MCP-3 was expressed in AL and its levels associated with clinical symptoms. MCP-3 might play a role in disease pathogenesis, possibly by stimulating mononuclear chemotaxis.

Polimorfismos del gen del receptor de muerte celular programada 1 (PDCD1) y diabetes tipo 1 en población Chilena / Programmed cell death 1 (PDCD1) gene polymorphisms and type 1 diabetes in Chilean children

Background: Programmed cell death 1 (PDCD-1) immune-receptor is a key element in the negative regulation of peripheral tolerance in T cells. Several polymorphisms of this gene have been described and it is linked with susceptibility to autoimmune diseases like Lupus and Multiple Sclerosis. Aim: To analyze four gene polymorphisms of PDCD-1 gene and explore its possible contribution as a susceptibility gene for type 1 diabetes (T1D). Patients and Methods: We analyzed 160 cases with T1D of recent diagnosis aged 9.5 ± 3.3 years and 160 control children aged 10.7 ± 3.1 years. Four genetic variants of PDCD-1 gene were studied (PD1.2; PD1.5; PD1.6 and PD1.9) by polymerase chain reaction and restriction enzymes. Autoantibodies GAD65 and anti-IA-2 were also measured in all studied children. The comparison of allelic and genotypic frequency and consistency with respect to Hardy-Weinberg equilibrium test were analyzed using Chi-square and Fisher exact test. Results: No differences between cases and controls were observed for PDCD1.2; PDCD1.5 and PDCD1.9 polymorphisms. PDCD1.6 polymorphism (carriers of allele A) had a higher frequency in the control group (0.794 versus 0.644, p < 0.017). There was no particular association of these polymorphisms with anti- GAD65 and anti-IA-2 antibodies among patients with T1D. Conclusions: Only PDCD1.6 polymorphism showed differences between T1D cases and controls. Possibly, none of these genetic variants of PDCD1 has a relevant role as a marker for T1D in the Chilean population.