Comparison of the dento-skeletal effects produced by Leaf expander versus rapid maxillary expander in prepubertal patients: a two-center randomized controlled trial.

OBJECTIVE: This study aimed to compare the skeletal and dentoalveolar effects produced by slow maxillary expansion (SME) with the Leaf expander versus the conventional rapid maxillary expansion (RME) on digital dental casts, lateral and postero-anterior cephalometric radiographs. TRIAL DESIGN: This is a superiority, two-center, two arms parallel balanced randomization trial. METHODS: Patients in the mixed dentition were included with a transverse interarch discrepancy of at least 3 mm. An expansion screw using moderate continuous forces (Leaf group) was compared to a conventional RME screw (RME group). The primary response variable was the difference in maxillary intermolar width (U6-U6) measured at baseline (T0) and one-year follow-up (T1) on the digital dental casts. Other dento-skeletal variables were also measured on digital dental casts and cephalograms. Computer-generated block randomization was used with allocation concealed in sequentially numbered opaque sealed envelopes. The examiner was blinded on the type of expander used. Linear models were used for statistical analysis. RESULTS: Twenty-eight patients in the Leaf group and 28 patients in the RME group were randomized and included in the study. There were no dropouts. U6-U6 did not show a statistically significant difference between the two groups (-0.4 mm in favor of the RME group, 95% CI from -1.2 to 0.5, P = 0.365). As for the other secondary variables no statistically significant differences were found between the two groups except maxillary intercanine width (U3-U3, -0.9 mm in favor of the RME group, 95%CI from -1.5 to -0.3, P = 0.005) and maxillary skeletal width (Mx-Mx, -1.4 mm in favor of the RME group, 95%CI from -2.4 to -0.3, P = 0.013). CONCLUSIONS: No significant differences between the RME and Leaf groups were detected for any of the analyzed dento-skeletal variables except the T1-T0 differences in U3-U3 and Mx-Mx that were significantly greater in the RME group. REGISTRATION: The study was registered in the ISRCTN register on 08/11/2016 with the number ISRCTN18263886. FUNDING: No funding or conflict of interest to be declared.

Comparison between two screws for maxillary expansion: a multicenter randomized controlled trial on patient's reported outcome measures.

OBJECTIVE: The objective of this study was to compare an expansion screw of the maxilla that generates moderate and continuous forces versus a conventional screw for rapid maxillary expansion (RME) on patient-reported outcome measure during the first 12 weeks of treatment. TRIAL DESIGN: This is a superiority, multicenter, two-arm parallel balanced randomization trial. METHODS: Patients in the mixed dentition were included with a transverse discrepancy between the two arches of at least 3 mm. An expansion screw using moderate continuous forces (Leaf group, treated with an expansion screw with Ni-Ti springs) was compared to a conventional RME screw that generates intermittent heavy forces (RME group). The primary response variable was the visual analogue scale (VAS) on pain calculated in the first 12 weeks of therapy. The VAS on difficulty on speaking and oral hygiene, patient satisfaction, and complications were also evaluated. A computer-generated block randomization was used with allocation concealed in sequentially numbered opaque-sealed envelopes. Blinding was not applicable. Linear models were used for statistical analysis. RESULTS: Twenty-eight patients in the Leaf group and 28 patients in the RME group were randomized and included in the study. There were no dropouts. The mean of the VAS for pain was 0.3 ± 0.4 in the Leaf group and 0.6 ± 0.5 in the RME group. The difference was -0.3 (95 per cent CI from -0.5 to -0.0; P = 0.017) in favour of the Leaf group. The difference in pain was marked in the first week (Leaf group 2.2 ± 2.3; RME group 3.7 ± 2.6; difference -1.5; 95 per cent CI from -2.7 to -0.3; P = 0.019). CONCLUSIONS: Patients in the Leaf group experienced a lower degree of pain, especially during the first week following the application of the expander. For the other variables, no significant differences were reported between the two treatments. REGISTRATION: The study was registered in the ISRCTN register on 8 November 2016 with the number ISRCTN18263886.

[Immunizations in adults with cardiovascular disease. Summary of the Consensus of the Argentine Cardiology Society]. / Inmunizaciones en adultos con cardiopatías. Resumen del Consenso de la Sociedad Argentina de Cardiología.

Cardiovascular diseases are the leading cause of death in most regions of the world, usually followed by infectious diseases. For decades, infections in general, and particularly those involving the respiratory system, have been known to be associated with an increased risk of cardiovascular and cerebrovascular events, and their consequent morbidity and mortality. Although vaccines are an excellent strategy in the prevention of infectious diseases, the proportion of immunized adults in our country is frankly deficient. Multiple barriers contribute to perpetuating this problem, within which the lack of prescription of the same by professionals who care for vulnerable populations occupies a central place. Patients with cardiovascular disease represent a particularly risky subpopulation. The spectrum of pathologies that can trigger respiratory infections is wide: development or worsening of heart failure, arrhythmias, acute coronary syndromes and cerebrovascular diseases, among the main ones. The role of immunoprophylaxis with influenza, pneumococcal and tetanus vaccine in patients with different heart diseases is addressed here, evaluating the evidence supporting its use, and placing special emphasis on practical aspects of its use, such as adverse effects, contraindications and special care situations, such as congenital heart disease in adults, heart transplantation, anticoagulation or egg allergy. Thus, this document aims to assist in decision-making for any doctor involved in the care of patients with cardiovascular disease.

Las enfermedades cardiovasculares ocupan la primera causa de muerte en la mayoría de las regiones del mundo, seguidas habitualmente por las enfermedades infecciosas. Desde hace décadas se conoce que las infecciones en general, y particularmente las que involucran el aparato respiratorio, se vinculan con un incremento en el riesgo de eventos cardiovasculares y cerebrovasculares, y su consecuente morbimortalidad. Si bien las vacunas constituyen una excelente estrategia en la prevención de enfermedades infectocontagiosas, la proporción de adultos inmunizados en nuestro país es francamente deficitaria. Múltiples barreras contribuyen a perpetuar esta problemática, dentro de las cuales la falta de prescripción de las mismas por parte de los profesionales que atienden a poblaciones vulnerables ocupa un lugar central. Los pacientes con enfermedades cardiovasculares representan una subpoblación de particular riesgo. El espectro de enfermedades que pueden originar las infecciones respiratorias es amplio: desarrollo o empeoramiento de insuficiencia cardíaca, arritmias, síndromes coronarios agudos y enfermedades cerebrovasculares, entre los principales. Se aborda aquí el rol de la inmunoprofilaxis con vacuna antigripal, antineumocócica y antitetánica en pacientes con diferentes cardiopatías, valorando la evidencia que respalda su empleo y haciendo especial hincapié en aspectos prácticos de su utilización, como efectos adversos, contraindicaciones y situaciones especiales de atención: cardiopatías congénitas del adulto, trasplante cardíaco, individuos anticoagulados o con alergia al huevo. Así, este documento tiene como objetivo asistir en la toma de decisiones a cualquier médico involucrado en el cuidado de pacientes con enfermedad cardiovascular.

Inmunizaciones en adultos con cardiopatías. Resumen del consenso de la Sociedad Argentina de Cardiología / Immunizations in adults with cardiovascular disease. Summary of the Consensus of the Argentine Cardiology Society

Resumen Las enfermedades cardiovasculares ocupan la primera causa de muerte en la mayoría de las regiones del mundo, seguidas habitualmente por las enfermedades infecciosas. Desde hace décadas se conoce que las infecciones en general, y particularmente las que involucran el aparato respiratorio, se vinculan con un incremento en el riesgo de eventos cardiovasculares y cerebrovasculares, y su consecuente morbimortalidad. Si bien las vacunas constituyen una excelente estrategia en la prevención de enfermedades infectocontagiosas, la proporción de adultos inmunizados en nuestro país es francamente deficitaria. Múltiples barreras contribuyen a perpetuar esta problemática, dentro de las cuales la falta de prescripción de las mismas por parte de los profesionales que atienden a poblaciones vulnerables ocupa un lugar central. Los pacientes con enfermedades cardiovasculares representan una subpoblación de particular riesgo. El espectro de enfermedades que pueden originar las infecciones respiratorias es amplio: desarrollo o empeoramiento de insuficiencia cardíaca, arritmias, síndromes coronarios agudos y enfermedades cerebrovasculares, entre los principales. Se aborda aquí el rol de la inmunoprofilaxis con vacuna antigripal, antineumocócica y antitetánica en pacientes con diferentes cardiopatías, valorando la evidencia que respalda su empleo y haciendo especial hincapié en aspectos prácticos de su utilización, como efectos adversos, contraindicaciones y situaciones especiales de atención: cardiopatías congénitas del adulto, trasplante cardíaco, individuos anticoagulados o con alergia al huevo. Así, este documento tiene como objetivo asistir en la toma de decisiones a cualquier médico involucrado en el cuidado de pacientes con enfermedad cardiovascular.

Abstract Cardiovascular diseases are the leading cause of death in most regions of the world, usually followed by infectious diseases. For decades, infections in general, and particularly those involving the respiratory system, have been known to be associated with an increased risk of cardiovascular and cerebrovascular events, and their consequent morbidity and mortality. Although vaccines are an excellent strategy in the prevention of infectious diseases, the proportion of immunized adults in our country is frankly deficient. Multiple barriers contribute to perpetuating this problem, within which the lack of prescription of the same by professionals who care for vulnerable populations occupies a central place. Patients with cardiovascular disease represent a particularly risky subpopulation. The spectrum of pathologies that can trigger respiratory infections is wide: development or worsening of heart failure, arrhythmias, acute coronary syndromes and cerebrovascular diseases, among the main ones. The role of immunoprophylaxis with influenza, pneumococcal and tetanus vaccine in patients with different heart diseases is addressed here, evaluating the evidence supporting its use, and placing special emphasis on practical aspects of its use, such as adverse effects, contraindications and special care situations, such as congenital heart disease in adults, heart transplantation, anticoagulation or egg allergy. Thus, this document aims to assist in decision-making for any doctor involved in the care of patients with cardiovascular disease.

Effect of Microalgal Extracts from Chlorella vulgaris and Scenedesmus quadricauda on Germination of Beta vulgaris Seeds.

Sugar beet (Beta vulgaris subsp. vulgaris) is a commercially important biennial root crop, providing about 20% of the world's annual sugar production. Seed quality is crucial for adequate plant growth and production. The productivity of sugar beet is often limited by heterogeneous germination in the field. In order to improve the sugar beet germination process, the effect of different concentrations of microalgal extracts from Chlorella vulgaris or Scenedesmus quadricauda was investigated by calculating several indices useful to evaluate the germination performance. Moreover, root morphological analysis was performed by using WinRHIZO software. B. vulgaris seeds were soaked with five different concentrations (from 0.1 to 10 mg Corg/L) of the microalgal extracts, considering the amount of organic carbon (Corg) in each extract. Our results show that these microalgal extracts exert a positive effect on sugar beet germination, by increasing efficiency and regularity of this critical process for B. vulgaris seeds. The best results, in terms of germination indices as well as root morphological traits, were reached by using C. vulgaris extract at the concentrations C2 (1 mg Corg/L) and C3 (2 mg Corg/L).

Molecular and Morphological Changes Induced by Leonardite-based Biostimulant in Beta vulgaris L.

Humic substances extracted from leonardite are widely considered to be bioactive compounds, influencing the whole-plant physiology and the crop yield. The aim of this work was to evaluate the effect of a new formulate based on leonardite in the early stage of growth of sugar beet (Beta vulgaris L.). A commercial preparation of leonardite (BLACKJAK) was characterized by ionomic analysis, solid-state 13C MAS NMR spectroscopy. Seedlings of sugar beet were grown in Hoagland's solution under controlled conditions. After five days of growth, an aliquot of the concentrated BLACKJAK was added to the solution to obtain a final dilution of 1:1000 (0.5 mg C L-1). The sugar beet response in the early stage of growth was determined by evaluating root morphological traits as well as the changes in the expression of 53 genes related to key morphophysiological processes. Root morphological traits, such as total root length, fine root length (average diameter < 0.5 mm), and number of root tips, were significantly (p < 0.001) increased in plants treated with BLACKJAK, compared to the untreated plants at all sampling times. At the molecular level, BLACKJAK treatment upregulated many of the evaluated genes. Moreover, both Real Time PCR and digital PCR showed that genes involved in hormonal response, such as PIN, ARF3, LOGL 10, GID1, and BRI1, were significantly (p < 0.05) upregulated by treatment with BLACKJAK. Our study provides essential information to understand the effect of a leonardite-based formulate on plant growth hormone metabolism, although the molecular and physiological basis for these complicated regulatory mechanisms deserve further investigations.

Innovative Approaches to Evaluate Sugar Beet Responses to Changes in Sulfate Availability.

In this study, a system based on omics profiling was set-up for sugar beet (Beta vulgaris L. subsp. vulgaris) evaluation after changes in sulfate availability. Seedlings were grown on sulfate-deprived Hoagland solution. Six days after germination, 100 µM MgSO4 was added to the solution. Root samples were collected 36 h after treatments. WinRHIZO root-scanning approach was used for the automated image analysis of plant root morphology. Inductively Coupled Plasma Spectrometry (ICP-OES) and quadrupole-time-of-flight mass spectrometry (Q-TOF) were used for ionomic and metabolic analysis, respectively. Nanofluidic real-time PCR (OpenArray system) was used for molecular profiling. OpenArray chips were designed with TaqMan probes for 53 sugar beet genes putatively involved in sulfate nutrition. At morphological level treated seedlings showed significantly higher values (P < 0.01) than untreated plants for root traits related to soil exploration and nutrient uptake, such as total root length, fine roots length and root tips number. ICP-OES, Q-TOF and transcriptomic data revealed changes due to sulfate availability in sugar beet samples. Two key results are highlighted in sulfate-supplied roots and leaves. Firstly, high expression levels of auxin efflux carrier component 1 (PIN) and 5-phosphoribosyl-anthranilate, precursor of tryptophan and auxin synthesis, were observed in roots. Secondly, high levels of 2-Cys peroxiredoxin BAS1, chloroplastic, thioredoxin reductase (NADPH) and cysteine synthase, chloroplastic/chromoplastic, O-acetylserine sulfhydrylase, involved in protection against oxidative stress and cysteine synthase activity, respectively, were observed in leaves. Based on our findings, the combination of evaluated omics approaches could become a key system for the evaluation of the nutritional status of sugar beet under different nutrient availability conditions.

Cultivating Chlorella vulgaris and Scenedesmus quadricauda microalgae to degrade inorganic compounds and pesticides in water.

This work evaluates the possibility of cultivating Scenedesmus quadricauda and Chlorella vulgaris microalgae in wastewater from the hydroponic cultivation of tomatoes with the aim of purifying the water. S. quadricauda and C. vulgaris were also used in purification tests carried out on water contaminated by the following active ingredients: metalaxyl, pyrimethanil, fenhexamid, iprodione, and triclopyr. Fifty-six days after the inoculum was placed, a reduction was found in the concentration of nitric nitrogen, ammonia nitrogen, and soluble and total phosphorus. The decrease was 99, 83, 94, and 94 %, respectively, for C. vulgaris and 99, 5, 88, and 89 %, respectively, for S. quadricauda. When the microalgae were present, all the agrochemicals tested were removed more quickly from the water than from the sterile control (BG11). The increase in the rate of degradation was in the order metalaxyl > fenhexamid > iprodione > triclopyr > pyrimethanil. It was demonstrated that there was a real degradation of fenhexamid, metalaxyl, triclopyr, and iprodione, while in the case of pyrimethanil, the active ingredient removed from the substrate was absorbed onto the cells of the microalgae. It was also found that the agrochemicals used in the tests had no significant effect on the growth of the two microalgae. The experiment highlighted the possibility of using cultivations of C. vulgaris and S. quadricauda as purification systems for agricultural wastewater which contains eutrophic inorganic compounds such as nitrates and phosphates and also different types of pesticides.

Recomendación de abandono del tabaquismo en una muestra de adultos de la ciudad de Rosario / Recommendation of Smoking Cessation in an Adult Sample of the City of Rosario

Introducción: El tabaquismo es la principal causa de muerte prevenible en el mundo; pese a ello, muchos médicos no aconsejan a sus pacientes dejar de fumar. Objetivos: Evaluar las características del consumo de tabaco y la frecuencia en la recomendación de su abandono en adultos de la ciudad de Rosario mediante un estudio transversal realizado entre julio y diciembre de 2010. Material y métodos: Encuesta cerrada prefijada realizada mediante muestreo no probabilístico por conveniencia a individuos mayores de edad concurrentes a los seis distritos de la ciudad de Rosario, a los cuales asistían por cuestiones no relacionadas con el cuidado de su salud. Resultados: Se encuestaron 1.217 voluntarios; el 57% fueron mujeres y el 11% trabajaban en ámbitos relacionados con la atención de la salud. La edad promedio fue de 48 años; fumaban el 28% de los encuestados y el 24% eran extabaquistas. La mediana de intentos para dejar de fumar fue menor en extabaquistas (1 vs. 3 veces; p < 0,0001). El 72,5% de los que recibieron la recomendación de dejar de fumar durante el año precedente intentaron hacerlo, mientras que de los que no recibieron consejo lo intentó el 57% (p = 0,003). Se realizó un análisis factorial de correspondencias múltiples y posterior clasificación, que mostró que los tabaquistas que no intentaron dejar de fumar comenzaron a edades mayores y consumían menos cigarrillos diarios. Conclusiones: La calidad de la recomendación de abandonar el hábito de fumar y la autopercepción del riesgo que esta adicción supone son aspectos no jerarquizados en forma sistemática al abordar esta temática. Consideramos que el presente estudio pone de relieve la importancia de estos aspectos, los cuales se deberán profundizar en el futuro para una mejor aproximación a la complejidad del logro del cese del consumo de tabaco.

Backgroung: Smoking is the leading cause of preventable death worldwide; nevertheless, many physicians do not advice to quit smoking. Objectives: The goal of this cross-sectional study was to evaluate the characteristics of tobacco use and the frequency of smoking cessation recommendation in adults in the city of Rosario between July and December 2010. Methods: A closed survey was performed to adults attending the seven districts of the city of Rosario for reasons not related to health care, using a prearranged questionnaire based on non-probability convenience sampling. Results: A total of 1,217 volunteers were surveyed; 57% were women and 11% worked in health care sectors. Mean age was 48 years; 28% were current smokers and 24% were former smokers. The median number of attempts to quit smoking was lower in former smokers (1 vs. 3 times; p < 0.0001). Of those who received advice to quit smoking, 72.5% attempted to do so during the preceding year, while 57% of those not receiving advice tried to quit smoking (p = 0.003). A multiple correspondence factor analysis with subsequent classification showed that current smokers who did not attempt cessation started smoking later in life and smoked fewer cigarettes per day. Conclusions: The quality of the recommendation for smoking cessation and the self-perception of the risk associated with this addiction are aspects that are not systematically taken into account when this topic is raised. We consider that the present study emphasizes the importance of theses aspects, which should undergo further evaluation in the future for a better approach to the complexity of achieving tobacco cessation.

Recomendación de abandono del tabaquismo en una muestra de adultos de la ciudad de Rosario / Recommendation of Smoking Cessation in an Adult Sample of the City of Rosario

Introducción: El tabaquismo es la principal causa de muerte prevenible en el mundo; pese a ello, muchos médicos no aconsejan a sus pacientes dejar de fumar. Objetivos: Evaluar las características del consumo de tabaco y la frecuencia en la recomendación de su abandono en adultos de la ciudad de Rosario mediante un estudio transversal realizado entre julio y diciembre de 2010. Material y métodos: Encuesta cerrada prefijada realizada mediante muestreo no probabilístico por conveniencia a individuos mayores de edad concurrentes a los seis distritos de la ciudad de Rosario, a los cuales asistían por cuestiones no relacionadas con el cuidado de su salud. Resultados: Se encuestaron 1.217 voluntarios; el 57% fueron mujeres y el 11% trabajaban en ámbitos relacionados con la atención de la salud. La edad promedio fue de 48 años; fumaban el 28% de los encuestados y el 24% eran extabaquistas. La mediana de intentos para dejar de fumar fue menor en extabaquistas (1 vs. 3 veces; p < 0,0001). El 72,5% de los que recibieron la recomendación de dejar de fumar durante el año precedente intentaron hacerlo, mientras que de los que no recibieron consejo lo intentó el 57% (p = 0,003). Se realizó un análisis factorial de correspondencias múltiples y posterior clasificación, que mostró que los tabaquistas que no intentaron dejar de fumar comenzaron a edades mayores y consumían menos cigarrillos diarios. Conclusiones: La calidad de la recomendación de abandonar el hábito de fumar y la autopercepción del riesgo que esta adicción supone son aspectos no jerarquizados en forma sistemática al abordar esta temática. Consideramos que el presente estudio pone de relieve la importancia de estos aspectos, los cuales se deberán profundizar en el futuro para una mejor aproximación a la complejidad del logro del cese del consumo de tabaco.(AU)

Backgroung: Smoking is the leading cause of preventable death worldwide; nevertheless, many physicians do not advice to quit smoking. Objectives: The goal of this cross-sectional study was to evaluate the characteristics of tobacco use and the frequency of smoking cessation recommendation in adults in the city of Rosario between July and December 2010. Methods: A closed survey was performed to adults attending the seven districts of the city of Rosario for reasons not related to health care, using a prearranged questionnaire based on non-probability convenience sampling. Results: A total of 1,217 volunteers were surveyed; 57% were women and 11% worked in health care sectors. Mean age was 48 years; 28% were current smokers and 24% were former smokers. The median number of attempts to quit smoking was lower in former smokers (1 vs. 3 times; p < 0.0001). Of those who received advice to quit smoking, 72.5% attempted to do so during the preceding year, while 57% of those not receiving advice tried to quit smoking (p = 0.003). A multiple correspondence factor analysis with subsequent classification showed that current smokers who did not attempt cessation started smoking later in life and smoked fewer cigarettes per day. Conclusions: The quality of the recommendation for smoking cessation and the self-perception of the risk associated with this addiction are aspects that are not systematically taken into account when this topic is raised. We consider that the present study emphasizes the importance of theses aspects, which should undergo further evaluation in the future for a better approach to the complexity of achieving tobacco cessation.(AU)