La obesidad y su relación con las patologías periodontales: una revisión narrativa / Obesity and its relation to periodontal diseases: a narrative review

La obesidad alcanza en Chile aproximadamente con un 63 por ciento, generando el desarrollo de enfermedades, algunas muy documentadas y otras con información incipiente, como las orales, por lo cual es necesario encontrar evidencia sobre la relación existente entre la obesidad y las enfermedades periodontales, considerando que alcanza cifras cercanas al 100 por ciento en adultos mayores de 35 años. Se realizó una búsqueda sistemática de la literatura, que consiste en la utilización de buscadores y bases de datos especializadas. Se efectúo finalmente un narrativo de los resultados, que implica la estandarización de los conceptos Se optó por dicho análisis de resultados debido a la inexistencia de estudios experimentales sobre el tema, sin embargo, es posible generar conclusiones metodológicamente válidas. Existen estudios sobre asociaciones entre la nutrición y la enfermedad periodontal, como una enfermedad inflamatoria, considerando el impacto de la obesidad en la modulación de la respuesta inflamatoria del individuo, provocando un alto riesgo de sufrir enfermedad periodontal. La evidencia demuestra la existencia de una relación entre ambas patologías, con una posible explicación biológica, pero aún se adolece de investigaciones experimentales.

Obesity in Chile reaches approximately 63 percent, resulting in the development of diseases, some are well documented and other incipient information, such as oral, which is necessary to find evidence on the relationship between obesity and disease periodontal, considering that scored close to 100 percent in adults over 35 years. We performed a systematic literature search, which involves the use of search engines and specialized databases. Finally, we conducted a narrative of the results, which involves the standardization of the concepts. The analysis of results was chosen, due to the lack of experimental studies on the subject, however, it is methodologically possible to generate valid conclusions. There are studies on associations between nutrition and periodontal disease as an inflammatory disease, considering the impact of obesity in the modulation of the inflammatory response of the individual, causing a high risk of periodontal disease. The evidence demonstrates the existence of a relationship between both disorders, with a possible biological explanation, but there is a lack of experimental research.

Prevalence of cardiac allograft vasculopathy assessed with coronary angiography versus coronary vascular ultrasound and virtual histology.

BACKGROUND: Cardiac allograft vasculopathy (CAV) is a major factor limiting long-term survival after heart transplantation (HT). The purpose of this study was to characterize the coronary artery structure and to determine the prevalence of vasculopathy after HT, comparing the sensitivity of coronary angiography with that of intravascular ultrasound (IVUS) and virtual histology (VH). METHODS: A prospective recruitment cross-sectional study was performed in 31 adult HT recipients including 22 men and, 9 women of overall mean age of 45.2 ± 12.6 years at an average of 3.7 ± 3.7 years after transplantation. They underwent simultaneously coronary angiography and IVUS assessment of the left anterior descending coronary artery. We investigated histological composition of the intima. Final data were analyzed using parametric and nonparametric tests. RESULTS: IVUS discovered the presence of CAV among 17/31 (54.8%) patients versus coronary angiography in 10 (32.3%; P = .009). The histological composition of the intima as assessed with IVUS VH was 26.1% fiber, 8.7% necrotic core, 5.7% calcium, and 4.3% lipid. There was no significant association between preexistent risk factors and the presence of CAV. There was a correlation between time elapsed since HT and CAV development. CONCLUSION: Time elapsed since HT is the most important risk factor for the development of CAV. Its prevalence almost doubled when measured with IVUS in contrast with angiography. IVUS was thus shown to be a more sensitive diagnostic tool compared with coronary angiography.

Heart transplantation in chile: preliminary report from the Gustavo Fricke hospital in Vina del Mar.

OBJECTIVE: The aim of this study was to analyze our results as the national reference center of the public health network in Chile. PATIENTS AND METHODS: Retrospective analysis of all transplantations performed between 1998 and 2005 was done and actuarial survival estimates were calculated according to Kaplan-Meier. RESULTS: Heart transplantations were performed in 25 patients of mean age 43 +/- 11.2 years. Eight patients (32%) were transplanted from a national priority list; all patients were under intensive care support with inotropic therapy, 4 were mechanically ventilated, and 1 required an intra-aortic counter pulsation balloon. The average time on the waiting list was 145 days in nonurgent cases and 9.4 days in urgent ones. Perioperative mortality occurred in 1 patient (4%) due to primary graft failure; 2 patients died due to infectious complications during the first year of follow-up; and 1 died due to a non-cytomegalovirus (CMV) infection at 51 months after transplantation. Two patients developed acute rejection with full recovery. The most common morbidities in the current series were hypertension (71%); hyperlipidemia (71%); renal dysfunction (24%); diabetes (10%); and vasculopathy (10%). Actuarial survival rates were 87.2% and 74.7% at 12 and 86 months, respectively. At 7 years follow-up, 20 patients were in New York Heart Association (NYHA) Class I and one Class II. CONCLUSION: Our heart transplantation program showed comparable results in the short and midterm follow-up when compared with other international reports, confirming that heart transplantation is an excellent therapeutic option for patients with end-stage heart failure.

4-Dialkylamino-1-(5-substituted or unsubstituted 1-phenyl-1H-pyrazol-4-yl)butan-1-ols: synthesis and evaluation of analgesic, anti-inflammatory and platelet anti-aggregating activities.

A number of 4-dialkylamino-1-(5-substituted or unsubstituted 1-phenyl-1H-pyrazol-4-yl)butan-1-ols 2a-n were synthesized and tested in vivo for anti-inflammatory and analgesic activities and in vitro for platelet anti-aggregating activity. Dimethylaminoderivatives 2b, e, g showed good analgesic activity; almost all of them had strong platelet anti-aggregating properties at a final concentration of 1 x 10(-3) M; pyrazoles 2c, d, f-h showed weak anti-inflammatory activity.

Effects of intravenous clonidine on the secretion of growth hormone in the perioperative period.

Growth hormone (GH) improves the metabolic and immunitary parameters in the postoperative period. Clonidine, a central acting alpha 2-adrenoceptor agonist stimulates GH release and is currently used as a screening test for GH-deficiency. A continuous iv infusion of clonidine may lead to a sustained increase in GH secretion during the perioperative period. With institutional approval and after informed consent, 20 healthy (ASA 1) patients scheduled for functional middle ear surgery under deliberate hypotensive anesthesia were studied. The anesthetic technique consisted of isoflurane, fentanyl and atracurium. Patients were randomly assigned to two groups. In group 1, hemodynamic stabilisation was obtained with a loading dose of clonidine (4 micrograms.kg-1 in 30 min) and maintained with an infusion of 1 microgram.kg-1.h-1. In group 2, a loading dose of labetalol 0.2 mg.kg-1 was followed by an infusion of 0.1 mg.kg-1.h-1. These infusions were stopped 30 min. before the end of the procedure. GH and glucose concentrations were assayed before the induction of anesthesia, after the loading dose and every 30 min. during the procedure and after the recovery during 2 hours. Serum clonidine levels were assayed after the loading dose, 1 and 3 hours later. Somatomedin C (IGF-I) concentration was measured before the induction and in the first postoperative morning along with GH, glucose and clonidine.(ABSTRACT TRUNCATED AT 250 WORDS)

[Cardiac transplantation: economizing cyclosporin A by including ketoconazole in the immunosuppressive schedule]. / Trasplante cardíaco: ahorro de ciclosporina "A" mediante la asociación de ketoconazol al esquema inmunosupresor.

Use of cyclosporin A has improved survival in patients submitted to cardiac transplantation. However, high cost of cyclosporin poses a problem for many patients in Chile. Ketoconazole is able to reduce hepatic metabolism of cyclosporin and thus prolong therapeutic levels. A 74 to 82% reduction in cyclosporin requirements was obtained in a cardiac transplant patient by adding ketoconazole. No renal damage was detected. Therefore, this drug association may help extend cardiac transplantation programs in Chile.