Oral and general health conditions involved in periodontal status during pregnancy: a prospective cohort study.

PURPOSE: Pregnancy is a period in a woman's life that has important consequences on oral health, particularly for gingival health. Present study aims to identify women at higher risk of developing periodontal disease (gingivitis and periodontitis) during late pregnancy and evaluate how this condition evolves during this period. METHODS: Prospective cohort study was designed with pregnant women who were assessed during the first and third trimesters of gestation in a southern Spanish public hospital. Data regarding gingival and periodontal health, oral hygiene, and overall health status (obesity and diabetes mellitus) were collected. Reporting followed STROBE checklist. RESULTS: Significantly higher number of women had the periodontal and gingival disease in the third trimester of gestation compared with in early pregnancy. In the third trimester of gestation, 42 (28.6%) and 63 (42.9%) of women presented symptoms of periodontal disease and gingival disease, respectively. Obesity (OR 2.834; 95%CI 0.919-8.741), worse oral hygiene during the first trimester of gestation (OR: 4.031; 95%CI 2.12-7.65), and periodontal disease during early pregnancy (OR: 15.104; 95%CI 3.60-63.36) most effectively predicted periodontal disease during late pregnancy. CONCLUSIONS: Pregnancy is associated with exacerbated periodontal and gingival disease symptoms throughout the different trimesters of gestation. Obesity and oral hygiene during early pregnancy were the risk factors that most contributed to the aforementioned changes in periodontal disease.

Asociación entre diabetes mellitus gestacional y enfermedad periodontal: revisión sistemática / Association between gestational diabetes mellitus and periodontal disease: Systematic review

Objetivo: Determinar si existe asociación entre la enfermedad periodontal en las gestantes y el desarrollo de diabetes mellitus gestacional durante su embarazo. Materiales y métodos: La presente revisión se realizó en base a las directrices de la declaración Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA). Se realizó una búsqueda sistemática en cuatro bases de datos: MEDLINE (vía PubMed), Cochrane Library, Scopus y Web of Science. Se incluyeron todos los trabajos encontrados hasta marzo del 2021. Los estudios que resultaron elegibles fueron evaluados a través de la escala de Newcastle-Ottawa en cuanto a su calidad metodológica. Resultados: De 161 estudios resultaron elegibles un total de 8 estudios, 3 de tipo caso-control, 2 de tipo transversal y 3 de tipo cohorte. En la mayoría de los estudios se verificó una asociación entre EP y DMG. Conclusión: La enfermedad periodontal aumenta el riesgo de desarrollar diabetes mellitus gestacional. Es necesario realizar más estudios con diferentes diseños, enfoque multicéntrico y distintas poblaciones para profundizar esta asociación.(AU)

Aim: To determine whether there is an association between periodontal disease in pregnant women and the development of gestational diabetes mellitus during their pregnancy. Objetive: To determine if there is an association between periodontal disease in pregnant women and the development of gestational diabetes mellitus during her pregnancy Methods: The present systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Four electronic data bases were searched: MEDLINE (via PubMed), Cochrane Library, Scopus and Web of Science, through February 2021. Eligible studies were assessed for methodological quality using the Newcastle-Ottawa scale. Results: From 161 studies, 8 were eligible: 3 case-control, 2 cross-sectional and 3 cohort studies. Most of the studies supported an association between periodontitis and GDM. Conclusion: Periodontitis is associated with increased risk for GDM compared to woman without periodontitis. Future robust studies with different designs in distinct populations are needed to enlarge on these findings.(AU)

Factors associated with oral health-related quality of life during pregnancy: a prospective observational study.

PURPOSE: To evaluate the evolution of perceived quality of life in relation to oral health during pregnancy and to determine the risk factors involved in this process. METHODS: A follow-up study was carried out with pregnant Spanish women. Two oral examinations and an oral health-related quality of life (OHRQoL) assessment, using the OHIP-14 questionnaire, were performed in the first and third trimester of pregnancy. Data on sociodemographic characteristics, medical history, O'Sullivan Test measures, oral hygiene habits, history of caries, and periodontal status of participants were collected through structured medical-dental questionnaires. RESULTS: A complete dataset comprising 246 pregnant women was available for analysis. Overall scores for negative impacts on the OHIP questionnaire were significantly higher during late pregnancy (74%). This indicated a deterioration in oral health-related quality of life amongst participants. Items describing "painful aching", "self-consciousness", "unsatisfactory diet", and "interrupted meals" showed the greatest increase between the first and third trimester of gestation. Multivariate analysis showed that pre-gestational/gestational diabetes mellitus and poor oral hygiene habits during the first trimester of gestation were directly associated with worse oral health-related quality of life during the third trimester of gestation (hyperglycemia: OR 2.86; 95% CI 1.019-8.050: p = 0.043 / oral hygiene: OR 1.33; 95% CI 0.970-1.836; p = 0.076). CONCLUSIONS: In the present research, hyperglycemia during pregnancy and poor oral hygiene habits during the first trimester of gestation led to a higher risk of poor oral quality of life during late pregnancy.

[Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy]. / Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.

INTRODUCTION: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. AIM: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. PATIENTS AND METHODS: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. RESULTS: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. CONCLUSION: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.

TITLE: Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente.Introducción. El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual son escasos. Objetivo. Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual. Pacientes y métodos. Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos. Resultados. Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global. Conclusión. La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.

SEROPREVALENCE OF ANTIBODIES AGAINST MYCOBACTERIUM AVIUM SUBSP. PARATUBERCULOSIS AND ITS RELATIONSHIP TO AGE AND SEX OF TEXAS WHITE-TAILED DEER (ODOCOILEUS VIRGINIANUS) IN COAHUILA, MEXICO.

Paratuberculosis (PTB) is a disease that affects cattle (Bos taurus), goats (Capra aegagrus hircus), sheep (Ovis aries), and wild animals, such as white-tailed deer (Odocoileus virginianus), since all ruminants are susceptible. The causal agent is Mycobacterium avium subsp. paratuberculosis (MAP). The disease is chronic, consumptive, and incurable; it causes chronic granulomatous gastroenteritis with lymphangiectasis and lymphangitis leading to a syndrome of malnutrition and eventually to death. Mycobacterium avium subsp. paratuberculosis is transmitted in feces mainly orally; however, it can also be transmitted vertically. Thus, the objective of this study was to determine the seroprevalence of MAP antibodies and its relationship to age and sex of Texas white-tailed deer in the subclinical stage of PTB in Coahuila, Mexico. The entire population (n=99) belonging to the Wildlife Management and Conservation Unit (WMCU) San Juan, Monclova, Coahuila, Mexico was captured. Mycobacterium avium subsp. paratuberculosis was diagnosed using an enzyme-linked immunosorbent assay by serologic test. Seroprevalence variables of adult vs. young females and males vs. females were compared. The treatments were assigned at random. For the analysis of data, the chi-square test was used. Total seroprevalence in an intensive WMCU was 16% (16/99). Total seroprevalence by sex was 5.0% (5/99) for males and 11% (11/99) for females, and total seroprevalence by age was 7% (7/99) for young and 9% (9/99) for adult. Within sex, the seroprevalence in males was 16% (5/31) and 16% (11/68) in females. There were no statistical differences for any of the comparisons. Total seroprevalence of the white-tailed deer population in the WMCU was 16%, and PTB seroprevalence was independent of sex or age of the sampled individuals of this population.

Alzemon: estudio de seguimiento prospectivo del acetato de eslicarbacepina en monoterapia en pacientes con epilepsia de diagnóstico reciente / Alzemon: a prospective follow-up study of eslicarbazepine acetate monotherapy in patients with newly diagnosed epilepsy

Introducción: El acetato de eslicarbacepina es un nuevo bloqueante de los canales de sodio en el tratamiento de las crisis de inicio focal. Los estudios prospectivos sobre su efectividad en monoterapia en pacientes con epilepsia parcia l de reciente diagnóstico en la práctica clínica habitual son escasos.Objetivo: Evaluar la efectividad de la eslicarbacepina en monoterapia de inicio en pacientes con epilepsia parcial de reciente diagnóstico en la práctica clínica habitual.Pacientes y métodos: Estudio postautorización prospectivo y multicéntrico. Se incluyó a pacientes con epilepsia parcial de reciente diagnóstico de 18 años o más sin tratamiento previo. Las variables de eficacia fueron: porcentaje de pacientes libres de crisis, respondedores y reducción en la frecuencia mensual de crisis. Las variables de seguridad analizan la tasa de retención a los 12 meses y la aparición de efectos adversos.Resultados: Se incluyó a 53 pacientes. La tasa de retención fue del 77,4%. Al final del período de observación, el 83% de los pacientes se encontraba libre de crisis y el 92,5% había reducido en un 50% o más su frecuencia basal. El 68% de los pacientes notificó algún efecto adverso y el 7,5% de ellos abandonó el estudio por este motivo. El análisis de efectividad del subgrupo de 65 años o más no mostró diferencias respecto a la población global.Conclusión: La eslicarbacepina en monoterapia en pacientes con epilepsia parcial de reciente diagnóstico, tanto en la población general como en la población de más de 65 años, es eficaz y segura en la práctica clínica habitual.(AU)

Introduction: Eslicarbazepine acetate is a novel sodium channel blocker for use in the treatment of focal onset seizures. Prospective studies on its effectiveness in monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice are scarce. Aim: To evaluate the effectiveness of eslicarbazepine as initial monotherapy in patients with newly diagnosed partial epilepsy in routine clinical practice. Patients and methods: A prospective, multicentre, post-authorisation study. Patients with newly diagnosed partial epilepsy aged 18 years or older without previous treatment were included. The efficacy variables were: percentage of seizure-free patients, responders and reduction in monthly frequency of seizures. The safety variables analyse the 12-month retention rate and the occurrence of adverse effects. Results: Fifty-three patients were included. The retention rate was 77.4%. At the end of the observation period, 83% of patients were seizure-free and 92.5% had reduced their baseline frequency by 50% or more. In addition, 68% of the patients reported some adverse effect and 7.5% of them dropped out of the study for this reason. The effectiveness analysis of the subgroup of patients aged 65 years or more showed no differences with respect to the overall population. Conclusion: Eslicarbazepine monotherapy in patients with newly diagnosed partial epilepsy, both in the general population and in the population over 65 years old, is effective and safe in routine clinical practice.(AU)

Molecular epidemiology of Mycobacterium tuberculosis in adult Filipino TB-HIV co-infected patients.

BACKGROUND: TB is the leading cause of death from a single infectious disease, particularly among people living with HIV (PLHIV). Molecular epidemiology provides information on prevalent genotypes of Mycobacterium tuberculosis and disease transmission dynamics, which aid in TB control. Identification of mutations that confer drug resistance is essential for the rapid diagnosis of drug-resistant TB, especially in high TB burden settings, like the Philippines.METHODS: This study aimed to determine mutations in M. tuberculosis drug resistance-conferring genes and circulating genotypes in PLHIV. MIRU-VNTR (mycobacterial interspersed repetitive unit-variable number of tandem repeats) typing using a set of 24-loci and sequencing of drug resistance-conferring genes were performed in 22 M. tuberculosis isolates from TB-HIV co-infected patients.RESULTS: The prevalence of resistance to any drug was 31.8%, 18.2% for isoniazid monoresistance, 4.5% for streptomycin monoresistance and 9.1% for multidrug resistance. The identified mutations in the katG, rpoB, pncA, rpsL and gyrA genes have been reported in the literature; none was found in the inhA and embB genes. All isolates belonged to the EAI2-Manila family and were grouped into four clusters based on their phenotypic drug resistance and mutation profiles.CONCLUSION: The use of 24-loci set may be used as a more discriminatory MIRU-VNTR typing in settings where the East African-Indian lineage is predominant, like the Philippines.

The effects of rumen nitrogen balance on intake, nutrient digestibility, chewing activity, and milk yield and composition in dairy cows vary with dietary protein sources.

The objective was to study the interaction effects of rumen nitrogen balance (RNB) and dietary protein source on feed intake, apparent total-tract digestibility (ATTD), eating and ruminating activity, milk yield (MY), and milk composition in lactating dairy cows. Twenty-four lactating Holstein cows were divided in 4 groups, which were randomly assigned to the dietary treatments included in a replicated 4 × 4 Latin square experimental design that consisted of four 20-d periods, each with 12 d of adaptation to the experimental diets and 8 d of sampling. The dietary treatments followed a 2 × 2 factorial arrangement with 2 main protein sources, faba bean grain (FB) and SoyPass (SP; Beweka Kraftfutterwerk GmbH), offered at 2 dietary RNB levels: RNB0 (RNB of 0 g/kg of dry matter) and RNB- (RNB of -3.2 g/kg of dry matter; i.e., 4 treatments). The composition of concentrate mixtures was adjusted to create diets with the desired RNB levels. Each of the protein sources supplied ≥35% of the total dietary crude protein (CP). Both diets within a protein source had similar forage sources and forage to concentrate ratios and were iso-energetic, but differed in CP concentrations. The main effects of RNB, protein source, and their interactions were tested by PROC MIXED in SAS 9.4 (SAS Institute Inc.). Interaction effects were observed for daily dry matter intake and energy-corrected MY, which were lower for RNB- than RNB0 in diets containing FB (23.5 vs. 24.4 kg dry matter/d; 28.6 vs. 30.6 kg milk/d), but similar in diets containing SP (24.2 vs. 24.3 kg dry matter/d; 31.3 vs. 31.7 kg milk/d). The ATTD of NDF was lower for RNB- compared with RNB0 in the FB (44.9 vs. 49.1 g/100 g) and SP (48.5 vs. 51.9 g/100 g) diets, and greater for the SP than for FB diets. There were interaction effects for ATTD of CP and concentrations of milk urea nitrogen, which were lower for RNB- compared with RNB0 in both, FB (55 vs. 63.1 g/100 g of CP; 5.65 vs. 11.3 mg/dL milk) and SP diets (60 vs. 64.4 g/100 g of CP; 8.74 vs. 13.4 mg/dL milk). However, differences between RNB levels were greater for FB than for SP diets. Furthermore, proportions of milk fatty acids followed the same pattern as that of dietary fatty acids, but biohydrogenation appeared to be greater for RNB- than RNB0 for both protein sources and in FB than in SP diets for both RNB levels. There was an interaction effect on total number of chews per unit of NDF intake, which was greater for RNB- compared with RNB0 for both protein sources. However, the differences between RNB levels were greater in FB than in SP diets. Overall, differences in the animal responses to negative RNB between FB and SP diets suggest a need to better understand the effect of negative RNB levels with different dietary ingredients at similar utilizable CP supply.

Uso del aprendizaje automático en el diagnóstico del melanoma. Limitaciones por superar / Machine Learning in Melanoma Diagnosis. Limitations About to be Overcome

ANTECEDENTES: La clasificación automática de imágenes es una rama prometedora del aprendizaje automático (de sus siglas en inglés Machine Learning [ML]), y es una herramienta útil en el diagnóstico de cáncer de piel. Sin embargo, poco se ha estudiado acerca de las limitaciones de su uso en la práctica clínica diaria. OBJETIVO: Determinar las limitaciones que existen en cuanto a la selección de imágenes usadas para el análisis por ML de las neoplasias cutáneas, en particular del melanoma. MÉTODOS: Se diseñó un estudio de cohorte retrospectivo, donde se incluyeron de forma consecutiva 2.849 imágenes dermatoscópicas de alta calidad de tumores cutáneos para su valoración por un sistema de ML, recogidas entre los años 2010 y 2014. Cada imagen dermatoscópica fue clasificada según las características de elegibilidad para el análisis por ML. RESULTADOS: De las 2.849 imágenes elegidas a partir de nuestra base de datos, 968 (34%) cumplieron los criterios de inclusión. De los 528 melanomas, 335 (63,4%) fueron excluidos. La ausencia de piel normal circundante (40,5% de todos los melanomas de nuestra base de datos) y la ausencia de pigmentación (14,2%) fueron las causas más frecuentes de exclusión para el análisis por ML. DISCUSIÓN: Solo el 36,6% de nuestros melanomas se consideraron aceptables para el análisis por sistemas de ML de última generación. Concluimos que los futuros sistemas de ML deberán ser entrenados a partir de bases de datos más grandes que incluyan imágenes representativas de la práctica clínica habitual. Afortunadamente, muchas de estas limitaciones están siendo superadas gracias a los avances realizados recientemente por la comunidad científica, como se ha demostrado en trabajos recientes

BACKGROUND: Automated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice. OBJECTIVE: To determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma. METHODS: Retrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis. RESULTS: Of the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis. DISCUSSION: Only 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show

Machine Learning in Melanoma Diagnosis. Limitations About to be Overcome. / Uso del aprendizaje automático en el diagnóstico del melanoma. Limitaciones por superar.

BACKGROUND: Automated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice. OBJECTIVE: To determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma. METHODS: Retrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis. RESULTS: Of the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis. DISCUSSION: Only 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show.

Etiología de la gangrena de Fournier como factor pronóstico de mortalidad: análisis de 121 casos / Etiology of Fournier gangrene as a prognostic factor in mortality: Analysis of 121 cases

Objetivo: Evaluar el origen de la gangrena de Fournier (GF) como factor pronóstico de morbimortalidad. Material y métodos: Los pacientes que acudieron a nuestra clínica con diagnóstico de GF entre 2010 y 2017 se incluyeron de forma retrospectiva. Los pacientes fueron categorizados según el origen de la infección. Se determinaron 3 factores de gravedad en cada grupo: duración de la estancia hospitalaria (días), índice de gravedad de GF y mortalidad. Se realizó un análisis de regresión logística para evaluar los datos. Resultados: De los 130 pacientes evaluados, el origen se estableció en 121 con base en la historia clínica y los hallazgos radiológicos y quirúrgicos. Treinta y cinco pacientes tuvieron un origen intestinal con una mortalidad del 20,68%, en 46 el origen fue testicular y la mortalidad del 2,22%, en 12 pacientes el origen fue urinario, con una mortalidad del 0%, y 28 pacientes tenían enfermedad de origen cutáneo y una mortalidad del 16,6%. El origen testicular fue el más frecuente (38%), además de presentar una estancia hospitalaria y un índice de gravedad de FG más bajo y una mortalidad menor que aquellos con enfermedad de origen intestinal (p = 0,022). Conclusiones: El origen de la infección tiene un valor pronóstico significativo en la mortalidad del paciente

Objective: Evaluate the origin of Fournier gangrene (FG) as a prognostic factor of morbidity and mortality. Material and methods: Patients who came to our clinic with a diagnosis of FG from 2010 to 2017 were included retrospectively. Patients were categorized depending on the origin of the infection. Three severity factors were determined in each group: days of hospital stay, the FG severity index, and mortality. Logistic regression test was performed to analyze the data. Results: Of the 130 patients evaluated, the origin was established in 121 based on the clinical history and radiological and surgical findings. Thirty-five patients had an intestinal origin with a mortality of 20.68%, 46 patients had a testicular origin with a mortality of 2.22%, 12 patients had a urinary origin with a mortality of 0%, and 28 patients with a cutaneous origin with a mortality of 16.6%. The testicular origin was the most frequent (38%) in addition to presenting a lower hospital stay, a lower FG severity index, and a lower mortality than those with an intestinal origin (P = .022). Conclusions: The origin of the infection has a significant prognostic value in the mortality of the patient

Etiology of Fournier gangrene as a prognostic factor in mortality: Analysis of 121 cases. / Etiología de la gangrena de Fournier como factor pronóstico de mortalidad: análisis de 121 casos.

OBJECTIVE: Evaluate the origin of Fournier gangrene (FG) as a prognostic factor of morbidity and mortality. MATERIAL AND METHODS: Patients who came to our clinic with a diagnosis of FG from 2010 to 2017 were included retrospectively. Patients were categorized depending on the origin of the infection. Three severity factors were determined in each group: days of hospital stay, the FG severity index, and mortality. Logistic regression test was performed to analyze the data. RESULTS: Of the 130 patients evaluated, the origin was established in 121 based on the clinical history and radiological and surgical findings. Thirty-five patients had an intestinal origin with a mortality of 20.68%, 46 patients had a testicular origin with a mortality of 2.22%, 12 patients had a urinary origin with a mortality of 0%, and 28 patients with a cutaneous origin with a mortality of 16.6%. The testicular origin was the most frequent (38%) in addition to presenting a lower hospital stay, a lower FG severity index, and a lower mortality than those with an intestinal origin (P=.022). CONCLUSIONS: The origin of the infection has a significant prognostic value in the mortality of the patient.

Molecular adsorption and dissociation of CO2 on TiO2 anatase (001) activated by oxygen vacancies.

A study on the influence of oxygen vacancies on the anatase (001) surface on the CO2 adsorption process is presented. For its realization, density functional theory (DFT) was used under the Perdew-Burke-Ernzerhof (PBE) generalized gradient and the spin-polarized approximations. Hubbard-U corrections and van der Waals interactions were also included. Three different types of oxygen vacancies were investigated at different sites on the anatase (001) surface; the formation energies in each case were 67.05, 113.84, and 93.16 kcal/mol, respectively. We identified a type of oxygen vacancy that could favor both the CO2 adsorption and dissociation. The differences on CO2 adsorption properties are due to electronic and structural causes, such as midgap states (Ti3+ polarons species) and changes in the structural properties on the TiO2 surface, generated upon the introduction of an oxygen vacancy. It is concluded that oxygen vacancies can play an important role in both CO2 adsorption and dissociation.

Associated factors with health-compromising behaviors among patients treated for oral cancer.

BACKGROUND: To improve eradication strategies of health-compromising behaviors between oral cancer survivors, this study aimed to explore the extent of clustering of risk behaviors and to assess possible factors associated. MATERIAL AND METHODS: A cross-sectional study was carried out among oral cancer patients at least 6 months after treatment. They completed a questionnaire about smoking, alcohol consumption, oral hygiene habits and dental visits. Presence of clusters was evaluated through pairwise Pearson correlations and principal component analysis. Factors associated with each identified cluster were analyzed with multivariate models. RESULTS: Among 142 patients, 14.8% smoked, 51.7% consumed alcohol, 52.1% performed oral hygiene less than twice a day, and 74.6% visited to dentist when there was a problem or never. There were two distinct clusters: smoking-alcohol consumption (general risk behaviors cluster) and oral hygiene-dental attendance (oral risk behaviors cluster). Multivariate analysis showed significant associations between males and both clustering patterns of health compromising behaviors, patients with clinical stage I or with longer follow-up and the presence of general risk behaviors cluster and worse social class and the presence of oral risk behaviors cluster. CONCLUSIONS: A high proportion of patients treated for oral cancer presented health-compromising behaviors occurring in clusters which reinforce the need for health promotion strategies to target multiple behaviors. Factors analyzed suggest that chances of having detrimental behavioral clustering are higher in male, patients with clinical stage I, with lower social class and those with longer follow-up after treatment.

Clinical and sociodemographic profile of epilepsy in adults from a reference centre in Colombia. / Perfil clínico y sociodemográfico de la epilepsia en adultos de un centro de referencia de Colombia.

OBJECTIVES: To describe the sociodemographic and clinical characteristics of a cohort of patients with epilepsy from a reference centre in Colombia. METHODS: Cross-sectional study including patients diagnosed with epilepsy who attended our epilepsy centre (Neurocentro) between 2013 and 2016. Data were gathered from patients' medical histories. RESULTS: We gathered data from a total of 354 patients diagnosed with epilepsy. Median age was 37 years; 52% were men. Seizures were focal in 57% of the patients and generalised in 38%; seizure type was not determined in 6% of the sample. The most frequent aetiology was cryptogenic (21%), followed by traumatic (14%). Median time of disease progression and age at onset were 23 and 11 years, respectively. Psychiatric comorbidities were found in 18% of the patients and 40% had some degree of cognitive impairment. Around 40% of our sample reported adverse reactions to antiepileptic drugs at some point during treatment. Antiepileptic drugs were administered in monotherapy in 36% of the patients. Around 37% had drug-resistant epilepsy and 14% underwent surgery. CONCLUSIONS: Psychiatric comorbidities, cognitive impairment, adverse drug reactions, and drug-resistant epilepsy are common among epileptic patients in Colombia. Knowledge of the factors with an impact on epilepsy may lay the foundations for improving management of these patients on the administrative level and improving quality of life.

Efecto del nivel de complementación con metionina-colina en vacas Holstein durante el periodo de transición sobre las concentraciones hepáticas de triglicéridos, colina y carnitina / Effect of the level of complementation with methionine-coline in Holstein cows during the transitional period on the hepatic concentrations of triglycerides, choline and carnitine

RESUMEN Con el objetivo de evaluar el potencial lipotropics de metionina-colina en vacas lecheras durante el periodo de transición, dosis de 20 g/d de una Fuente Comercial Protegida de la Degradación Ruminal (FCPDR) de metionina y sus combinaciones con una FCPDR de colina en dosis de 60 y 120 g/d se suministraron a vacas entre el día 260 de gestación y el día 20 posparto. Estas pastoreaban kikuyo (Cenchrus clamdestinus) y recibieron un complemento alimenticio. En los días 270 de gestación y 10 y 20 posparto se cuantificaron las concentraciones plasmáticas de ácidos grasos no esterificados (AGNES), β-Hidroxibutirato (BHB) y triglicéridos (TG), así como las concentraciones hepáticas de triacilglicéridos, de colina, carnitina total, carnitina libre y acil carnitina. Durante el preparto se presentaron los valores significativamente más altos (p < 0.05) de TG plasmáticos y los significativamente más bajos (p < 0.05) de AGNES y BHB. Las concentraciones hepáticas de TG, de colina y de las diferentes formas de carnitina no difirieron significativamente entre periodos de muestreo y no se vieron afectadas por la suplementación con metionina-colina. Por su parte, las concentraciones plasmáticas de BHB aumentaron significativamente (p < 0.05) con la suplementación conjunta de metionina y colina, lo que sugiere un aumento en la oxidación de ácidos grasos. Se concluye que con concentraciones bajas de AGNES la metionina y colina no son nutrientes limitantes para la exportación de TG desde el hígado a la sangre. Bajo esta condición no se observó lipidosis hepática y como consecuencia la suplementación con metionina-colina no ocasionó efectos significativos sobre las concentraciones hepáticas de TG.

ABSTRACT In order to evaluate the lipotropic potential of methionine-coline in dairy cows during the transition period, the effect of supplementation with 20 g / d of a Ruminal Degradation Protected Commercial Source (FCPDR) of methionine was evaluated, and their combinations with a choline FCPDR in doses of 60 and 120 g / day. Cows grazed kikuyo (Cenchrus clandestinus) and received a nutritional supplement between day 260 of gestation and day 20 postpartum. On day 270 of gestation and on days 10 and 20 postpartum blood samples and liver biopsy were taken, in which were quantified: Non-esterified Fatty Acids (NEFAS), β-Hydroxybutyrate (BHB) and Triglycerides; And hepatic concentrations of triacylglycerides, choline, total carnitine, free carnitine and acyl carnitine. The highest values (p < 0.05) of plasma triglycerides and the significantly lower values (p < 0.05) of AGNES and BHB were presented during the prepartum. Hepatic concentrations of triglycerides, choline and different forms of carnitine did not differ significantly between sampling periods, and were unaffected by methionine-choline supplementation. Plasma concentrations of BHB increased significantly (p < 0.05) with co-supplementation with methionine and choline, suggesting an increase in fatty acid oxidation. At relatively low concentrations of AGNES, methionine and choline are not limiting nutrients for the exportation of triglycerides from the liver to the blood, therefore under this condition no hepatic lipidosis was observed and consequently methionine-choline supplementation did not cause significant effects on hepatic triglyceride concentrations.

Exercise and glucose control in children with insulin resistance: prevalence of non-responders.

BACKGROUND: Exercise training improves cardiometabolic outcomes in 'mean terms', but little information is available in children about the impact of the frequency/week and the wide inter-individual variability to exercise training reported in adults. OBJECTIVES: We compared the effects of resistance training (RT) and high-intensity interval training (HIT), and 'high' and 'low' frequency of training/week, for their effectiveness in decreasing insulin resistance (IR) levels in schoolchildren. A second aim was to decscribe and compare the prevalence of non-responders (NRs) between the different frequencies of training protocol. METHODS: Fifty-three schoolchildren with IR were randomly assigned into four groups: RT at high frequency (three times/week), HIT at high frequency, RT at a low frequency (two times/week) and HIT at low frequency. The intervention lasted 6 weeks. Blood samples and body composition, blood pressure and performance measurements were taken before and after the intervention. RESULTS: The prevalence of NRs was similar between the RTHF and HITHF (25.0% vs. 25.0%, P > 0.05) and RTLF and HITLF groups (20.0% vs. 46.6%, P = 0.174) for decreasing homeostasis model assessment of IR. However, significant differences in the prevalence of NRs were detected between RTHF and HITHF groups in fasting glucose (FGL) (18.7% vs. 58.3%, P < 0.031). CONCLUSIONS: Both RT and HIT improves the glucose control parameters in schoolchildren over 6 weeks, but only HIT is independent of a high or low frequency of training/week. The prevalence of NRs is similar for decreasing homeostasis model assessment of IR comparing each exercise mode in high vs. low frequency/week. However, both high- and low-frequency RT and HIT results in differences in the prevalence of NRs for FGL and other cardiometabolic and performance outcomes.

Cortical hypoactivation during resting EEG suggests central nervous system pathology in patients with chronic fatigue syndrome.

We investigated central fatigue in 50 patients with chronic fatigue syndrome (CFS) and 50 matched healthy controls (HC). Resting state EEG was collected from 19 scalp locations during a 3 min, eyes-closed condition. Current densities were localized using exact low-resolution electromagnetic tomography (eLORETA). The Multidimensional Fatigue Inventory (MFI-20) and the Fatigue Severity Scale (FSS) were administered to all participants. Independent t-tests and linear regression analyses were used to evaluate group differences in current densities, followed by statistical non-parametric mapping (SnPM) correction procedures. Significant differences were found in the delta (1-3 Hz) and beta-2 (19-21 Hz) frequency bands. Delta sources were found predominately in the frontal lobe, while beta-2 sources were found in the medial and superior parietal lobe. Left-lateralized, frontal delta sources were associated with a clinical reduction in motivation. The implications of abnormal cortical sources in patients with CFS are discussed.

Retrospective study of perampanel efficacy and tolerability in myoclonic seizures.

OBJECTIVES: Perampanel is an antiepileptic drug (AED) approved for add-on treatment of focal seizures (with or without generalization) and primary generalized tonic-clonic (GTC) seizures. Our objective was to explore the effectiveness and tolerability of adjunctive perampanel in patients with drug-resistant myoclonic seizures, after failure of other AEDs. MATERIALS AND METHODS: Retrospective, multicenter, observational study. Data were collected from individual patient clinical files and analysed using appropriate descriptive statistics and inferential analyses. RESULTS: Data are reported for 31 patients with mean age 36.4 years, who had an average epilepsy duration of 18 years, previously taken an average of 5.03 AEDs, and were taking an average of 2.4 AEDs on perampanel initiation. Patients exhibited myoclonic, GTC, absence, tonic and focal seizures, and most had associated cognitive decline and/or ataxia. Median time on perampanel was 6 months, most common dose was 6 mg, and overall retention rate was 84%. The responder rate for myoclonic seizures was defined via reduction of days with myoclonic seizures per month. At 6 months, 15 (48.4%) of the 31 patients were classed as myoclonic seizure responders, 10 (32.3%) were myoclonic seizure free, and 39% saw improvements in functional ability. Of 17 patients with GTC seizures at baseline, 9 (53%) were responders at 6 months, and 8 (47.1%) were seizure free. The most frequent side effects were psychiatric disorders, instability, dizziness and irritability, and mostly resolved with dose reduction. Five patients discontinued perampanel due to side effects. CONCLUSIONS: Perampanel caused clinically meaningful improvements in patients with drug-resistant myoclonic seizures. It was generally well tolerated, but psychiatric and neurological side effects sometimes required follow-up and dose reduction.

3D Deep Learning Angiography (3D-DLA) from C-arm Conebeam CT.

BACKGROUND AND PURPOSE: Deep learning is a branch of artificial intelligence that has demonstrated unprecedented performance in many medical imaging applications. Our purpose was to develop a deep learning angiography method to generate 3D cerebral angiograms from a single contrast-enhanced C-arm conebeam CT acquisition in order to reduce image artifacts and radiation dose. MATERIALS AND METHODS: A set of 105 3D rotational angiography examinations were randomly selected from an internal data base. All were acquired using a clinical system in conjunction with a standard injection protocol. More than 150 million labeled voxels from 35 subjects were used for training. A deep convolutional neural network was trained to classify each image voxel into 3 tissue types (vasculature, bone, and soft tissue). The trained deep learning angiography model was then applied for tissue classification into a validation cohort of 8 subjects and a final testing cohort of the remaining 62 subjects. The final vasculature tissue class was used to generate the 3D deep learning angiography images. To quantify the generalization error of the trained model, we calculated the accuracy, sensitivity, precision, and Dice similarity coefficients for vasculature classification in relevant anatomy. The 3D deep learning angiography and clinical 3D rotational angiography images were subjected to a qualitative assessment for the presence of intersweep motion artifacts. RESULTS: Vasculature classification accuracy and 95% CI in the testing dataset were 98.7% (98.3%-99.1%). No residual signal from osseous structures was observed for any 3D deep learning angiography testing cases except for small regions in the otic capsule and nasal cavity compared with 37% (23/62) of the 3D rotational angiographies. CONCLUSIONS: Deep learning angiography accurately recreated the vascular anatomy of the 3D rotational angiography reconstructions without a mask. Deep learning angiography reduced misregistration artifacts induced by intersweep motion, and it reduced radiation exposure required to obtain clinically useful 3D rotational angiography.