Odontogenic tumours in a Chilean population: a retrospective study of 544 cases based on 2022 WHO classification.

BACKGROUND: Odontogenic tumours are infrequent lesions. Studies on the frequency of odontogenic tumours from Latin America are scarce. This work aimed to determine the relative frequency of odontogenic tumours in a Chilean population using the 2022 World Health Organization classification. MATERIAL AND METHODS: This is a case series retrospective study. We reviewed 35,530 samples from 1975 to 2022 from the Oral Pathology Referral Institute and the Pathological Anatomy Service, Faculty of Dentistry, University of Chile. We utilized the 2022 World Health Organization classification for histological typification. RESULTS: According to 2022 World Health Organization classification, 544 odontogenic tumours were confirmed. The most frequent odontogenic tumours were: odontoma (n=241; 44.3%), ameloblastoma (n=109; 20.0%) and cemento-ossifying fibroma (n=71; 13.1%). Benign odontogenic tumours corresponded to 538 cases (98.9%) and malignant tumours were only six cases (1.1%). CONCLUSIONS: In our population, odontoma was the most frequent odontogenic tumour followed by ameloblastoma and cemento-ossifying fibroma. Malignant odontogenic tumours were very rare. The results of this study are similar to reports from America, but there are some differences concerning the data from Africa and Asia.

A rare case of a secondary pituitary abscess arising in a craniopharyngioma with atypical presentation and clinical course / Un caso raro de absceso hipofisario secundario derivado de un craneofaringioma con presentación y evolución clínica atípicas

Pituitary abscesses are very uncommon. They are divided into primary, arising within a healthy gland, and secondary, observed with an underlying pre-existing lesion. Here we present the eighth case reported of a secondary abscess within a craniopharyngioma. A 59-year-old-woman presented with a 3-week history of headache, and fever. Physical examination was unremarkable. An Magnetic Resonance Imaging (MRI) showed a pituitary lesion suggestive of a chronic inflammatory process. She was diagnosed with lymphocytic meningitis with hypophysitis and she was treated with corticosteroids. Two months later she presented with headache and fever again. Control MRI showed enlargement of the pituitary lesion. Therefore, a transsphenoidal biopsy was performed. During the procedure, purulent material was released. Histological study demonstrated a craniopharyngioma and meningeal inflammation. Empiric antibiotics were started. Three months post-operatively, a follow-up MRI showed a suspect minimal residual mass. Secondary pituitary abscesses are rare. The key to successful management is a high index of suspicion. Transsphenoidal surgical evacuation plus antibiotics is the mainstay of treatment. Although most symptoms resolve, endocrinopathies improve only rarely (AU)

Los abscesos hipofisarios son infrecuentes. Se pueden dividir en primarios o secundarios, si se producen sobre una lesión previa. Presentamos el octavo caso de un absceso asentado sobre un craneofaringioma. Una mujer de 59 años consultó por fiebre y cefalea de tres semanas de evolución. La exploración física era anodina. Una resonancia magnética (RMN) evidenció una lesión hipofisaria sugestiva de un proceso inflamatorio crónico. Finalmente, se diagnosticó de una meningitis linfocítica e hipofisitis y se trató con corticoides. Dos meses después reconsultó por los mismos síntomas. En la RMN se evidenció crecimiento de la lesión, por lo que se biopsia endoscópicamente. Durante el procedimiento salió pus. En el examen histológico se evidenció un craneofaringioma y una inflamación meníngea. Se iniciaron antibióticos empíricamente. En el seguimiento a tres meses, la RMN evidenciaba un dudoso resto. Los abscesos hipofisarios secundarios son raros y hay que tener un alto índice de sospecha para diagnosticarlos. El tratamiento se basa en antibioterapia y evacuación transesfenoidal. Aunque los síntomas se suelen resolver, las endocrinopatías no (AU)

Women and COVID-19: severity and mortality in hospitalized middle-aged and older patients.

OBJECTIVE: The aim of the study was to evaluate the clinical features, severity, and mortality of coronavirus disease-2019 (COVID-19) in hospitalized middle-aged and older women, and the risk factors associated with severity and mortality in women. METHODS: A retrospective study was conducted in hospitalized patients with COVID-19. The clinical features, severity, and mortality of COVID-19 in middle-aged and older women (age 45 years and older) were compared to those of younger women (age <45 years). RESULTS: A higher frequency of hypertension, invasive mechanical ventilation (IMV) requirement, and mortality was evidenced in middle-aged and older women. Age ≥45 years (odds ratio 2.7; 95% confidence interval 1.21-6.27; p = 0.01) and IMV requirement (odds ratio 3.0; 95% confidence interval 1.34-6.76; p = 0.004) predicted mortality. CONCLUSIONS: Severity and mortality are higher in middle-aged and older women with COVID-19 compared to younger women.

Clinical significance of the ABCB1 and ABCG2 gene expression levels in acute lymphoblastic leukemia.

OBJECTIVES: Acute lymphoblastic leukemia (ALL) is a clonal disease that accounts for 20% of acute leukemias in adults. A high percentage of adult patients (ranging from 70 to 80%) reach complete remission; however, the 5-year survival rate is only 20-40%. One of the main obstacles to treatment success is the drug resistance of leukemic cells. Therefore, our research group analyzed the ABCB1 and ABCG2 gene expression levels in 61 patients diagnosed with ALL and assessed whether the levels affected the clinical parameters and 40-month survival rate. METHODS: The ABCB1 and ABCG2 gene expression levels were analyzed using real-time polymerase chain reaction in 61 patients diagnosed with ALL and 99 healthy donors as controls. The association between ABCB1 and ABCG2 gene expression levels and clinical variables was determined using the Chi-square test and Fisher's exact test. Overall survival (OS) was determined using the Kaplan-Meier method. RESULTS: The results showed high ABCB1 and ABCG2 gene levels, which were 4.5 and 2.3 times the levels of healthy donors, respectively. A total of 52% of the study patients expressed high ABCB1 levels and were significantly associated with the high-risk patient group and a decreased 40-month survival rate of 78%. Only 49% of the patients expressed high ABCG2 gene levels. No association was found between the clinical parameters and the ABCG2 gene expression levels. CONCLUSIONS: Early detection of ABCB1 gene expression levels could be important for the diagnosis and monitoring of ALL patients.

Malestar psicológico en familiares de pacientes con daño neurológico durante la fase subaguda de NeuroRehabilitación / Psychological distress in relatives of patients with neurological damage during the subacute phase of NeuroRehabilitation

Durante la última década la Neurorehabilitación ha comenzado a prestar mayor atención a las familias de personas que adquieren un daño neurológico. Este giro parece responder a un creciente número de estudios describiendo importantes niveles de malestar psicólogico en dichas familias y advirtiendo de su impacto en el proceso de rehabilitación. En Chile, lamentablemente, no contamos con estudios que exploren el estado emocional de familiares en ninguna de las etapas de rehabilitación, esto, a pesar de existir guías clínicas que sugieren el abordaje familiar como meta central. Dicha falta de información limita tanto la capacidad diagnóstica como interventiva de los equipos de rehabilitación. El objetivo de este artículo es describir, y comparar, el perfil de malestar psicológico en familiares de personas con lesión cerebral y medular en etapa subaguda de rehabilitación. Método. 89 familiares de personas con daño neurológico (Lesión Cerebral Adquirida = 50; Trauma Raquimedular = 39) respondieron el General Health Questionnaire-28 como medida de malestar psicológico. Este instrumento que se compone de cuatro subescalas: síntomas somáticos, ansiedad e insomnio, disfunción social y depresión grave. Resultados. En ambas poblaciones el puntaje total del GHQ-28 se observó por encima de los estándares poblacionales, sugiriendo niveles clínicos de malestar psicológico en 90 por ciento de la muestra. No se observaron diferencias entre ambas poblaciones en términos de puntaje total o puntaje de subescalas, sugiriendo similares perfiles de malestar psicólogico. Dicho perfil se caracterizó por altos niveles de ansiedad e insomnio, seguido en menor grado de síntomas somáticos...

During the last decade NeuroRehabilitation has begun to pay more attention to the families of people with neurological damage. This shift seems to respond to a growing number of studies describing significant levels of psychological distress in families, and warning professionals of its potential impact in the process of rehabilitation. In Chile, unfortunately, we have no studies that explore the emotional state of families in any stage of the rehabilitation process, this, despite the existence of clinical guidelines suggesting to address family needs as a central goal. This lack of information limits rehabilitation teams’ ability as well as their capacity to develop interventions. The aim of this article is to describe, and compare, the profile of psychological distress in relatives of people with brain damage and spinal cord injuries, during the sub-acute phase of rehabilitation. Method. 89 relatives of people with neurological damage (Acquired Brain Injury = 50; Spinal Cord Injury = 39) completed the General Health Questionnaire-28, a self-report measure of psychological distress. This instrument has four subscales, each of them screening for different types of symptoms: somatic, anxiety/insomnia, social dysfunction and severe depression. Results. Both neurological groups presented GHQ-28 total scored above population standards, thus suggesting clinical levels of psychological distress in 90 percent of the sample. No differences were observed between the two groups in terms of GHQ-28 total score or subscale score, thus, suggesting similar profiles of psychological distress. High levels of anxiety and insomnia, followed to a lesser degree by somatic symptoms, characterized this profile...

Stem cells and androgen receptor in human periapical periodontitis / Células madre y receptor de andrógenos en periodontitis periapical humana

Activation of macrophages in periapical granulomas occurs through the presence of cytokines, endotoxin and other genetic and epigenetic factors, allowing the initiation of inflammation and bone resorption. The present study aims to analyze the presence of CD133 protein (marker of stem cells) and the AR (androgen receptor) protein in biopsies of human odontogenic periapical granuloma. Biopsies from 14 adult male patients with diagnosis of periapical granuloma included in paraffin blocks were processed histologically to obtain 5-um thick sections. Protein presence was detected and analyzed by immunohistochemistry of CD133 and AR. The quantification considered the number of positive cells in 0.17 mm2 random areas under the microscope using a 1000X objective. Both CD133 and AR proteins are expressed abundantly in cells in pathological periapical granulomas tissue. The number of cells expressing CD133 and AR shows a wide variation coefficient, so its variation is a particular feature for each individual. We concluded that in human odontogenic periapical granuloma there are abundant stem cells and cells expressing AR that may be important for the pathogenic inflammatory process.

La activación de los macrófagos en los granulomas periapicales humanos se producen a través de la presencia de citoquinas, endotoxinas y otros factores genéticos y epigenéticos que permiten la iniciación de la inflamación y la reabsorción ósea. El presente estudio pretende analizar la presencia de proteína CD133 (marcador de células madre) y de la proteína RA (receptor de andrógenos) en las biopsias de granulomas periapicales odontogénicos humanos. Las biopsias de 14 pacientes varones adultos con diagnóstico de granuloma periapical fueron incluidos en bloques de parafina y se procesaron histológicamente para obtener secciones de 5 micras de espesor. La presencia de CD133 y RA fueron detectadas y analizadas por inmunohistoquímica. La cuantificación se realizó considerando el número de células positivas en áreas al azar de 0,17mm2, utilizando microscopio con objetivo de 1000X. Ambas proteínas, CD133 y RA se expresan en abundancia en las células del tejido patológico con granuloma periapical. El número de células que expresan CD133 y RA presentan un amplio coeficiente de variación, por lo que su variación es una característica particular de cada individuo. Se concluye que en granuloma periapical odontogénico humano se expresan abundantes células madre y proteínas receptoras de andrógenos, antecedentes que pueden sermuy importantes en la expresión y diagnosis de los procesos patológicos inflamatorios.

Involvement of MT1-MMP and TIMP-2 in human periodontal disease.

OBJECTIVES: Periodontal disease is characterized by an increased collagen metabolism. Although membrane type-1 matrix metalloproteinase (MT1-MMP) plays a critical role in collagen degradation, its involvement in human periodontitis remains to be determined. METHODS: MT1-MMP and TIMP-2 expression and distribution were evaluated in gingival tissue samples derived from 10 healthy and 12 periodontitis-affected human subjects. MT1-MMP and TIMP-2 expression were assessed through Western-blot of tissue homogenates. The main cell types involved in MT1-MMP and TIMP-2 production were evaluated by means of immunohistochemistry. RESULTS: Both MT1-MMP and TIMP-2 were significantly increased in periodontitis-affected gingival tissues when compared to healthy gingiva. Moreover, the balance between MT1-MMP and its inhibitor TIMP-2 was altered in periodontitis-affected tissues, suggesting an imbalance in this proteolytic axis. Immunohistochemistry demonstrated the expression of MT1-MMP in fibroblasts and macrophages in gingival tissues. MT1-MMP was detected in cells in close association with the gingival collagen matrix. TIMP-2 expression was identified in fibroblasts, macrophages and epithelial cells. CONCLUSIONS: Our observations show an increased expression of MT1-MMP and TIMP-2 in periodontitis-affected gingival tissues. The altered balance between these two molecular mediators of collagen remodeling suggests their involvement in human periodontal disease.

Tratamiento quirúrgico para la epilepsia focal de aparición / Surgical treatment for the late focal epilepsy

Presentamos el estado actual, para el tratamiento quirúrgico de un grupo de lesiones, las cuales han sido consideradas, entre otras causas, como las responsables de Epilepsia Focal de Aparición Tardía (EFAT). Si bien, esta forma de tratamiento data desde hace más de un siglo, inclusive en países desarrollados no es considerada muy frecuentemente como una alternativa, debido a la poca información y a la escasa difusión de la tecnología y de sus posibilidades; e nuestro país, por diferentes circunstancias, no ha podido ser operativa hasta fechas recientes y aun en forma limitada. Revisamos un grupo de 10 pacientes sometidos a cirugía específicamente para esta enfermedad y cuya patología de base estuvo dada por dos condiciones: la primera, una Malformación Arterio Venosa tipo Angioma Cavernoso (AC) y la segunda, por una Cicatriz Cortical postraumática (CCPT), los cuales fueron considerados como candidatos adecuados para esta modalidad terapéutica, ya que su control clínico fue inaceptable. Exponemos el tipo de la evaluaión previa, la técnica quirúrgica, los resultados finales y las complicaciones

[Spectrophotometric determination of oleanolic acid and saponins from quinoa (Chenopodium quinoa Willd, Kancolla variety)]. / Determinación espectrofotométrica de acido oleanolico y saponinas de quinua (Chenopodium quinoa Willd, variedad Kancolla).

Saponins were extracted from quinoa (Chenopodium quinoa Willd, Kancolla variety) by refluxing with a methanol-water (4:1) mixture. Once the methanol was evaporated, the remaining residue was treated following Honerlagen and Tretter's method with only slight modifications. The extract was then hydrolyzed with 12N sulfuric acid in a 1:1 dioxane-water system at 110 degrees C for 1.5 hr. The sapogenins were extracted with chloroform, concentrated and some microliters (equivalent to 121 mg of quinoa) were spotted, against an oleanolic acid standard, on a silicagel g plate and developed with a chloroform-acetone-benzene (80:20:10; v/v) mixture. The spots were located by iodine vapor, and the band whose Rf was similar to that of the oleanolic acid, was scraped into a glass column, eluted with chloroform, dried out, dissolved in 1 ml of glacial acetic acid, treated with 4 ml of (1:1; v/v) sulfuric acid:glacial acetic acid mixture, heated in a water bath at 60 degrees C for 25 minutes, cooled and taken to the spectrophotometer where it was read at a wave length of 527 nm against a reagent blank. Under the same conditions, the oleanolic acid employed as a standard showed a linearity in the range of 60 to 480 micrograms. The oleanolic acid percentage has been determined (0.269 +/- 0.025) in quinoa, and the content of saponins estimated using a conversion factor found by gas chromatography and expressed in the following relationship: % Saponin = (8.5204) x (% oleanolic acid) The sapogenin extract obtained - analyzed by this method - showed an error of 10.7% in relation to its gas chromatography determination.