Incomplete type of intestinal metaplasia has the highest risk to progress to gastric cancer: results of the Spanish follow-up multicenter study.

BACKGROUND AND AIM: In high or moderate risk populations, periodic surveillance of patients at risk of progression from gastric precursor lesions (PL) to gastric cancer (GC) is the most effective strategy for reducing the burden of GC. Incomplete type of intestinal metaplasia (IIM) may be considered as the best candidate, but it is still controversial and more research is needed. To further assess the progression of subtypes of IM as predictors of GC occurrence. METHODS: A follow-up study was carried-out including 649 patients, diagnosed with PL between 1995-2004 in 9 participating hospitals from Spain, and who repeated the biopsy during 2011-2013. Medical information and habits were collected through a questionnaire. Based on morphology, IM was sub-classified as complete (small intestinal type, CIM) and incomplete (colonic type, IIM). Analyses were done using Cox (HR) models. RESULTS: At baseline, 24% of patients had atrophic gastritis, 38% CIM, 34% IIM, and 4% dysplasia. Mean follow-up was 12 years. 24 patients (3.7%) developed a gastric adenocarcinoma during follow-up. The incidence rate of GC was 2.76 and 5.76 per 1,000 person-years for those with CIM and IIM, respectively. The HR of progression to CG was 2.75 (95% CI 1.06-6.26) for those with IIM compared with those with CIM at baseline, after adjusting for sex, age, smoking, family history of GC and use of NSAIDs. CONCLUSIONS: IIM is the PL with highest risk to progress to GC. Sub-typing of IM is a valid procedure for the identification of high risk patients that require more intensive surveillance.

CAD / CAM dental systems in implant dentistry: update.

CAD/CAM systems (computer-aided design / computer aided manufacturing) used for decades in restorative dentistry have expanded its application to implant dentistry. This study aimed to look through CAD/CAM systems used in implant dentistry, especially emphasizing implant abutments and surgical templates manufacturing. A search of articles published in English at Medline and Scopus databases at present was conducted, introducing "dental CAD/CAM" , "implants abutments" and "surgical guide CAD/CAM" as key words. These systems consist of three components: 1) data capture using optical systems or laser scanning, 2) CAD for the design of the restoration, and 3) CAM to produce the restoration through the information generated by computer. CAD/CAM abutments present the advantages of being specific to each patient and providing a better fit than the rest of abutments, in addition to being much more tough as they employ materials such as titanium, alumina and zirconium. In order to improve accuracy during implant placement we use stereolithography to manufacture CAD/CAM surgical templates. Using this method, minimally invasive surgery is performed without a flap, and the prosthesis is delivered, achieving immediate functional loading to the implants.

Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School.

INTRODUCTION: Third molar extraction is the most frequent procedure in oral surgery. The present study evaluates the indication of third molar extraction as established by the primary care dentist (PCD) and the oral surgeon, and compares the justification for extraction with the principal reason for patient consultation. PATIENTS AND METHOD: A descriptive study was made of 319 patients subjected to surgical removal of a third molar in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Barcelona, Spain) between July 2004 and March 2005. The following parameters were evaluated: sex, age, molar, type of impaction, position according to the classifications of Pell and Gregory and of Winter, and the reasons justifying extraction. RESULTS: The lower third molars were the most commonly extracted molars (73.7%). A total of 69.6% of the teeth were covered by soft tissues only. Fifty-six percent of the lower molars corresponded to Pell and Gregory Class IIB, while 42.1% were in the vertical position. The most common reason for patient reference to our Service of Oral Surgery on the part of the PCD was prophylactic removal (51.0% versus 46.1% in the case of the oral surgeon). DISCUSSION AND CONCLUSIONS: Our results show prophylaxis to be the principal indication of third molar extraction, followed by orthodontic reasons. Regarding third molars with associated clinical symptoms or signs, infectious disease - including pericoronitis - was the pathology most often observed by the oral surgeon, followed by caries. This order of frequency was seen to invert in the case of third molars referred for extraction by the PCD. A vertical position predominated among the third molars with associated pathology.

Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School

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Introduction. Third molar extraction is the most frequent procedure in oral surgery. The present study evaluates the indication of third molar extraction as established by the primary care dentist (PCD) and the oral surgeon, and compares the justification for extraction with the principal reason for patient consultation.Patients and method. A descriptive study was made of 319 patients subjected to surgical removal of a third molar in the context of the Master of Oral Surgery and Implantology (Barcelona University Dental School, Barcelona, Spain) between July 2004 and March 2005. The following parameters were evaluated: sex, age, molar, type of impaction, position according to the classifications of Pell and Gregory and of Winter, and the reasons justifying extraction.Results. The lower third molars were the most commonly extracted molars (73.7%). A total of 69.6% of the teethwere covered by soft tissues only. Fifty-six percent of the lower molars corresponded to Pell and Gregory Class IIB, while 42.1% were in the vertical position.The most common reason for patient reference to our Service of Oral Surgery on the part of the PCD was prophylactic removal (51.0% versus 46.1% in the case of the oral surgeon).Discussion and conclusions. Our results show prophylaxis to be the principal indication of third molar extraction,followed by orthodontic reasons. Regarding third molars with associated clinical symptoms or signs, infectious disease – including pericoronitis – was the pathology most often observed by the oral surgeon, followed by caries. This order of frequency was seen to invert in the case of third molars referred for extraction by the PCD. A vertical position predominated among the third molars with associated pathology

A BAD link to mitochondrial cell death in the cochlea of mice with noise-induced hearing loss.

Acoustic overstimulation induces calcium overload and activation of mitochondria-mediated cell death pathways in outer hair cells (OHC) of the cochlea. However, it is not known whether these events are interrelated or independent. We have recently reported that the calcium-dependent phosphatase calcineurin is activated in OHC following noise exposure and now postulate that calcium overload triggers mitochondria-mediated death pathways through activation of Bcl-2-associated death promoter (BAD) by calcineurin. CBA/J mice were exposed to broadband noise (2-20 kHz), causing a permanent threshold shift of about 40 dB at 12 and 20 kHz, corresponding to damage in the middle and basal turns of the cochlea. Loss of OHC in the basal region was evident in surface preparations. BAD immunostaining in control animals had a cytoplasmic distribution in the cells of the organ of Corti. Five hours after acoustic overstimulation, mitochondria and BAD redistributed to the perinuclear region of OHC in the basal and middle turns but not in the apical turn. The nonapoptotic phospho-BAD (Ser 112) was up-regulated in cells undamaged by noise (supporting cells and inner hair cells) but not in OHC. These data establish a connection between calcium overload and mitochondria-mediated death pathways in OHC and also suggest a dual role for BAD. The translocation of BAD to the mitochondria in degenerating cells is indicative of the activation of its proapoptotic capacity, whereas up-regulation of phospho-BAD is consistent with a nonapoptotic role of BAD in less vulnerable cells.

Biochemical evidence for the presence of serotonin transporters in the rat cochlea.

Cochlear serotonergic innervation is constituted by efferent fibers projecting both to the area below the inner and the outer hair cells. Previous detection of serotonin (5-HT) metabolites and 5-HT receptor mRNAs suggests the existence of serotonergic synaptic activity in the cochlea. The present study explores this possibility through the effect of 6-nitroquipazine (6-NQ), a 5-HT selective reuptake inhibitor, on the basal turnover of 5-HT. The concentrations of 5-HT and its metabolite 5-hydroxyindole-3-acetic acid (5-HIAA) were quantified by high performance liquid chromatography with electrochemical detection in blood-free cochleae of rats treated with 6-NQ or saline and kept under silent conditions. Treatment with 6-NQ induced a significant increase of the cochlear concentration of 5-HT and a significant reduction of 5-HIAA concentration with respect to saline treatment. These findings could indicate that 6-NQ induced the blockade of the 5-HT selective reuptake to the cochlear serotonergic fibers. This suggests that plasma membrane 5-HT transporters are present in cochlear serotonergic fibers. Even though the role of serotonergic innervation on cochlear physiology remains unknown, the existence of cochlear serotonergic synaptic activity is strongly supported by present contributions.

[Pulmonary hypertension associated with human immunodeficiency virus infection: a review of 4 cases]. / Hipertensión pulmonar asociada a infección por VIH: revisión de 4 casos.

Several cardiorespiratory diseases can complicate human immunodeficiency virus (HIV) infection. Primary pulmonary hypertension is a rare clinical disorder with a poor prognosis. We describe this syndrome in four HIV- positive patients who were examined in our hospital.

Hipertensión pulmonar asociada a infección por VIH: revisión de 4 casos / Pulmonary hypertension associated with human immunodeficiency virus infection: a review of 4 cases

Diversas enfermedades cardiorrespiratorias pueden complicar la infección por el virus de la inmunodeficiencia humana (VIH). La hipertensión pulmonar primaria es una rara entidad clínica que conlleva un mal pronóstico. Describimos este síndrome en 4 pacientes positivos para el VIH estudiados en nuestro hospital (AU)

Effects of aging on cochlear monoamine turnover.

The aging of the cochlear dopaminergic system has been analyzed by quantifying the levels of dopamine (DA) and its metabolites (3,4-dihydroxyphenylacetic acid, DOPAC, and homovanillic acid, HVA) in adult rats aged 3, 12 or 24 months. The main results were an increase in DA, DOPAC and HVA basal concentrations in aged females with respect to the adults (3 or 12 months old), while just DA and DOPAC increased in aged males. A higher synthesis of DA in aged animals could support these findings, which could indicate some kind of compensatory mechanism related to presbycusis.

Age- and gender-related changes in the cochlear sympathetic system of the rat.

The sympathetic innervation projecting to the cochlea plays an important role in the auditory function, there is, however, no information about whether it is altered with advancing age. High performance liquid chromatography coupled to electrochemical detection was used to quantify both basal and noise-induced concentrations of norepinephrine (NE) in the rat cochlea. The cochlear concentration of NE was found to be independent of age in adult (3-12 months old) and aged (19 and 24 months old) males and the adult females. However, the concentrations of NE increased in aged females with respect to the younger ones, which suggests an increase in NE synthesis and a reduced NE release. Thus, a prominent gender effect emerged from this study, since the NE cochlear concentration was lower in adult females than in males, but tended to be the same level in aged animals. These modifications could be related to dramatic hormonal changes occurring in females with advancing age.