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.

Análisis descriptivo del índice de discapacidad vocal pediátrico en niños con patología vocal benigna / Descriptive analysis of the pediatric voice handicap index in children with benign vocal fold pathology

Resumen Introducción: La disfonía infantil puede afectar negativamente la autoestima del niño y su calidad de vida relacionada con la voz. Objetivo: Describir los resultados del cuestionario Pediatric Voice Handicap Index (pVHI) en niños con patología vocal benigna. Material y Método: Se diseñó un estudio descriptivo en pacientes con patología vocal benigna entre 3 y 15 años en la Unidad de Voz del Hospital de Niños Dr. Luis Calvo Mackenna entre octubre de 2016 y febrero de 2020. La evaluación se realizó mediante un examen laringoscópico y el cuestionario pVHI para evaluar el impacto en la calidad de vida. Resultados: Se incluyeron 49 pacientes, 35 varones (71,4%) y 14 mujeres (28,6%). La edad media fue de 9,27 años. En el examen laringoscópico, el hallazgo más frecuente fueron los nódulos vocales. La puntuación media total en el pVHI fue de 38,77: 11,67 en la subescala o categoría funcional, 18,59 en la física y 8,42 en la emocional. En la evaluación de pVHI por género no existieron diferencias significativas. Conclusión: La patología vocal benigna en la edad pediátrica ocasiona un impacto negativo en la calidad de vida relacionada con la voz. El cuestionario pVHI es un valioso instrumento para evaluar dicha repercusión.

Abstract Introduction: Childhood dysphonia can negatively affect a child's self-esteem and voice-related quality of life. Aim: To describe the results of the Pediatric Voice Handicap Index (pVHI) questionnaire in children with benign vocal fold pathology. Material and Method: A descriptive study was designed in patients with benign vocal fold pathology between 3 and 15 years of age in the Voice Unit of the Dr. Luis Calvo Mackenna Children's Hospital between October 2016 and February 2020. The evaluation was carried out through a laryngoscopic examination and pVHI questionnaire to assess the impact on quality of life. Results: Forty-nine patients were included, 35 boys (71.4%) and 14 girls (28.6%). The mean age was 9.27 years. On laryngoscopic examination, the most frequent finding was vocal fold nodules. The total mean score on the pVHI was 38.77: 11.67 on the functional subscale, 18.59 on the physical subscale, and 8.42 on the emotional subscale. In the evaluation of pVHI by gender, no significant differences were found. Conclusion: Benign vocal fold pathology in pediatric age causes a negative impact on voice-related quality of life. The pVHI questionnaire is a valuable instrument to assess this repercussion.

Adaptación cultural y validación del índice de discapacidad vocal pediátrico al español chileno

Resumen Introducción: La prevalencia de patología vocal en niños fluctúa entre el 6% y el 23%. El cuestionario Pediatric Voice Handicap Index (pVHI) se ha transformado en el instrumento más utilizado a nivel internacional para determinar el impacto de la disfonía en la calidad de vida de los niños. Objetivo: Realizar la traducción, adaptación cultural y validación del Pediatric Voice Handicap Index al español chileno. Material y Método: Estudio transversal que incluyó a 151 niños y niñas entre 3 y 15 años. Se siguieron los 5 pasos recomendados por Beaton. La versión original del pVHI en inglés fue traducida al español por dos traductoras. Posteriormente, la versión traducida y unificada fue revisada por una lingüista chilena quien realizó la adaptación cultural al idioma español chileno. El cuestionario se aplicó a dos grupos de estudio, un grupo de niños con disfonía (n = 51) y un grupo control de niños sin alteraciones de la voz (n = 100) para obtener la versión final. Resultados: Se encontraron diferencias significativas entre el grupo de niños con disfonía y el grupo control en la puntuación global del pVHI y las diferentes subescalas (p < 0,001). Se encontró una consistencia interna óptima con un excelente alfa de Cronbach (α = 0,93), con una alta fiabilidad test-retest (puntuación de correlación de Pearson = 0,95). Conclusión: La versión chilena del cuestionario pVHI presenta un alto grado de validez y confiabilidad. Recomendamos su uso e implementación como protocolo estándar en la evaluación y seguimiento de la voz pediátrica.

Abstract Introduction: The prevalence of vocal pathology in children fluctuates between 6% and 23%. The pediatric voice handicap index (pVHI) questionnaire has become the most widely used instrument to determine the impact of dysphonia on the quality of life of children. Aim: Perform the translation, cultural adaptation, and validation of the pediatric voice handicap index into Chilean Spanish. Material and Method: Cross-sectional study that included 151 boys and girls between 3 and 15 years old. The 5 steps recommended by Beaton were followed. The original version of the pVHI in English was translated into Spanish by two translators. Subsequently, the translated and unified version was reviewed by a Chilean linguist who made the cultural adaptation to the Chilean Spanish language. The questionnaire was applied to two study groups, a group of children with dysphonia (n = 51) and a control group of children without voice disorders (n = 100) to obtain the final version. Results: Significant differences were found between the group of children with dysphonia and the control group in the global pVHI score and the different subscales (p < 0.001). Optimal internal consistency was found with excellent Cronbach's alpha (α = 0.93), with high test-retest reliability (Pearson's correlation score = 0.95). Conclusion: The Chilean version of the pVHI questionnaire presents a high degree of validity and reliability. We recommend its use and implementation as a standard protocol in the evaluation and monitoring of pediatric voice.

Ovarian thecoma: A very unusual cause of postmenopausal bleeding.

We describe a 67-year-old woman with postmenopausal bleeding having ceased estrogen plus progestogen therapy nine months before. Transvaginal ultrasonography showed endometrial thickening with normal ovarian appearance. Hormonal studies revealed high estradiol and inhibin B levels but normal androgens and adrenal hormones. Magnetic resonance image demonstrated a 13-mm left ovarian tumour. Hysterectomy and bilateral salpingo-oophorectomy were performed, and the pathological study revealed an 8 mm ovarian thecoma. This case illustrates a very unusual cause of postmenopausal bleeding. We suggest a study protocol and discuss the differential diagnosis of this case.

Bruxismo y su relación con otorrinolaringología: una revisión de la literatura

Resumen El bruxismo es una condición que se observa frecuentemente en los pacientes y estos a menudo consultan por sus consecuencias físicas, como pueden ser el desgaste o destrucción dentaria, el dolor orofacial, así como también por el deterioro de la calidad de vida tanto de ellos mismos como de las personas cercanas. En la última década han aumentado en forma importante las investigaciones en torno a esta condición, así como los consensos en cuanto a su definición, clasificación y manejo clínico. Los dentistas son quienes actualmente reconocen esta actividad parafuncional y manejan estos problemas, pero es importante que los profesionales de otras áreas de la salud, como médicos y en especial otorrinolaringólogos, puedan identificar los signos, síntomas y consecuencias del bruxismo, ayudando en la detección de esta condición. Así, el objetivo de esta revisión es establecer un estado del arte sobre bruxismo e incentivar la formación de equipos multidisciplinares que ayuden en el diagnóstico y la terapéutica de esta condición.

Abstract Bruxism is a condition that is frequently observed in patients, and they often consult for physical consequences, such as teeth wear or destruction, orofacial pain, as well as for the decrease of the quality of life, of both patients and their loved ones. In the last decade, research on this phenomenon has increased significantly, as well as the consensus in terms of definition, classification and clinical management. Dentists are those who at present recognize this parafunctional activity and manage these problems, but it is important that professionals from other health areas, such as medical doctors, and specially otolaryngologists, can identify signs, symptoms and consequences of bruxism, helping in the detection of this condition. Thus, the objective of this review is to establish a state of the art about bruxism and encourage the formation of multidisciplinary teams that help to in the diagnosis and better management of this condition.

Effect of Cervical Lesions on Fracture Resistance and Failure Mode of Maxillary Central Incisors Restored with Fiber Posts and Complete Crowns.

PURPOSE: To investigate the effect of a cervical cavity extending 1 mm apical to the cemento-enamel junction (CEJ) on fracture resistance and failure mode of maxillary central incisors that have been treated endodontically, present with complete and incomplete ferrules, and are restored with and without a fiber post. METHODS AND MATERIALS: 50 intact human maxillary central incisors were divided into five groups (n=10): CG (control group) 6-mm fer-rule height, no cervical cavity, and without post; (CO) 6-mm ferrule height without post, with a cervical cavity (access to root canal and cervical cavity restored with composite resin), cervical cavity; and post with ferrule heights of 1 mm (CP1), 2 mm (CP2), and 6 mm (CP6) restored with fiberglass post and composite resin core. After complete metal crowns were cemented on all specimens, they were subjected to thermal cycling (6000 cycles, 5°C/55°C), followed by immediate testing of fracture resistance. After failure, the specimens were sectioned buccolingually to evaluate and identify the mode of failure. The data were analyzed with an analysis of variance (ANOVA) and the Student-Newman-Keuls multiple comparison tests (α =0.05). RESULTS: A 1-mm ferrule height (CP1) fracture resistance was significantly lower (531±125 N) compared to the 6-mm ferrule height (CP6) (769±175 N) (p<0.05). With respect to the groups with similar residual dentin, with and without a cervical cavity, CG (667±119 N) and CO (668±119 N), the presence of a post (CP6) increased the resistance to fracture, although no statistically significant difference was demonstrated. Partial decementation was observed in all specimens of CG and CP6, in nine of CP1 and CP2, and in three in CO. Root fractures occurred in 23 specimens. The root surface was exposed 2 mm below the CEJ to simulate bone level. Propagation of subosseous cracks occurred in four specimens in CG and CP2, in seven specimens in CP6, in two specimens in CP1, and in six specimens in CO. All were considered catastrophic failures. CONCLUSIONS: Within the limitations of this study it is suggested that, when restoring an endodontically treated maxillary central incisor that has a cervical lesion and needs to be restored with a complete crown, a fiber post is cemented to improve fracture resistance.

El ojo seco está relacionado con un aumento intrasujeto de la variabilidad de osmolaridad lagrimal confirmado por tecnología de aprendizaje de máquinas / Dry eye is matched by increased intrasubject variability in tear osmolarity as confirmed by machine learning approach

Objetivo: La medición de la osmolaridad lagrimal en pacientes con ojo seco ha sido cuestionada debido a su alta variabilidad. El entendimiento del origen de dicha variabilidad ayudaría a la interpretación clínica de los valores obtenidos. Esta investigación evalúa la medición de la variabilidad lagrimal en la práctica clínica. Material y métodos: Veinte pacientes con ojo seco y 20 controles fueron evaluados. Fueron realizadas 3 mediciones consecutivas de osmolaridad a intervalos de 5min. La variabilidad fue definida como la diferencia entre las mediciones más extremas obtenidas en cada ojo. Se utilizaron técnicas de aprendizaje de máquinas para evaluar la capacidad discriminadora de la osmolaridad lagrimal. Resultados: La osmolaridad promedio en el grupo control y ojo seco fueron 295,1 ± 7,3 mOsm/L y 300,6 ± 11,2 mOsm/L, respectivamente (p = 0,004). La variabilidad de la osmolaridad lagrimal fue 7,5 ± 3,6 mOsm/L en el grupo control y 16,7 ± 11,9 mOsm/L en los pacientes con ojo seco (p < 0,001). Basado en la osmolaridad, un clasificador logístico obtuvo un 85% de precisión. Conclusiones: La osmolaridad promedio y la variabilidad fueron significativamente más altas en pacientes con ojo seco. Por otra parte, las técnicas de aprendizaje de máquina demostraron buena precisión para clasificar a los pacientes. Por tanto, la alta variabilidad parece ser característica propia de la enfermedad de ojo seco

Objective: Because of high variability, tear film osmolarity measures have been questioned in dry eye assessment. Understanding the origin of such variability would aid data interpretation. This study aims to evaluate osmolarity variability in a clinical setting. Material and methods: Twenty dry eyes and 20 control patients were evaluated. Three consecutive osmolarity measurements per eye at 5min intervals were obtained. Variability was represented by the difference between both extreme readings per eye. Machine learning techniques were used to quantify discrimination capacity of tear osmolarity for dry eye. Results: Mean osmolarities in the control and dry eye groups were 295.1 ± 7.3 mOsm/L and 300.6 ± 11.2 mOsm/L, respectively (P=.004). Osmolarity variabilities were 7.5 ± 3.6 mOsm/L and 16.7 ± 11.9 mOsm/L, for the control and dry eye groups, respectively (P < .001). Based on osmolarity, a logistic classifier showed an 85% classification accuracy. Conclusions: In the clinical setting, both mean osmolarity and osmolarity variability in the dry eye group were significantly higher than in the control group. Machine learning techniques showed good classification accuracy. It is concluded that higher variability of tear osmolarity is a dry eye feature

Dry eye is matched by increased intrasubject variability in tear osmolarity as confirmed by machine learning approach. / El ojo seco está relacionado con un aumento intrasujeto de la variabilidad de osmolaridad lagrimal confirmado por tecnología de aprendizaje de máquinas.

OBJECTIVE: Because of high variability, tear film osmolarity measures have been questioned in dry eye assessment. Understanding the origin of such variability would aid data interpretation. This study aims to evaluate osmolarity variability in a clinical setting. MATERIAL AND METHODS: Twenty dry eyes and 20 control patients were evaluated. Three consecutive osmolarity measurements per eye at 5min intervals were obtained. Variability was represented by the difference between both extreme readings per eye. Machine learning techniques were used to quantify discrimination capacity of tear osmolarity for dry eye. RESULTS: Mean osmolarities in the control and dry eye groups were 295.1±7.3mOsm/L and 300.6±11.2mOsm/L, respectively (P=.004). Osmolarity variabilities were 7.5±3.6mOsm/L and 16.7±11.9mOsm/L, for the control and dry eye groups, respectively (P<.001). Based on osmolarity, a logistic classifier showed an 85% classification accuracy. CONCLUSIONS: In the clinical setting, both mean osmolarity and osmolarity variability in the dry eye group were significantly higher than in the control group. Machine learning techniques showed good classification accuracy. It is concluded that higher variability of tear osmolarity is a dry eye feature.

Implante de válvula de Ahmed para el manejo del glaucoma uveítico refractario: seguimiento a largo plazo / Ahmed glaucoma drainage implant surgery in the management of refractory uveitic glaucoma: Long-term follow up

OBJETIVO: Evaluar la eficacia, seguridad y complicaciones a largo plazo del implante de válvula de Ahmed en pacientes con glaucoma uveítico refractario. MÉTODOS: Revisión retrospectiva de casos consecutivos de pacientes con glaucoma uveítico refractario intervenidos mediante un implante de válvula de Ahmed entre los años 2004-2014. Las características demográficas, la agudeza visual, la presión intraocular (PIO), el número de medicamentos antiglaucomatosos y las complicaciones operatorias y postoperatorias fueron registradas. El éxito completo se definió como una PIO ≥ 5 y ≤ 18 mmHg sin medicamentos, y el éxito calificado, como una PIO ≤ 18 mmHg con uno o más medicamentos. Aquellos pacientes con un seguimiento inferior a 12 meses fueron excluidos. RESULTADOS: Veintiún pacientes (26 ojos) fueron incluidos. El seguimiento promedio postoperatorio fue de 53,5 ± 31 meses. Ocho ojos (30%) tuvieron al menos una cirugía de glaucoma fallida previamente. La PIO se redujo de una media de 30 a 14mmHg en la última visita (p < 0,001). El número de medicamentos antiglaucomatosos se redujo de una mediana de 2,9 a 1,1 en la última visita (p < 0,001). Siete ojos (27%) se calificaron como éxito completo, 13 ojos (50%) como éxito calificado y 6 ojos (23%) cumplieron el criterio de falla. La complicación postoperatoria más frecuente fue la fase hipertensiva en 12 ojos (46%). El análisis de supervivencia de Kaplan-Meier mostró una probabilidad acumulada de éxito del 65% a los 84 meses. CONCLUSIONES: La cirugía de implante de drenaje de glaucoma de Ahmed se puede considerar una opción quirúrgica eficaz y segura a largo plazo para los pacientes con glaucoma uveítico refractario

OBJECTIVE: To examine the long-term efficacy, safety and complications of Ahmed glaucoma drainage implant surgery in patients with refractory uveitic glaucoma. METHODS: Retrospective review of consecutive cases of patients with refractory uveitic glaucoma who underwent Ahmed glaucoma drainage implant surgery between 2004-2014. Demographic characteristics of the study population, visual acuity, intraocular pressure (IOP), number of antiglaucoma medications and operative and postoperative complications were recorded. Complete success was defined as IOP ≥ 5 and ≤ 18 mmHg without any medication, as qualified success if IOP ≤ 18 mmHg with one or more medications. Patients with less than 12 months of follow-up were excluded. RESULTS: 21 patients (26 eyes) were included. The mean postoperative follow-up was 53.5 ± 31 months. Eight eyes (30%) had at least one previously failed glaucoma surgery. IOP was reduced from a mean of 30.0mmHg to 14.0mmHg at the last follow-up visit (P < .001). The number of IOP-lowering medications was reduced from a median of 2.9 preoperatively to 1.1 at the last follow-up (P < .001). Overall, 7 eyes (27%) were classified as complete success, 13 eyes (50%) were considered as qualified success, and 6 eyes (23%) met the criteria for failure. The most common postoperative complication was hypertensive phase in 12 eyes (46%). Kaplan-Meier life-table analysis showed a cumulative probability of success after Ahmed glaucoma valve implantation of 65% at 84 months. CONCLUSIONS: Ahmed glaucoma drainage implant surgery may be considered a long-term effective and safety surgical option for patients with refractory uveitic glaucoma

Ahmed glaucoma drainage implant surgery in the management of refractory uveitic glaucoma: Long-term follow up. / Implante de válvula de Ahmed para el manejo del glaucoma uveítico refractario: seguimiento a largo plazo.

OBJECTIVE: To examine the long-term efficacy, safety and complications of Ahmed glaucoma drainage implant surgery in patients with refractory uveitic glaucoma. METHODS: Retrospective review of consecutive cases of patients with refractory uveitic glaucoma who underwent Ahmed glaucoma drainage implant surgery between 2004-2014. Demographic characteristics of the study population, visual acuity, intraocular pressure (IOP), number of antiglaucoma medications and operative and postoperative complications were recorded. Complete success was defined as IOP≥5 and ≤18mmHg without any medication, as qualified success if IOP≤18mmHg with one or more medications. Patients with less than 12 months of follow-up were excluded. RESULTS: 21 patients (26 eyes) were included. The mean postoperative follow-up was 53.5±31 months. Eight eyes (30%) had at least one previously failed glaucoma surgery. IOP was reduced from a mean of 30.0mmHg to 14.0mmHg at the last follow-up visit (P<.001). The number of IOP-lowering medications was reduced from a median of 2.9 preoperatively to 1.1 at the last follow-up (P<.001). Overall, 7 eyes (27%) were classified as complete success, 13 eyes (50%) were considered as qualified success, and 6 eyes (23%) met the criteria for failure. The most common postoperative complication was hypertensive phase in 12 eyes (46%). Kaplan-Meier life-table analysis showed a cumulative probability of success after Ahmed glaucoma valve implantation of 65% at 84 months. CONCLUSIONS: Ahmed glaucoma drainage implant surgery may be considered a long-term effective and safety surgical option for patients with refractory uveitic glaucoma.

Púrpura en los pies: Meningococcemia? Reporte de caso clínico y revisión de la literatura / Purpura in the feet: Meningococcemia? Clinical case report and literature review

Neisseria meningitidis es la etiología de infecciones severas incluso letales, afectando principalmente a la población joven. No obstante, dado que el único reservorio es la nasofaringe humana, hay portadores asintomáticos. El meningococo es sensible a los antibióticos de uso habitual, como: cefalosporinas de tercera generación y quinolonas, pero el retraso en el diagnóstico por presentaciones clínicas infrecuentes y la administración tardía de la terapia, se asocian a elevada morbimortalidad. Presentamos una paciente de 18 años, con un cuadro de rápida evolución, con parámetros inflamatorios de laboratorio alterados, asociado a lesiones cutáneas purpúricas, que evolucionó con falla multiorgánica y desenlace fatal, lográndose la confirmación etiológica por el Instituto de Salud Pública. Reportamos el caso para tener en consideración el diagnóstico de meningococcemia, frente a pacientes con cuadro clínico y exámenes de laboratorio sugerentes de sepsis, que presentan lesiones cutáneas compatibles.

Neisseria meningitidis is the etiology of severe, even lethal infections, affecting mainly the young population. However, since the only reservoir is the human nasopharynx, there are asymptomatic carriers. Meningococcus is sensitive to commonly used antibiotics such as third generation cephalosporins and quinolones, but delayed diagnosis due to infrequent clinical presentation and delayed therapy are associated with high morbidity and mortality. We present an 18-year-old female patient with a rapid evolution, with altered inflammatory laboratory parameters, associated with purpuric skin lesions, which evolved with multiorgan failure and fatal outcome, and the etiological confirmation was obtained by the Public Health Institute. We report the case to take into account the diagnosis of meningococcemia in patients with clinical symptoms and laboratory tests suggestive of sepsis and compatible skin lesions.

Tofacitinib in patients with moderate-to-severe chronic plaque psoriasis: long-term safety and efficacy in an open-label extension study.

BACKGROUND: Tofacitinib is an oral Janus kinase inhibitor. Final safety and efficacy data from an open-label extension study of tofacitinib in psoriasis are reported. OBJECTIVES: To evaluate the long-term safety and durability of efficacy of tofacitinib in adults with moderate-to-severe chronic plaque psoriasis. METHODS: Eligible patients who completed qualifying phase II/III tofacitinib studies received tofacitinib 10 mg twice daily (q12h) until month 3; subsequently, the dose could be adjusted by investigators to either 5 or 10 mg q12h. Adverse events (AEs) are reported up to month 66 and laboratory data up to month 54. Efficacy end points up to month 54 included Physician's Global Assessment of 'clear' or 'almost clear' (PGA response) and 75% improvement in Psoriasis Area and Severity Index (PASI 75). RESULTS: Overall, 2867 patients received tofacitinib, with a median treatment duration of 35·6 months. Adverse events (AEs) and serious AEs were reported in 82·5% and 13·7% of patients, respectively; 13·9% of patients discontinued owing to AEs; and 29 patients died. Incidence rates (patients with event/100 patient-years) were 1·16 for serious infections, 0·67 for malignancies and 0·26 for major adverse cardiovascular events. After initial changes in qualifying studies, most laboratory parameters were generally stable over 54 months. PGA response was achieved by 52-62% of patients and PASI 75 by 56-74% of patients at each study visit through month 54. CONCLUSIONS: In patients with psoriasis, the safety profile of tofacitinib over 66 months was similar to previous reports in phase III studies and efficacy was sustained through 54 months (NCT01163253).

Alta prevalencia de infestación por Demodex spp. en pacientes con blefaritis posterior: correlación con edad y caspa cilíndrica / High prevalence of Demodex spp. infestation among patients with posterior blepharitis: correlation with age and cylindrical dandruff

Objetivo: Determinar la prevalencia e índice de infestación (II) por Demodex spp. en pacientes con blefaritis en distintos grupos etarios y evaluar su asociación con la presencia de caspa cilíndrica (CC). Materiales y métodos: Estudio prospectivo que incluye a pacientes de la Fundación Oftalmológica Los Andes (Chile), con diagnóstico clínico de blefaritis con compromiso de la lámina posterior entre 2013 y 2015, sin tratamiento acaricida previo. Cuatro pestañas de cada párpado fueron extraídas al azar para la detección del ectoparásito y determinación del II, calculado como el cociente entre el número observado de especímenes de demodex y la totalidad de las pestañas extraídas. Además, se realizó una determinación semicuantitativa de la presencia de CC. Resultados: Se incluyó a 178 pacientes, de los cuales el 51,3% eran hombres. La edad promedio fue de 58,49 ± 20,66 años. El 83,7% de los pacientes resultaron infestados por demodex, con un II promedio de 0,96 ± 0,84 ácaros/pestaña. El II fue significativamente mayor en pacientes sobre los 50 años (p<0,0001). La edad de los pacientes y el II presentaron un coeficiente de correlación lineal de Pearson (R2) de 0,12 (p<0,0001). El 71,4% de los pacientes presentaron CC, con valores significativamente más altos en pacientes mayores de 50 años. Se observó una correlación positiva entre la cantidad de CC y el II (R2=0,33; p<0,0001). Conclusiones: Existe una elevada prevalencia de infestación por demodex en pacientes con blefaritis posterior. El II por Demodex folliculorum se correlaciona positivamente con la edad de los pacientes y con la presencia de CC en el borde palpebral (AU)

Objective: To determine prevalence of Demodex spp. and infestation index (II) by the parasite among patients of different ages with blepharitis and to assess association with occurrence of cylindrical dandruff (CC). Materials and methods: Prospective study including patients diagnosed with posterior blepharitis between 2013 and 2015, without previous acaricide treatment, was conducted by Fundación Oftalmológica Los Andes (Chile). Four eyelashes were randomly extracted from each eyelid for parasite detection. The II was calculated as the ratio between the total number of demodex specimens found in the total number of eyelashes removed. A semi-quantitative determination of the CC was performed. Results: A total of 178 patients (91 men, 87 women), with a mean age of 58.49 ± 20.66 years, were included. It was found that 83.7% of patients were infested with Demodex folliculorum with a mean II of 0.96 ± 0.84 mites/eyelash. The II was significantly higher in patients over 50 years (p<.0001). Patient age and II showed a Pearson correlation coefficient (R2) of 0.12 (p<.0001). CC was observed in 71.4% of patients, with those over 50 years-old showing significantly higher values. A positive correlation was also observed between the amount of CC and the II (R2=.33; p<.0001). Conclusions: The prevalence of infestation by Demodex folliculorum is high in patients with posterior blepharitis. The II by the parasite is positively correlated with age and with the occurrence of CC on the eyelid border (AU)

Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis: Subgroup analysis of Latin American patients in the phase 3 randomized UNCOVER-3 study / Comparación de ixekizumab y etanercept o placebo en la psoriasis de moderada a grave: análisis del subgrupo de pacientes latinoamericanos de la fase 3 del estudio aleatorizado UNCOVER-3

Background and objectives: Ixekizumab demonstrated greater efficacy than placebo and etanercept in UNCOVER-3. Subgroup analysis of Latin American patients was performed. We report 12-week and 60-week data. Patients and methods: Analysis included 102 Latin American patients randomized to receive placebo (n = 14), etanercept 50 mg twice weekly (n=30), or ixekizumab 160-mg starting dose followed by 80 mg every 2 weeks (Q2W; n = 29) or every 4 weeks (Q4W; n = 29). At week 12, patients maintaining efficacy response and adequate overall safety were assigned, at the discretion of the investigator, to long-term extension with ixekizumab Q4W. Results: At week 12, Psoriasis Area and Severity Index (PASI) 100 scores were 0%, 20.0% (p = 0.075 vs placebo), 62.1% (p < 0.001 vs placebo; p = 0.001 vs etanercept), and 48.3% (p = 0.002 vs placebo; p = 0.023 vs etanercept) for placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. Among patients who continued therapy up to week 60 (n = 97), PASI 100 scores were 71.4%, 60.0%, 77.8%, and 57.7% for patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively (non-responder imputation). By week 60, ≥1 serious adverse event was experienced by 7.1% (n = 1/14), 3.3% (n = 1/30), 14.8% (n = 4/27), and 0% (n = 0/26) of patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. There were no cases of active tuberculosis with ixekizumab treatment through 60 weeks. Conclusions: In Latin American patients, both ixekizumab dosing regimens demonstrated greater efficacy than etanercept for treating psoriasis over 12 weeks. The safety profile of ixekizumab through 60 weeks was well tolerated and consistent with the overall profile (AU)

Antecedentes y objetivos: Ixekizumab demostró una mayor eficacia que el placebo y etanercept en el estudio UNCOVER-3. Tras realizar un análisis del subgrupo de pacientes latinoamericanos, se presentan los resultados transcurridas 12 y 60 semanas. Pacientes y métodos: El análisis incluyó a 102 pacientes latinoamericanos aleatorizados para la administración de placebo (n=14), etanercept 50 mg 2 veces por semana (n = 30), o ixekizumab 160mg como dosis inicial y 80mg cada 2 semanas (Q2W; n=29) o 4 semanas (Q4W; n = 29). A la semana 12 los pacientes con buena respuesta de eficacia y ausencia de efectos adversos fueron asignados al tratamiento de ampliación a largo plazo con ixekizumab Q4W, a discreción del investigador. Resultados: A las 12 semanas las puntuaciones del PASI fueron del 0%, 20% (p = 0,075 vs placebo), 62,1% (p < 0,001 vs placebo; p = 0,001 vs etanercept) y 48,3% (p = 0,002 vs placebo; p = 0,023 vs etanercept) para placebo, etanercept, ixekizumab Q2W, e ixekizumab Q4W, respectivamente. Entre los pacientes que prosiguieron la terapia hasta la semana 60 (n = 97) las puntuaciones PASI 100 fueron del 71,4%, 60%, 77,8%, y 57,7% para los pacientes a quienes se administró placebo de inducción, etanercept, ixekizumab Q2W e ixekizumab Q4W, respectivamente (imputación del no respondedor). En la semana 60 ≥1 presentaron reacción adversa grave el 7,1% (n = 1/14), 3,3% (n = 1/30), 14,8% (n = 4/27) y 0% (n = 0/26) de los pacientes a quienes se administró placebo, etanercept, ixekizumab Q2W e ixekizumab Q4W, respectivamente. No se produjeron casos de tuberculosis activa con el tratamiento de ixekizumab a lo largo de las 60 semanas. Conclusiones: En los pacientes latinoamericanos ambos regímenes de dosificación de ixekizumab demostraron mayor eficacia que etanercept para el tratamiento de la psoriasis durante 12 semanas. En cuanto al perfil de seguridad, ixekizumab a lo largo de 60 semanas fue bien tolerado y consistente con el perfil general (AU)

High prevalence of Demodex spp. infestation among patients with posterior blepharitis: correlation with age and cylindrical dandruff. / Alta prevalencia de infestación por Demodex spp. en pacientes con blefaritis posterior: correlación con edad y caspa cilíndrica.

OBJECTIVE: To determine prevalence of Demodex spp. and infestation index (II) by the parasite among patients of different ages with blepharitis and to assess association with occurrence of cylindrical dandruff (CC). MATERIALS AND METHODS: Prospective study including patients diagnosed with posterior blepharitis between 2013 and 2015, without previous acaricide treatment, was conducted by Fundación Oftalmológica Los Andes (Chile). Four eyelashes were randomly extracted from each eyelid for parasite detection. The II was calculated as the ratio between the total number of demodex specimens found in the total number of eyelashes removed. A semi-quantitative determination of the CC was performed. RESULTS: A total of 178 patients (91 men, 87 women), with a mean age of 58.49±20.66 years, were included. It was found that 83.7% of patients were infested with Demodex folliculorum with a mean II of 0.96±0.84 mites/eyelash. The II was significantly higher in patients over 50 years (p<.0001). Patient age and II showed a Pearson correlation coefficient (R2) of 0.12 (p<.0001). CC was observed in 71.4% of patients, with those over 50 years-old showing significantly higher values. A positive correlation was also observed between the amount of CC and the II (R2=.33; p<.0001). CONCLUSIONS: The prevalence of infestation by Demodex folliculorum is high in patients with posterior blepharitis. The II by the parasite is positively correlated with age and with the occurrence of CC on the eyelid border.

Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis: Subgroup analysis of Latin American patients in the phase 3 randomized UNCOVER-3 study.

BACKGROUND AND OBJECTIVES: Ixekizumab demonstrated greater efficacy than placebo and etanercept in UNCOVER-3. Subgroup analysis of Latin American patients was performed. We report 12-week and 60-week data. PATIENTS AND METHODS: Analysis included 102 Latin American patients randomized to receive placebo (n=14), etanercept 50mg twice weekly (n=30), or ixekizumab 160-mg starting dose followed by 80mg every 2 weeks (Q2W; n=29) or every 4 weeks (Q4W; n=29). At week 12, patients maintaining efficacy response and adequate overall safety were assigned, at the discretion of the investigator, to long-term extension with ixekizumab Q4W. RESULTS: At week 12, Psoriasis Area and Severity Index (PASI) 100 scores were 0%, 20.0% (p=0.075 vs placebo), 62.1% (p<0.001 vs placebo; p=0.001 vs etanercept), and 48.3% (p=0.002 vs placebo; p=0.023 vs etanercept) for placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. Among patients who continued therapy up to week 60 (n=97), PASI 100 scores were 71.4%, 60.0%, 77.8%, and 57.7% for patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively (non-responder imputation). By week 60, ≥1 serious adverse event was experienced by 7.1% (n=1/14), 3.3% (n=1/30), 14.8% (n=4/27), and 0% (n=0/26) of patients who received induction placebo, etanercept, ixekizumab Q2W, and ixekizumab Q4W, respectively. There were no cases of active tuberculosis with ixekizumab treatment through 60 weeks. CONCLUSIONS: In Latin American patients, both ixekizumab dosing regimens demonstrated greater efficacy than etanercept for treating psoriasis over 12 weeks. The safety profile of ixekizumab through 60 weeks was well tolerated and consistent with the overall profile.

Is the snail shell repair process really influenced by eggshell membrane as a template of foreign scaffold?

Biominerals are inorganic-organic hybrid composites formed via self-assembled bottom up processes under mild conditions. Biominerals show interesting physical properties, controlled hierarchical structures and robust remodeling or repair mechanisms. Biological processes associated with biominerals remain to be developed into practical engineering processes. Therefore, the formation of biominerals is inspiring for the design of materials, especially those fabricated at ambient temperatures. The study described herein involves the influence of chicken outer eggshell membrane on the type of calcium carbonate (CaCO3) polymorph deposited on the shell of the land snail Helix aspersa during the repair process after an injury. A piece of snail shell was removed by perforating a hole from the largest body whorl. The operated area was left either uncovered or covered with either a thermoplastic flexible polyolefin-based film Parafilm® or a piece of chicken eggshell membrane. The repaired shells of control and experimental animals were analyzed using SEM, EDS, Raman and FTIR spectroscopies. We found that in the presence of eggshell membrane, the polymorph deposited on the substratum during the first hours resembles calcite, the polymorph present in eggshell normal formation, but at 24 and 48h, when snail mantle cells produced their normal organic matrix (mainly ß-chitin plus proteins and proteoglycans), the polymorph deposited is aragonite, the characteristic polymorph of Helix shell. Therefore, the eggshell membrane influences the type of polymorph, but only in the initial stages of biomineral deposition, before an organic matrix layer is deposited by the snail.

Evaluation of the efficacy of Grofactor, a beta-adrenergic agonist based on zilpaterol hydrochloride, using feedlot finishing bulls.

Beta-adrenergic agonists (ß-AA) have been shown to positively impact finishing performance and some carcass traits of feedlot cattle. Our objective was to evaluate the efficacy of a ß-AA on the basis of zilpaterol hydrochloride (Grofactor, Laboratorios Virbac México, Guadalajara, Mexico) on growth and DMI, carcass characteristics, and meat quality of finishing bulls. Forty-five bulls (75% 25% ) initially weighing 448.7 ± 2.58 kg were blocked by BW and randomly assigned to 1 of 3 diets, using pens of 3 animals, in a randomized complete block design: 1) daily feeding without ß-AA in the basal diet (Control), 2) daily feeding with 0.15 mg/kg BW of Grofactor added to the basal diet (ZHG), or 3) daily feeding with 0.15 mg/kg BW of Zilmax (MSD Salud Animal México, Mexico City, Mexico) added to the basal diet (ZHZ). The duration of the feeding period was 30 d with a subsequent 4-d withdrawal period. Compared with Control bulls, the group fed ZHG had a 12% better ( < 0.025) G:F ratio, and their final BW ( 0.094) and ADG ( 0.084) tended to be enhanced. Feedlot performance of ZHG and ZHZ bulls was similar, although the DMI was ∼4% lower ( 0.05) in ZHG bulls vs. the ZHZ and Control groups. The HCW ( 0.001) and dressing percentage ( 0.015) were higher by 20 kg and 3%, respectively, in ZHG bulls vs. Control bulls. The KPH fat was lower ( 0.007) in bulls fed ZHG than in nonsupplemented bulls, but other carcass characteristics were not different in the ZHG and ZHZ bulls, and noncarcass components were not affected by ZHG or ZHZ supplementation. At 48 h postmortem, ZHG bulls had lower ( 0.007) water holding capacity and trended toward ( 0.06) increased chroma and reduced pH ( 0.09) compared to Control bulls. However, compared to ZHZ bulls, ZHG bulls had higher ( 0.02) chroma and a trend ( 0.08) toward increased hue angle. At 14 d postmortem, meat quality variables did not differ between the 3 groups of bulls. Supplementation of ZH Grofactor improved feedlot performance and some carcass characteristics of finishing bulls without affecting meat quality. The effects of Grofactor on feedlot performance, carcass traits, and meat quality were similar to those of Zilmax.

Evidences of Polymorphism Associated with Circadian System and Risk of Pathologies: A Review of the Literature.

The circadian system is a supraphysiological system that modulates different biological functions such as metabolism, sleep-wake, cellular proliferation, and body temperature. Different chronodisruptors have been identified, such as shift work, feeding time, long days, and stress. The environmental changes and our modern lifestyle can alter the circadian system and increase the risk of developing pathologies such as cancer, preeclampsia, diabetes, and mood disorder. This system is organized by transcriptional/tranductional feedback loops of clock genes Clock, Bmal1, Per1-3, and Cry1-2. How molecular components of the clock are able to influence the development of diseases and their risk relation with genetic components of polymorphism of clock genes is unknown. This research describes different genetic variations in the population and how these are associated with risk of cancer, metabolic diseases such as diabetes, obesity, and dyslipidemias, and also mood disorders such as depression, bipolar disease, excessive alcohol intake, and infertility. Finally, these findings will need to be implemented and evaluated at the level of genetic interaction and how the environment factors trigger the expression of these pathologies will be examined.