Retrospective Evaluation of Non-Invasive Assessment Based on Routine Laboratory Markers for Assessing Advanced Liver Fibrosis in Chronic Hepatitis B Patients.

Background: At present, there is a lack of cheap, effective and convenient detection methods for hepatitis B-related liver fibrosis, especially in the developing area. Aim: To evaluate the non-invasive methods for the significant and advanced fibrosis stage in chronic hepatitis B virus (HBV) patients in basic hospitals and to assess their diagnostic utility. Methods: The study included 436 consecutive naive HBV individuals who had their livers biopsied. They were examined in one week using aspartate aminotransferase-to-aspartate aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), Forns, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), S-index and transient elastography (TE). Scheuer scoring system was used to determine the histologic fibrosis grades (S0-S4). The diagnostic effectiveness was assessed using AUROCs and the DeLong test, both of which were based on statistical comparisons. Results: For both substantial (≧S2) and advanced (≧S3) fibrosis phases, TE had good diagnostic performance in determining the hepatic fibrosis. Similar diagnostic performance was shown with Forns and S-index when it came to detecting fibrosis stages lower than S3. One model's diagnostic value was not significantly improved by combining serum models. Correlation coefficients between clinical features and fibrosis phases were greatest for Forns (r = 0.397), S-index (r = 0.382) and TE (r = 0.535) when compared to other variables. Conclusion: This investigation showed that Forns and S-index may be helpful strategies for detecting advanced fibrosis in HBV patients admitted to community hospitals.

Can simple Non-Invasive Fibrosis Models Determine Prognostic Indicators (Fibrosis and Treatment Response) of Primary Biliary Cholangitis?

OBJECTIVE: The fibrosis stage during diagnosis and the response to ursodeoxycholic acid in the 1st year of treatment are considered to be prognostic indicators in primary biliary cholangitis (PBC). Determining these indicators with non-invasive models can enable the risk of liver failure to be monitored with continuous variables from the moment of diagnosis. The aim of this study was to evaluate the diagnostic performance of non-invasive models for determining the prognostic indicators in patients with PBC. MATERIALS AND METHODS: Data from patients with PBC were screened retrospectively. Patients were divided into early (≤2) and advanced (≥3) fibrosis groups. In addition, treatment response status according to the Paris-II criteria and liver failure risk (LFR) according to the UK-PBC score were determined. The S-Index consisting of gamma-glutamyltransferase (GGT), platelets (PLT), and albumin, (S-index: 1000×GGT÷[PLT×Albumin2]), other non-invasive models were calculated. The diagnostic effectiveness of non-invasive indicators to determine the fibrosis stage, response to treatment, and low LFR was analyzed. RESULTS: Fifty-three patients were included in the study. The overall mean age at diagnosis was 49.6±13.6 years and 86.8% of the patients (n=46) were female. The S-Index was able to determine fibrosis stage, treatment responded, and patients with low LFR (AUC: 0.747, 0.823, and 0.752; p=0.006, <0.001, and 0.0007, respectively). Furthermore, S-Index found to superior to other non-invasive indicators in terms diagnosis of prognostic indicators of PBC. CONCLUSION: S-index is a practical and inexpensive non-invasive model that can identify liver fibrosis and treatment response in patients with PBC. It can be used as a continuous variable prognostic model in PBC.

Seasonal variation of the S-index as it relates to the concentration of 222Rn inside a bunker that stores radioactive material.

In this work, the seasonal variation of the concentration of radon in soil and its contribution to concentrations inside of a bunker used for the storage and operation of radioactive material was studied. The measurements obtained inside and outside of the installation allowed establish a method for the calculation of the diffusion coefficient for the concrete, variable that directly influences the concentration of radon gas inside of the bunker. With the obtained results of the gamma dose rate and the concentration of radon inside the bunker, the S-index was calculated in order to determine whether the bunker would require some remediation process. The high radon gas concentration rates to which workers are exposed led to study the relative risk of contracting lung cancer (RRLC).

TSPO-PET and diffusion-weighted MRI for imaging a mouse model of infiltrative human glioma.

BACKGROUND: Glioblastoma (GBM) is the most devastating brain tumor. Despite the use of multimodal treatments, most patients relapse, often due to the highly invasive nature of gliomas. However, the detection of glioma infiltration remains challenging. The aim of this study was to assess advanced PET and MRI techniques for visualizing biological activity and infiltration of the tumor. METHODS: Using multimodality imaging, we investigated [18F]DPA-714, a radiotracer targeting the 18 kDa translocator protein (TSPO), [18F]FET PET, non-Gaussian diffusion MRI (apparent diffusion coefficient, kurtosis), and the S-index, a composite diffusion metric, to detect tumor infiltration in a human invasive glioma model. In vivo imaging findings were confirmed by autoradiography and immunofluorescence. RESULTS: Increased tumor-to-contralateral [18F]DPA-714 uptake ratios (1.49 ± 0.11) were found starting 7 weeks after glioma cell implantation. TSPO-PET allowed visualization of glioma infiltration into the contralateral hemisphere 2 weeks earlier compared with the clinically relevant biomarker for biological glioma activity [18F]FET. Diffusion-weighted imaging (DWI), in particular kurtosis, was more sensitive than standard T2-weighted MRI to detect differences between the glioma-bearing and the contralateral hemisphere at 5 weeks. Immunofluorescence data reflect in vivo findings. Interestingly, labeling for tumoral and stromal TSPO indicates a predominant expression of TSPO by tumor cells. CONCLUSION: These results suggest that advanced PET and MRI methods, such as [18F]DPA-714 and DWI, may be superior to standard imaging methods to visualize glioma growth and infiltration at an early stage.

Assessment of Maximum Dynamic Inspiratory Pressure.

BACKGROUND: Inspiratory muscle strength has been considered an important marker of ventilatory capacity and a predictor of global performance. A new tool has become available for dynamically evaluating the maximum inspiratory pressure (the S-Index). However, the proper assessment of this parameter needs to be determined. Thus, the aim of the present study was to investigate the number of inspiratory maneuvers necessary to reach a maximum and reliable S-Index and the influence of inspiratory muscle warm-up on this assessment. METHOD: We performed a retrospective study from the database of 432 healthy subjects who underwent S-Index tests and inspiratory muscle warm-up or sham. The effect of repeated maneuvers on the S-Index and the impact of inspiratory muscle warm-up were analyzed by using the intraclass correlation coefficient and unpaired t test. RESULTS: We analyzed 81 subjects, (55% men), mean ± SD age 38.1 ± 9.6 y, 43 subjects in the inspiratory muscle warm-up group. Maximum and reliable S-Indexes were reached at the eighth maneuver in both groups preceding inspiratory muscle warm-up or sham, 102 cm H2O (95% CI 95-109 cm H2O); intraclass correlation coefficient 0.96; P < .001. Only the inspiratory muscle warm-up group presented a significant increase in the S-Index after warm-up, 13.5 cm H2O (95% CI 10-17), P < .001. CONCLUSIONS: Eight maneuvers were necessary to reach maximum and reliable values of the S-Index preceding inspiratory muscle warm-up or sham. Moreover, inspiratory muscle warm-up preceding S-Index assessment improved inspiratory muscle performance.

[Relation between preoperative prognostic Onodera's Index and postsurgery complications in the R0 gastric carcinoma resection]. / Relación entre el índice de Onodera pre-operatorio y las complicaciones post-cirugía R0 en el cáncer de estómago.

BACKGROUND: It has been postulated in the Asian literature that a low prognostic nutritional index (OI) could be associated with a higher rate of complications following radical gastric cancer surgery, but there is a lack of data concerning western countries. The aim is to analyze the relationship between a low preoperative OI and the frequency and severity of surgical complications in R0 gastric cancer resection. PATIENTS AND METHODS: In the present article, 124 cases of gastric cancer with R0 resection were reviewed. An OI <45 was considered pathologically low. The complication rate was compared between both groups: OI <45 vs OI =45. A multivariate analysis was performed adjusting for: age > 68 years, ASA score, preoperative hemoglobin level <12 g/dL, pTNM stage, administration of neoadyuvant therapy and type of gastrectomy. The relationship between a PNI<45 and the severity of complications graded according to the Clavien-Dindo classification was determined. RESULTS: We registered mild complications in 11.3% of cases, severe complications in 9.7% and a mortality rate of 2.4%. Patients with a OI <45 showed a higher complication rate: 37.7% versus 12.7% [odds ratio (OR) = 4.17; CI95% = (1.71 - 10.20 p = 0.001)], confirmed by multivariate analysis: [OR = 4.17; CI95% = (1.54 - 11.30); p = 0.005]. Patients with OI <45 had more severe complication-exitus: 20.8% versus 5.6% [OR = 4.39; CI95% = (1.31 - 14.68); p = 0.011]. CONCLUSIONS: We confirmed that patients with a low preoperative OI show a higher independent risk of complications after a R0 gastric cancer resection in a western country as well. Complications, in these cases with OI <45, registered a significantly higher severity grade.

Analysis of Diagnosis Value on S Index Evaluating Slight Chronic Hepatitis B Fibrosis / 浙江中医药大学学报

Objective] To observe the diagnosis value of noninvasive diagnosis model S index used to evaluate the fibrosis degree of slight chronic hepatitis B(CHB). [Method] Trace back and investigate the routine serological indicators GGT, PLT, ALB and liver aspiration biopsy results of 63 cases of CHB;use noninvasive diagnosis formula to calculate:S index=1000×GGT/(PLT×ALB2),use ROC curve to analyze and evaluate the clinical diagnosis value of S index. [Result] S index is in positive relation with liver fibrosis degree. S index can forecast the fibrosis having or not with best truncation point 0.04h, the sensitivity 87.0%, specificity 47.5%and area under the curve(AUC) 0.690,close to 0. 7; in forecasting obvious fibrosis, with best truncation point 0.04h, sensitivity 100%,specificity 36.8%,AUC 0.664. [Conclusion] S index used for forecasting slight CHB having or not fibrosis has high value of diagnosis, but it has low correctness for diagnosing having or not obvious liver fibrosis.

Qualidade física de um latossolo vermelho sob sistema de semeadura direta e cultivo convencional / Physical quality of an oxisol under no-tillage and conventional tillage

Para garantir a sustentabilidade dos sistemas agrícolas, a compreensão e a quantificação do impacto do uso e manejo do solo na sua qualidade física são de fundamental importância. Nesse sentido, objetivou-se com este trabalho avaliar a qualidade de um Latossolo Vermelho sob cultivo convencional (CC) e sistema de semeadura direta (PD), por meio de diferentes indicadores físicos. Os sistemas de uso e manejo do solo foram: CC e PD por sete e oito anos consecutivos (solo de textura média) e CC e PD por nove e dez anos consecutivos (solo de textura argilosa). Foram determinadas, nas camadas de 0-0,10; 0,10-0,20 e 0,20-0,30 m, a resistência do solo à penetração, a porosidade total, a macroporosidade e a microporosidade, a retenção de água no solo, o índice S, a densidade, a densidade do solo máxima e também a densidade do solo relativa. Foi verificada grande variação da resistência do solo à penetração ao longo do ciclo das culturas da soja e do milho, sendo que seus maiores valores foram constatados nas camadas superficiais. Dentre os sistemas de manejo, o PD apresentou maior resistência do solo à penetração. Dentre os sistemas de manejo, o CC apresentou melhores resultados em relação aos indicadores de qualidade física do solo.

The understanding and quantification of the impact of tillage systems in their physical quality are fundamental in the development of sustainable agricultural systems. This study aimed to evaluate the quality of an Oxisol under conventional tillage (CT) and no-tillage system (NT), through different physical indicators. The management systems were: CT and NT for seven or eight consecutive years (medium textured soil) and CT and NT by nine and ten consecutive years (clay soil). Were determined, at the layers 0-0.10, 0.10-0.20; 0.20-0.30 m, soil resistance to penetration, total soil porosity, macroporosity and microporosity, soil water retention, S index, soil bulk density, maximum density and relative bulk density. Was observed great variation of soil resistance to penetration throughout the soybean and corn cycles, with its highest values were found in the surface layers. The NT showed greater resistance to penetration. Among the management systems, the results against indicators of soil physical quality were similar.

Trophic analysis of three species of Marilia (Trichoptera: Odontoceridae) from the neotropics / Análisis trófico de tres especies de Marilia (Tri-choptera: Odontoceridae) del neotrópico

The trophic ecology of the aquatic insect fauna has been widely studied for the Northern temperate zone. However, the taxa originally classified within a given particular trophic group in temperate ecosystems, do not necessarily exhibit the same dietary profile beyond its geographic limits. Since, the trophic ecology of caddisfly larvae is largely incomplete in the Neotropical Region, the present work aims to describe feeding habits inferred from quantitative analysis of data taxonomically resolved at the species level. For this, the feeding habits of three Trichoptera species Marilia cinerea, M. elongata and M. flexuosa were recorded in the Yungas forests of Argentina and Bolivia. A total of 15 larvae of each species were sampled from 13 different streams were selected for gut content analysis. The ingested material was extracted from the foregut and midgut by using ventral dissection of thorax. For each species, mandibles were dissected, mounted in glycerin and illustrated in order to highlight morphological differences between these mouth pieces purportedly associated to the dietary behavior of individuals, and their habitats. The niche overlap was estimated through Schoener’s method. The diet analysis revealed that M. cinerea, M. elongata and M. flexuosa feed on the same food items, but through different patterns of preferences. Larvae of M. cinerea were collected on both emerging surfaces of rocks on which a thin layer of running water flows and streams sliding areas with stony bottoms attached to the rock surfaces. They displayed a gut content consisting predominantly of invertebrate vestiges and have strong mouthparts provided of large molar areas; this allowed us to allocate the species within the functional group of predators. M. elongata feeds mainly on fine particulate material, its mouthparts are scoop-shaped and occurs in areas of low flow; this set of features is linked to a collector-gatherer strategy. Finally, larvae of M. flexuosa have been primarily assigned to the functional group of shredders and secondarily to the collector-gatherer class. They inhabit sandy bottoms of mountain streams, have strong scoop-shaped mouthparts and show a diet dominated by leaf litter and fine particulate material. We concluded that the functional group assignment to the genus level for Marilia is not recommended, and further studies at species level are necessary. Rev. Biol. Trop.62 (2): 543-550. Epub 2014 June 01.

La ecología trófica de insectos acuáticos ha sido desarrollada en zonas templadas. Sin embargo, la asignación de un taxón a un grupo trófico no representa necesariamente el mismo en otras regiones. En la Región Neotropical, el conocimiento sobre la ecología trófica de larvas de tricópteros es incompleta y la literatura sobre este tema rara vez se ocupa del análisis de los hábitos alimentarios de larvas con datos cuantitativos a nivel de especie. Este trabajo aporta al conocimiento de las características tróficas de la trichopterofauna del Neotrópico. Se describen los hábitos alimentarios de tres especies de Trichoptera registrados en arroyos de Yungas de Argentina y Bolivia: Marilia cinerea, M. elongata y M. flexuosa. Se seleccionaron 15 larvas de cada especie en 13 arroyos de Yungas surandinas para analizar las piezas bucales y el contenido estomacal. El solapamiento de nicho trófico se estimó mediante el índice de Schoener. El análisis de la dieta reveló que las especies difieren en la preferencia de los ítems registrados, hábitat y forma de sus mandíbulas. Las larvas de M. cinerea habitan en superficies de rocas emergentes. Poseen mandíbulas fuertes con grandes zonas molares y consumen principalmente invertebrados. Esta evidencia permite asignarle el grupo funcional depredador. M. elongata consume material fino, sus mandíbulas tienen forma de cuchara y su ubicación en zonas de bajo flujo permite asignarle una estrategia colectora-recolectora. Las larvas de M. flexuosa habitan en fondos arenosos de arroyos de montaña, tienen fuertes piezas bucales en forma de cuchara y una dieta dominada por hojarasca y material fino. Pertenecen al grupo funcional triturador, secundariamente colector-recolector. Sugerimos que la asignación de grupo funcional a nivel de género no es recomendable para Marilia. Se recomiendan mayores estudios a nivel de especie.

Chou's pseudo amino acid composition improves sequence-based antifreeze protein prediction.

Antifreeze proteins (AFP) in living organisms play a key role in their tolerance to extremely cold temperatures and have a wide range of biotechnological applications. But on account of diversity, their identification has been challenging to biologists. Earlier work explored in this area has yet to cover introduction of sequence order information which is known to represent important properties of various proteins and protein systems for prediction purposes. In this study, the effect of Chou's pseudo amino acid composition that presents sequence order of proteins was systematically explored using support vector machines for AFP prediction. Our findings suggest that introduction of sequence order information helps identify AFPs with an accuracy of 84.75% on independent test dataset, outperforming approaches such as AFP-Pred and iAFP. The relative performance calculated using Youden's Index (Sensitivity+Specificity-1) was found to be 0.71 for our predictor (AFP-PseAAC), 0.48 for AFP-Pred and 0.05 for iAFP. We hope this novel prediction approach will aid in AFP based research for biotechnological applications.

Effect of the generation and physical-chemical characterization of swine and dairy cattle slurries on treatment technologies.

Differences in biodegradability can affect the treatment of slurry before its use in spraying. The objective of this study was to evaluate the effect of the generation and physical-chemical characterization of swine and dairy cattle slurries on different biological treatment technologies. This research involved monthly sampling (number/composition) for 1 year of 24 swine farms (16%), cattle farms (38%), and mixed swine and cattle farms (46%). The results obtained showed differences in feeding (3 l water kg(-1) food for cattle and 5 l water kg(-1) food for swine) and assimilation (0.6 kg food kg (-1) milk produced and 3 kg kg(-1) weight gain), which may influence the generation of slurry (57 l animal(-1)d(-1) in cattle and 31 l animal(-1) d(-1) in swine) and its composition. In addition, the composition of swine slurry [23 g chemical oxygen demand (COD) l(-1), 3 g total nitrogen (TN) l(-1)] is significantly different (P < 0.01) to cattle slurry (4 g COD l(-1), 0.3 g TN l(-1)). Finally, the composition and the S index applied to swine slurry [COD N(-1) = 8, biological oxygen demand (BOD)5 COD(-1) = 0.3, S index > 0] and cattle slurry (COD N(-1) = 16, BOD5 COD(-1) = 0.6, S index < 0) show a difference on the biodegradability of both slurries. Suitability of anaerobic and aerobic treatment was assessed based on the findings.

Comparison of shear wave velocity with noninvasive serum score systems in diagnosis of liver fibrosis of patients with chronic hepatitis / 中华临床感染病杂志

Objective To evaluate the clinical application of liver shear wave velocity (SWV) in comparison with common serum score systems [AST to platelet ratio index (APRI),Forns,S index and FIB-4] in assessment of liver fibrosis in patients with chronic hepatitis.Methods A total of 237 chronic hepatitis patients with liver fibrosis confirmed by liver biopsy,who were admitted in Ningbo Second Hospital during October 2010 and April 2013,were enrolled in the study.Liver shear wave velocity were measured by acoustic radiation force impulse (ARFI),and the score of APRI,Forns,S index and FIB-4 were calculated based on the measurement of serum markers.Liver fibrosis stages were classified as S0-S4 according to the Scheuer scoring system,and stages ≥ S2 were identified as significant liver fibrosis.The diagnosis value of SWV,4 common score systems and their combination for significant liver fibrosis was evaluated by receiver operating characteristic curve (ROC).Results A significant linear correlation was found between SWV and the stage of fibrosis (r =0.46,P ＜ 0.01).The areas under the ROCs of SWV and 4 common score systems (APRI,Forns,S index and FIB-4) for the diagnosis of significant liver fibrosis were 0.758 (0.696-0.821),0.727 (0.662-0.793),0.777 (0.717-0.836),0.747 (0.684-0.810) and 0.737 (0.673-0.802),respectively.The area under the ROC of the combined prediction nodel established with Logistic regression was 0.810.Conclusion Liver shear wave velocity measured by ARFI is of clinical value in noninvasive assessment of liver fibrosis,and the prediction accuracy can be improved when it is combined with other noninvasive indices.

Utilidad diagnóstica del método de Kramer para la detección clínica de la hiperbilirrubinemia neonatal / Usefullness of the Kramer’s index in the diagnosis of hyperbilirubinemia of the newborn

El objetivo de la presente investigación fue correlacionar los valores séricos de bilirrubina con el índice de Kramer en un grupo de pacientes con ictericia neonatal de tres diferentes etnias. Representa un estudio prospectivo, aleatorio, observacional descriptivo-analìtico, longitudinal, comparativo y controlado en 50 recién nacidos con ictericia neonatal sin complicaciones. Se dividieron en 3 grupos: A (Control), n = 25 de origen caucásico; B, n = 15 de origen indígena local Wayúu y C, n = 10 de origen Afro americano. Al ingreso, a cada neonato se le determinaron las zonas dérmicas de Kramer y se le tomó una muestra de sangre venosa braquial para medir la bilirrubina de ingreso. Los valores al ingreso fueron: bilirrubina sérica 12,02 ± 3,41 mg/dL y el 62,8% estaban en nivel 3 de Kramer. No hubo diferencias entre los grupos étnicos estudiados y la correlación bilirrubina sérica-índice de Kramer fue de r= 0,93 (p < 0,005). Al 3er día se empezó a notar el descenso de la bilirrubina y de los índices de Kramer. El método de Kramer ofrece múltiples ventajas en la evolución del RN ictérico. No se encontraron diferencias raciales. Se recomienda implementar la aplicación de este método de Kramer en todas las unidades de neonatos en los hospitales, preferentemente en aquellas que carezcan de bilirrubinómetros transcutáneos.

The objective of the present study was to correlate seric values of bilirubin with the Kramer’s index in a group of newborns with neonatal jaundice, from three different ethnic groups. This was a prospective, randomized, observational, descriptive-analytical, longitudinal, comparative and controlled study of 50 newborns with neonatal jaundice, without complications. They were divided into three groups: A (Control), n = 25, of Caucasian descent; B, n = 15, of local indigenous descent (Wayúu) and C, n = 10, of Afro-American descent. Each newborn was screened at the start of the study for their Kramer’s dermic areas and simultaneously, a venous blood sample from the arm was taken for bilirubin quantification. They were compared through a correlation-regression analysis. Values at the beginning of the study were: serum bilirubin 12.02 ± 3.41 mg/dL, and 62.8% of neonates were at Kramer’s level 3. There were no differences among the ethnic groups studied and the correlation bilirubin/Kramer’s index was r= 0.93 (p < 0.005). At the third day, both bilirubin and Kramer’s indexes started to decrease. There were no ethnic differences. In conclusion, the Kramer’s method offers multiple advantages to evaluate a jaundiced newborn; it is a safe, non-invasive method with no cost. Besides, it is of great help in the prevention of the kernicterus. It is recommended to implement the use of the Kramer method in all the newborns units in our Hospitals, preferably in those lacking transcutaneous bilirubinometers.

Determinación de los índices CPO-D e IHOS en estudiantes de la Universidad Veracruzana, México / Determing OHI-S and DMFT in students at Universidad Veracruzana, México

Introducción: El conocimiento de la salud bucal de la población constituye una tarea fundamental desde la perspectiva de la salud pública, ya que las enfermedades bucales - tales como la caries y las periodontopatías- son los padecimientos con mayor incidencia y prevalencia alrededor del mundo. El objetivo de esta investigación es determinar el índice de dientes, cariados, perdidos, obturados (CPOD), determinar el índice de higiene oral simplificado (IHOS), de los jóvenes universitarios de nuevo ingreso en el estado de Veracruz, provincia de México. Material y método: se realizó un estudio transversal, descriptivo, observacional, mediante la aplicación del examen de salud integral el cual constó de dos partes; un interrogatorio y una exploración clínica Resultados: El índice CPOD fue de 13.1. La prevalencia de caries fue de 80.9, perdidos 37.9 y de obturados 47.0. El índice de higiene oral simplificada que se obtuvo fue: el 81.5 por ciento bueno, el 17.4 por ciento regular y el 1.02 por ciento malo. Los alumnos que ingresaron tuvieron un índice CPO muy alto según los estándares de la OMS. Discusión: Los hallazgos en la determinación del índice CPO-D que se registró en este estudio determinan un serio problema de salud pública, Esta situación no sólo es particular en nuestro país, sino que se da la misma tendencia en otros lugares, aspectos que determinan intervenciones necesarias en el ámbito de la salud pública para una mejor calidad de vida de los estudiantes universitarios.

Introduction: Knowledge of the dental health of the population constitutes a fundamental task of public health, since oral diseases- such as cavities and periodontal disease- are the health conditions with highest incidence and prevalence around the world. The objective of this study was to determine the index of decayed, missing or filled teeth (DMFT) and the simplified oral health index (OHI-S) of first year university students in the state of Veracruz, province of Mexico. 27Material y method: A descriptive, cross-sectional, observational study was carried out, applying a comprehensive health ex am which consisted of two parts: a questionnaire and a clinical exam. Results: The DMFT index was 13.1. The prevalence of cavities was 80.9, missing teeth was 37.9 y filled teeth was 47.0. The OHI-S was the following: 81.5 percent good, 17.4 percent regular and 1.02 percent bad. Students had a very high OHI-S according to WHO standards. Discussion: The findings for the DMFT index constitute a serious public health problem. This situation is not found only in our country. Findings should guide the necessary interventions in order to improve quality of live for university students.

Four noninvasive score systems for diagnosis of liver fibrosis in patients with chronic hepatitis B / 中华临床感染病杂志

Objective To assess the value of S index and FIB-4 for diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB) by comparing with traditional indexes APRI and Forns.Methods A total of 361 patients with confirmed CHB from the First Hospital of Nanjing Medical University and Huashan Hospital Affiliated to Fudan University during January 2006 and December 2011 were enrolled in the study.The clinical,laboratory and pathological data of patients were collected.Four noninvasive score systems APRI,Forns,S index and FIB-4 were computed.With liver biopsy as the gold standard,the area under the ROC curve (AUROC) was used to assess the value of above 4 score systems in diagnosis of liver fibrosis,and Z test was performed to evaluate the effectiveness of above systems.Results The areas under ROC curve (AUCs) of APRI,Forns,S index and FIB-4 for significant fibrosis (≥S2) were (0.737 ±0.027),(0.716 ± 0.028),(0.745 ± 0.026) and (0.781 ± 0.025),respectively.When the cut off value of FIB-4 was set at 1.62,the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) for diagnosis of significant fibrosis were 59.3％,85.8％,89.4％ and 51.2％,respectively,which were better than Forn index (Z =3.28,P =0.001).While for S4 (cirrhosis) the AUCs of APRI,Foms,S index and FIB-4 were (0.687 ± 0.035),(0.792 ± 0.028),(0.863 ± 0.024) and (0.832 ± 0.025),respectively.When the cut off value of S index was set at 1.06,the sensitivity,specificity,PPV and NPV for diagnosis of cirrhosis were 77.9％,85.5％,59.4％ and 93.5％,respectively,which were better than APRI and Forns (Z =6.74 and 3.21,P ＜ 0.01).Conclusions APRI,Forns,S index and FIB-4 are simple and accurate methods for assessing liver fibrosis.FIB-4 and S index are better than APRI and Forns in diagnosis of significant fibrosis and cirrhosis,which may replace liver biopsy in certain extend.

Prevalencia de fluorosis y experiencia de caries dental en un grupo de escolares en el área urbana del Municipio de Yondó (Antioquia, Colombia), 2010 / Prevalence of fluorosis and dental caries experience in a school age group in the urban area of the Municipality of Yondó (Antioquia, Colombia), 2010

Introducción y Objetivo: La caries dental y la fluorosis dental son problemas de Salud Pública que requieren sistemas de vigilancia y control en edades tempranas. El objetivo fue determinar la prevalencia de fluorosis dental en escolares de 12 años, y la historia de caries en escolares de 5 y 12 años en la Institución Educativa Luis Eduardo Díaz del área urbana del Municipio de Yondó (Antioquia) durante el año 2010. Materiales y Métodos: Estudio transversal en una población de 62 escolares de 5 años y 145 de 12 años. Se realizó examen clínico y se estableció la experiencia de caries dental (índices ceo-d; 5 años, COP-D; 12 años) y la prevalencia de fluorosis dental (Índice de Dean). Se calcularon frecuencias, medianas y promedios por sexo en el caso de caries dental y prevalencia de fluorosis global y por grados de severidad. Cálculo de razones de prevalencia de fluorosis por sexo con sus intervalos de confianza al 95% (RP, IC95%). Se analizaron las principales fuentes de agua del área de estudio. Resultados: El promedio ceo-d a los 5 años fue de 2,37 ±3,39, con experiencia de caries del 61%. A los 12 años se encontró un promedio COP-D de 0,73 ±1,28, y una experiencia de caries del 33,1%. No se encontraron diferencias estadísticamente significativas por sexo. La prevalencia global de fluorosis fue de 97,9%, con mayor prevalencia en hombres, aunque sin diferencias significativas (RP 1,05, IC95% 0,98- 1,12). El análisis fisicoquímico no mostró niveles altos de concentración de flúor en agua. Conclusión: Se encontraron niveles altos de experiencia de caries dental a los 5 años y alta prevalencia de Fluorosis a los 12 años que exigen acciones de mejoramiento y estrategias en salud pública para esta población.

Introduction and Objetive: Dental caries and dental Fluorosis are public health problems, which require surveillance and control systems in primary ages. We aim to determine the prevalence of dental Fluorosis in school children age 12 and the caries experience of school children between 5 and 12 years old at the Institution “Luis Eduardo Diaz”, located in the urban area of the Municipality of Yondó (Antioquia, Colombia), during 2010. Materials and Methods: A cross-sectional study was conducted in 62 scholars of 5 years and 145 scholars of 12 years. Clinical examinations were carried out and the caries dental experience was established (DMFT and dmf indexes) and the prevalence of dental Fluorosis (Dean’s index). Prevalence, mean and median and for sex were estimated in case of dental caries and the global prevalence of Fluorosis and taking into account severity groups and sex. We calculate the prevalence ratio for sex and the 95% confidence intervals (PR, 95% CI). The main water sources of the study area were analyzed. Results: Mean dmf for 5 years was 2,37(±3,39) and the dental experience was 61%. At 12 years a DMTF mean was 0,73 (±1,28) and the dental experience was 33,1%. No statistical significance was found for sex. The global prevalence of Fluorosis was of 97,9%, the frequency was higher in males but the differences do not have statistical significance (RP 1z5, 95%CI 0,98- 1,12). The physicochemical analysis did not show high levels of fluoride concentrations in water. Conclusion: Higher levels of dental caries in case of scholars of 5 years dental Fluorosis for scholars of 12 years were found. Improvement actions and public health strategies are required for these populations.

Cistouretropexia laparoscópica tipo Burch para el tratamiento de la incontinencia urinaria de esfuerzos: seguimiento a largo plazo / Laparoscopic Burch colposuspension for the treatment of stress urinary incontinence

Objetivos: Conocer las complicaciones, las tasas de cura subjetiva y valoración con el índice de severidad de Sandvik a largo plazo de pacientes en quienes se realizó cistouretropexia laparoscópica tipo Burch para la corrección de su incontinencia urinaria de esfuerzo (IUE). Método: Análisis descriptivo, retrospectivo. Nivel de evidencia III. Se incluyeron las pacientes con diagnóstico de IUE tipo Blaivas IIB, a quienes se les practicó Burch laparoscópico en la Clínica del Prado y Profamilia Medellín, entre los años 2003 y 2007. Las variables principales a evaluar fueron edad, tiempo quirúrgico, cura subjetiva, índice de severidad de Sandvik y complicaciones. Resultados: Se analizaron 72 pacientes con promedio de edad de 46,57 +/- 9,54 años. El tiempo promedio de seguimiento fue de 24,4 meses (rango: 9,0-55,8 meses). El tiempo quirúrgico promedio fue de 79,83 minutos (rango: 44-160 minutos). Refirieron cura subjetiva 56 pacientes (77,8 por ciento). El índice de severidad de Sandvik muestra que a largo plazo 56,9 por ciento pacientes estaban secas con remisión completa de los síntomas y el 13,8 por ciento pacientes tenían pérdidas leves. Conclusiones: El Burch laparoscópico es una opción efectiva para el manejo de la incontinencia urinaria de esfuerzo tipo Blaivas IIB. Provee tasas de curación subjetiva a largo plazo similares a otros tipos de tratamiento. Es una opción más a tener en cuenta en el manejo de la IUE, en especial aquellas pacientes con patologías asociadas que se beneficien del abordaje por laparoscopia.

Objectives: To describe the subjective cure rate, the score of the Sandvik test and the complications after laparoscopic Burch in patients with stress urinary incontinence (SUI). Methods: Prospective descriptive study. We included all patients diagnosed with SUI Blaivas type IIB, and operated on by laparoscopy in two reference institutions between 2003 and 2007. Results: We analyzed 72 patients with an average age of 46.57 +/- 9.54 years. The average follow-up was 24.4 months, with a minimum of 9 and a maximum of 55.8. The average operating time in 29 patients in which we only performed laparoscopic Burch with or without colporrhaphy was 93.7 minutes (55-180 minutes); 56 patients (77.8 percent) reported subjective cure. The Sandvik's severity index found 56.9 percent dry patients and 13.8 percent with mild losses. Conclusion: The laparoscopic management may be useful in some patients, especially those who will be carried to laparoscopy by some other indication. Subjective cure rates are similar to other types of surgery.