Prevalence of Candida albicans in primary endodontic infections associated with a higher frequency of apical periodontitis in type two diabetes mellitus patients.

To identify the prevalence of C. albicans in primary endodontic infections of type two diabetes mellitus (T2DM) patients and compare their clinical and radiographical characteristics with a non-diabetic control group, establishing the possible relationship between primary endodontic infection, T2DM, and C. albicans, since diabetes mellitus (DM), influences the development, course, and response to the treatment of apical periodontitis, but the presence of Candida albicans (C. albicans) has not been considered before. A total of 120 patients were selected and divided into two groups: 60 T2DM diagnosed patients and 60 non-diabetic controls. A clinical examination and radiographic analysis were performed to establish a periapical index score (PAI). Root canal samples were taken. Deoxyribonucleic acid (DNA) was extracted, and specific primers were used to identify C. albicans by polymerase chain reaction (PCR). A twofold increase in the prevalence of C. albicans in T2DM patients was observed in contrast to control patients (p = 0.0251). Sixty-five percent of T2DM patients with positive C. albicans scored a ≥ 3 PAI, while only 27% of the patients without C. albicans had a ≥ 3 PAI score (p = 0.0065). Long-term DM patients presented C. albicans more frequently (p < 0.0001). In this study, long-term T2DM patients carried C. albicans in their root canals more frequently when having a primary endodontic infection. Furthermore, this C. albicans presence seems to be related to a higher frequency of apical periodontitis.

Critical role of HLA-DRß* binding peptides' peripheral flanking residues in fully-protective malaria vaccine development.

A vaccine candidate component must fit perfectly into the antigen presenting HLA-DRß* molecule's groove (or canonical nonapeptide) peptide binding region (PBR) during antigen presentation to the T-cell receptor (TCR), conforming a specific and stable macromolecular complex and induce an appropriate immune response. Antigen's peripheral flanking residues (PFR, positions (p) -p2 and p10) must thus establish strong interactions with the HLA-DRß* - TCR complex. These amino acids (aa) have specific physico-chemical characteristics enabling differentiation between non-protective but antibody-inducer (NPAI), short-lived protection inducer (SLPI) and long-lasting protection inducer (LLPI) peptides when used as an antimalarial vaccine component. Their identification (through 1H-NMR and Aotus monkey immunization) and proper modification contributes to a logical and rational methodology for long-lasting and protective immunological memory.

The Malaria Parasite's Achilles' Heel: Functionally-relevant Invasion Structures.

Malaria parasites have their Achilles' heel; they are vulnerable in small parts of their relevant molecules where they can be wounded and killed. These are sporozoite and merozoite protein conserved high activity binding peptides (cHABPs), playing a critical role in binding to and invasion of host cells (hepatocytes and erythrocytes, respectively). cHABPs can be modified by specific amino acid replacement, according to previously published physicochemical rules, to produce analogues (mHABPs) having left-handed polyproline II (PPIIL)-like structures which can modulate an immune response due to fitting perfectly into the HLA-DRß1* peptide binding region (PBR) and having an appropriate presentation to the T-cell receptor (TCR).

Neural plasticity of the uterus: New targets for endometrial cancer?

Endometrial carcinoma is the most common gynecological malignancy in Western countries and is expected to increase in the following years because of the high index of obesity in the population. Recently, neural signaling has been recognized as part of the tumor microenvironment, playing an active role in tumor progression and invasion of different solid tumor types. The uterus stands out for the physiological plasticity of its peripheral nerves due to cyclic remodeling brought on by estrogen and progesterone hormones throughout the reproductive cycle. Therefore, a precise understanding of nerve-cancer crosstalk and the contribution of the organ-intrinsic neuroplasticity, mediated by estrogen and progesterone, of the uterine is urgently needed. The development of new and innovative medicines for patients with endometrial cancer would increase their quality of life and health. This review compiles information on the architecture and function of autonomous uterine neural innervations and the influence of hormone-dependent nerves in normal uterus and tumor progression. It also explores new therapeutic possibilities for endometrial cancer using these endocrine and neural advantages.

mARC preoperative rectal cancer treatments vs. 3D conformal radiotherapy. A dose distribution comparative study.

PURPOSE: mARC (modulated arc) is the arc therapy technique provided by Siemens. The present study analyses the dose distributions and treatment times corresponding to preoperative rectal cancer mARC treatments. The results are compared to those corresponding to 3D-CRT plans. METHODS: The plans of 30 patients, each having one mARC and one 3D-CRT plan, were evaluated. Every plan was calculated on a sequential two-phase treatment scheme with prescription doses of 45 Gy in the initial phase and 5.4 Gy in the boost phase. Dosimetric parameters and mean DVHs corresponding to the PTVs and OARs were assessed for both techniques. RESULTS: All mARC plans were considered valid for treatment and yielded a highly significant improvement in the CI over 3D-CRT plans (p <0.001). They also showed statistically significant advantage on the parameters D98%, D95% and D2% of the high dose PTV. Regarding the OARs, mARC plans showed reductions in the mean dose of 3.5 Gy in the bladder and greater than 4 Gy in the femoral heads. Considering the small bowel, the mARC plans resulted in a 2.7 Gy mean reduction in the mean dose and lower irradiated volumes over the entire dose range. CONCLUSIONS: Arc therapy plans with the mARC technique for preoperative rectal cancer treatment in a sequential two-phase treatment scheme provide important advantages in the PTVs and OARs. mARC plans show superior protection of the femoral heads, bladder and small bowel, similar to the results found with other more widespread arc therapy techniques.

Impacto del momento de medición y de la sintomatología acontecida durante la hemodiálisis en la Calidad de Vida percibida por el paciente / Impact of measurement timing and symptomatology during hemodialysis on perceived quality of life by the patient

Objetivo: Determinar la relación entre calidad de vida percibida por el paciente en hemodiálisis, el momento de medición de esta y el número de síntomas/complicaciones acontecidos durante la sesión.Material y Método: Estudio observacional longitudinal en pacientes en hemodiálisis con capacidad cognitiva conservada. Se recogieron variables sociodemográficas y clínicas, así como calidad de vida mediante instrumento Coop-Wonka.El estudio se desarrolló en 2 fases:Primera fase: evaluación calidad de vida preHD, cuestionario autoadministrado (en las 12 h previas a 1ª sesión semanal).Segunda fase: 4 semanas más tarde, cumplimentación del mismo cuestionario de calidad de vida, administrado por enfermería (al finalizar 1ª sesión semanal).Durante cuatro semanas se recogieron todos los síntomas, complicaciones mecánicas y situaciones de estrés experimentadas por el paciente durante las sesiones.Resultados: Se estudiaron 61 pacientes, 39 hombres (64%). Edad 67,7±13 años. Tiempo en hemodiálisis 68,7±79 meses. Las puntuaciones globales de calidad de vida relacionada con la salud fueron 25,6±6,9 puntos (1ª fase) y 24,2±7 puntos (2ª fase), con diferencias significativas entre ambos periodos. Se registraron 328 síntomas (0,44±0,54/paciente y sesión).El tiempo en hemodiálisis se relacionó con sintomatología y calidad de vida, presesión y post-sesión.Y la sintomatología se relacionó con calidad de vida relacionada con la salud pre y post-sesión.Conclusiones: A mayor tiempo en hemodiálisis los pacientes presentan peor calidad de vida y más sintomatología durante las sesiones. La percepción sobre su estado de salud, es mejor post-sesión en comparación con la percibida antes de la sesión de diálisis. (AU)

Objective: To determine the relationship between patients’ perceived quality of life on hemodialysis, the timing of its measurement, and the number of symptoms/complications occurring during the session.Material and Method: Longitudinal observational study in hemodialysis patients with preserved cognitive capacity. Sociodemographic and clinical variables and quality of life were collected using the Coop-Wonka instrument. The study was conducted in 2 phases:First phase: pre-HD quality of life evaluation, self-administered questionnaire (12 hours before the 1st weekly session).Second phase: 4 weeks later, completion of the same quality of life questionnaire, administered by nursing staff at the end of the 1st weekly session. All symptoms, mechanical complications, and stress situations experienced by the patient during the sessions were recorded for four weeks.Results: Sixty-one patients were studied, 39 men (64%). The mean age was 67.7±13 years. Time on hemodialysis was 68.7±79 months. Overall scores for health-related quality of life were 25.6±6.9 points (1st phase) and 24.2±7 points (2nd phase), with significant differences between both periods. 328 symptoms were recorded (0.44±0.54/patient and session). Time on hemodialysis was related to symptomatology and quality of life, pre-session and post-session. Symptoma-tology was related to health-related quality of life pre and post-session.Conclusions: Patients who have been on hemodialysis for more extended periods have worse quality of life and more symptoms during the sessions. Their perception of their health status is better post-session compared to pre-dialysis sessions. (AU)

Detection of the antimicrobial resistance genes blaTEM-1, cfxA, tetQ, tetM, tetW and ermC in endodontic infections of a Mexican population.

OBJECTIVES: The aim of this study was to identify the prevalence of genes encoding resistance to three groups of antimicrobial agents in root canal samples from primary infection or post-treatment disease in Mexico. METHODS: A total of 64 subjects requiring root canal treatment because of primary infection or post-treatment disease were enrolled in this cross-sectional analytical study. Root canal samples were obtained and DNA was isolated. Specific primers for six antimicrobial resistance genes (ARGs) and seven bacterial taxa (five genera and two species) were used. Student's t-test, χ2 test and Fisher's exact test were applied where appropriate to detect statistical differences. RESULTS: The blaTEM-1, ermC and tetM genes were found more frequently in the post-treatment disease group compared with the primary infection group. The occurrence of assessed bacteria was similar in both groups, except for Enterococcus spp. and Porphyromonas endodontalis, which were found at a significantly higher frequency in the post-treatment disease group. It was observed that the post-treatment disease group harboured more ARGs. The most frequent ARG was tetW, whereas tetQ and cfxA were not detected in any case. With respect to bacterial taxa, Fusobacterium spp. was present in 100% of samples, whereas Porphyromonas gingivalis was not observed in any of the samples. CONCLUSIONS: At least one ARG was detected in all cases; moreover, 32.8% of samples were positive for four ARGs, 54.7% for three ARGs, 9.4% for two ARGs and only 3.1% for one ARG. This indicates a high prevalence and diversity of ARGs in these root canal samples.

Functionally relevant proteins in Plasmodium falciparum host cell invasion.

A totally effective, antimalarial vaccine must involve sporozoite and merozoite proteins (or their fragments) to ensure complete parasite blocking during critical invasion stages. This Special Report examines proteins involved in critical biological functions for parasite survival and highlights the conserved amino acid sequences of the most important proteins involved in sporozoite invasion of hepatocytes and merozoite invasion of red blood cells. Conserved high activity binding peptides are located in such proteins' functionally strategic sites, whose functions are related to receptor binding, nutrient and protein transport, enzyme activity and molecule-molecule interactions. They are thus excellent targets for vaccine development as they block proteins binding function involved in invasion and also their biological function.

A dose index as a tool to estimate paediatric patient doses in digital projection radiography.

Radiation exposure during childhood is estimated to have a lifetime risk up to seven times greater than exposures at adult age. Therefore, paediatric patient dose monitoring is a major concern in radiology. The aim of this study is to evaluate the validity of a dose index, displayed at the digital imaging and communication in medicine (DICOM) header of the images, as a dosimetric quantity to estimate the entrance surface dose (ESD) for each procedure. It was carried out over a sample of 156 paediatric patients who underwent a chest examination. National Radiation Protection Board Report 318 model was used to categorise patients by age and to estimate their thickness. Corrected dose index values were compared with calculated ESD, estimated from tube output and radiographic technique. The deviation between both values remained within 2% for every age group, except for patients up to 1 y. Therefore, the index could be used to estimate ESD, allowing to manage greater patient dose databases.

Local public health performance measurement: implementation strategies and lessons learned from aligning program evaluation indicators with the 10 essential public health services.

This case study summarizes the development and implementation of the evaluation framework, preliminary data results, and lessons learned for overcoming barriers and challenges. The framework development was based on best practices in evaluation and the Public Health Essential Services. Results were as follows: (1) implemented a department-wide framework for program evaluation; (2) developed and implemented 34 program evaluation plans; (3) collected data on 52 indicators across 492 measurable objectives; and (4) identified challenges and recommendations to improve evaluation processes. Although the importance of program evaluation is recognized in public health, program evaluation models do not take into account the variety of goals inherent in the diversity of public health programming. The case study presented provides guidance and lessons learned for the evaluation of public health practice in local governments.

Manual para padres. Aspectos psicológicos del desarrollo infantil / Manual for parents. Psychologic aspects of child development

Proporciona conceptos y conocimientos respecto a los elementos afectivos, sociales y de ambiente familiar que afectan y moldean el desarrollo infantil. Contenido: Presentación. Introducción. 1) La Familia. 2) Concepción, embarazo y nacimiento. 3) Alimentación en el niño y sus implicaciones. 4) El sueño en el niño. 5) Entrenamiento en el control de esfínteres. 6) Establecimiento de límites de crianza. 7) Socialización. 8) Desarrollo de la personalidad del niño. 9) Sexualidad infantil. 10) Desarrollo de la inteligencia. 11) El niño y el juego. 12) Auto-estima. 13) Adolescencia. 14) Repercusión psicológica en la familia de los trastornos de la comunicación humana. Glosario

Manual para padres. Aspectos psicológicos del desarrollo infantil / Manual for parents. Psychologic aspects of child development

Proporciona conceptos y conocimientos respecto a los elementos afectivos, sociales y de ambiente familiar que afectan y moldean el desarrollo infantil. Contenido: Presentación. Introducción. 1) La Familia. 2) Concepción, embarazo y nacimiento. 3) Alimentación en el niño y sus implicaciones. 4) El sueño en el niño. 5) Entrenamiento en el control de esfinteres. 6) Establecimiento de límites de crianza. 7) Socialización. 8) Desarrollo de la personalidad del niño. 9) Sexualidad infantil. 10) Desarrollo de la inteligencia. 11) El niño y el juego. 12) Auto-estima. 13) Repercusión psicológica en la familia de los trastornos de la comunicación humana. Glosario