A longitudinal study of free leptin index in pre-eclamptic pregnancies.

The ratio between circulating levels of leptin and soluble leptin receptor (sOB-R), the free leptin index (FLI), is used as a marker of leptin resistance. Therefore, the aim of our study was to investigate the FLI in mild pre-eclamptic pregnancies in a nested case-control study within a prospective observational study. Circulating levels of leptin and sOB-R levels rise significantly during pregnancy in healthy (p < 0.05) (n = 46) and pre-eclamptic pregnancies (p < 0.05) (n = 20). Serum levels of leptin were significantly higher in pre-eclamptic compared to healthy pregnancies at second and third trimesters of pregnancy (p < 0.05). Additionally, serum levels of sOB-R were significantly lower in pre-eclamptic pregnancies during the second and third trimesters of pregnancy compared to healthy pregnancies (p < 0.05). Moreover, we found that FLI did not vary significantly during pregnancy in healthy women (p > 0.05), while it increases in pre-eclamptic pregnancies (p < 0.05). Indeed, FLI was significantly higher at second and third trimesters of pregnancy in pre-eclamptic compared to healthy pregnancies (p < 0.05). In addition, FLI was significantly higher in the luteal phase compared with the follicular phase of the menstrual cycle in eumenorrheic women (p < 0.05). Receiver operating characteristic (ROC) curve analysis revealed the ability of leptin (AUC = 0.72) and FLI (AUC = 0.67) as a reliable predictor for mild pre-eclampsia during the second trimester of pregnancy. In conclusion, our findings show that FLI were significantly increased in mild pre-eclamptic pregnancies and allowed us to hypothesize that this rise might alter leptin bioavailability and bioactivity which might lead to the sympathetic hyperactivity and the hypertensive disorders during pregnancy.

Accuracy of dental implant placement with or without the use of a dynamic navigation assisted system: A randomized clinical trial.

OBJECTIVES: To assess dental implant placement accuracy with a dynamic computer-assisted implant surgery (dCAIS) system and a freehand approach. Secondarily, to compare the patients' perception and quality of life (QoL) with the two approaches. METHODS: A double-arm randomized clinical trial was conducted. Consecutive partially edentulous patients were randomly allocated to the dCAIS or standard freehand approach groups. Implant placement accuracy was evaluated by overlapping the preoperative and postoperative Cone Beam Computer Tomographs (CBCT) and recording linear deviations at the implant apex and platform (in mm) and angular deviations (in degrees). Questionnaires recorded self-reported satisfaction, pain and QoL during surgery and postoperatively. RESULTS: Thirty patients (22 implants) were enrolled in each group. One patient was lost to follow-up. A significant difference (p < .001) in mean angular deviation was found between the dCAIS (4.02°; 95% CI: 2.85 to 5.19) and the FH (7.97°; 95% CI: 5.36 to 10.58) groups. Linear deviations were significantly lower in the dCAIS group, except for the apex vertical deviation, where no differences were found. Although dCAIS took 14 min longer (95% CI: 6.43 to 21.24; p < .001), patients in both groups considered the surgical time acceptable. Postoperative pain and analgesic consumption during the first postoperative week were similar between groups and self-reported satisfaction was very high. CONCLUSION: dCAIS systems significantly increase the accuracy of implant placement in partially edentulous patients in comparison with the conventional freehand approach. However, they increase the surgical time significantly and do not seem to improve patient satisfaction or reduce postoperative pain.

Analysis of neutropenia as a predictive factor of the efficacy of trifluridine-tipiracil treatment.

OBJECTIVES: Trifluridine-tipiracil (TAS-102), an oral cytotoxic agent used in adult patients with refractory metastatic colorectal cancer (mCRC), has been associated with neutropenia (chemotherapy-induced neutropenia) (CIN)). MATERIALS AND METHODS: We evaluated the efficacy and safety of TAS-102 in a group of 45 mCRC patients (median age 66 years) in Huelva province, Spain, in a retrospective, multicenter observational study. RESULTS: We showed that the association between TAS-102 and CIN can be used as a predictor of efficacy. 20% (9/45) of patients with an Eastern Cooperative Oncology Group (ECOG) score of 2 had received at least one previous chemotherapy treatment. Overall, 75.5% (34/45) and 28.9% (13/45) had received anti-VEGF and anti-EGFR monoclonal antibodies, respectively. Additionally, 80% (36/45) of patients had received third-line treatment. The mean treatment period, duration of overall survival (OS), and duration of progression-free survival (PFS) were 3.4, 12, and 4 months, respectively. A partial response was seen in 2 patients (4.3%), and disease stabilization was observed in 10 patients (21.3%). Neutropenia was the most frequent grade 3 - 4 toxicity (46.7%; 21/45). Other findings were anemia (77.8%; 35/45), all grades of neutropenia (73.3%; 33/45), and gastrointestinal toxicity (53.3%; 24/45). The dose of TAS-102 needed to be reduced in 68.9% (31/45) of patients, whereas treatment needed to be interrupted in 80% (36/45) of patients. Grade 3 - 4 neutropenia was a positive prognostic factor for OS (p = 0.023). CONCLUSION: A retrospective evaluation shows that grade 3 - 4 neutropenia is an independent predictor of treatment response and survival in patients undergoing routine treatment for mCRC, but this finding needs confirmation in a prospective study.

Pericardial effusion with pembrolizumab.

INTRODUCTION: The treatment of non-small cell lung cancer (NSCLC) has profoundly changed on account of the arrival of new therapies, like immunotherapy. Within this group of drugs, those aimed at the programmed cell death-1 or programmed cell death ligand-1(PD1/PDL-1) are very relevant, for example, Pembrolizumab. Although its adverse reactions are generally mild and well tolerated, it has been associated with certain immune-related adverse events (IrAEs) than can be serious and affect any organ. CASE REPORT: A 62-year-old woman diagnosed with stage IV NSCLC with a single bone metastasis and PD-L1 expression of 60% started treatment with cisplatin-pemetrexed-pembrolizumab, and maintenance with pembrolizumab. MANAGEMENT AND OUTCOME: The patient attended the ER with pericardial effusion that was assumed to be a Pembrolizumab IrAE and was managed with corticosteroids. The patient fully recovered but immunotherapy was not reintroduced due to the severity of the AE. DISCUSSION: The cardiovascular system is among the least affected organs by immunotoxicity, with an incidence between 0.09-0.6%. However, some authors suspect the incidence is underestimated. Median time to onset is highly variable, ranging from 6 weeks since the first dose to 2 years after discontinuation of the treatment. There are not guidelines on the most effective management of the IrAEs, but according to the pharmaceutical reference, corticosteroids should be initiated followed by a progressive reduction. If no response is obtained, another immunosuppressive agent should be added. The determination to restart immunotherapy depends on the severity of the adverse reaction, the availability of other alternative treatments, and the cancer response.

Study of the Ghrelin/LEAP-2 Ratio in Humans and Rats during Different Phases of Pregnancy.

The Liver-Expressed Antimicrobial Peptide 2 (LEAP-2) has emerged as an endogenous GHS-R antagonist and blunts the orexigenic action of ghrelin. This study aimed to determine the Ghrelin/LEAP-2 ratio in humans and rats during pregnancy. In humans, we conducted a nested case-control study within an observational prospective cohort. Healthy and mild preeclamptic pregnant women were studied at each trimester of gestation and three months postpartum. In addition, a group of non-pregnant women was studied into the follicular and luteal phases of the menstrual cycle. Furthermore, Ghrelin/LEAP-2 ratio was investigated in non-pregnant rats and at different periods of rat pregnancy. Human and rat serum ghrelin and LEAP-2 levels were determined using the commercially available ELISA kits. The Ghrelin/LEAP-2 ratio peak around the second trimester of gestation in healthy pregnant women (p < 0.05). Additionally, there were no statistically significant differences in Ghrelin/LEAP-2 ratio between healthy and preeclamptic pregnant women at each trimester of gestation (p > 0.05). The Ghrelin/LEAP-2 ratio in pregnant rat reached the peak around mid-gestation with a similar pattern to the human pregnancy. LEAP-2 was visualized by immunohistochemistry in human term placenta and rat placentas on days 12, 16 and 21 of pregnancy. In conclusion, this study provides the first evidence of a Ghrelin/LEAP-2 ratio peak around the half-way point of pregnancy onwards during human and rat pregnancy, and it might be associated with increased rates of weight gain during pregnancy. Thus, this study suggests that LEAP-2 and Ghrelin/LEAP-2 ratio might play an important role in maternal physiology adaptation of weight gain during pregnancy.

Body Mass Index Is Significantly Associated With Disease Severity in Spinocerebellar Ataxia Type 2 Patients.

BACKGROUND: Spinocerebellar ataxia type 2 is a progressive neurodegenerative disorder due to an unstable expansion of a CAG repeat in the ATXN2 gene. Although weight loss has been associated with disease progression in several neurodegenerative conditions, it has been barely assessed in patients with spinocerebellar ataxia type 2. OBJECTIVE: The objective of this study was to test whether body mass index is altered in patients with spinocerebellar ataxia type 2 with varying expansion sizes from early to late disease stages. METHODS: A cross-sectional case-control study was performed, which included 222 clinically and molecularly diagnosed patients and 214 sex- and age-matched healthy individuals. ATXN2 genotypes and sex were considered as risk factors. Clinical outcomes included the body mass index, age at onset, disease duration, Scale for the Assessment and Rating of Ataxia score, disease stage, dysphagia, and progression rate. Multiple linear regression models were generated. RESULTS: Body mass index was significantly decreased in male patients, but not in female patients, relative to control subjects. In addition to sex, body mass index was significantly associated with age at onset and progression rate. Conversely, body mass index, along with repeat length in ATXN2 expanded alleles and disease duration, was associated with Scale for the Assessment and Rating of Ataxia score. In addition, body mass index, along with the age at onset and the repeat length in ATXN2 normal and expanded alleles, has a significant influence on progression rate. CONCLUSIONS: Body mass index might be a useful biomarker of disease severity, particularly in male patients with spinocerebellar ataxia type 2 in the context of nutritional interventions or clinical trials assessing the efficacy of promising new drugs. © 2021 International Parkinson and Movement Disorder Society.

Guided bone regeneration using beta-tricalcium phosphate with and without fibronectin-An experimental study in rats.

OBJECTIVE: This histomorphometric study compared bone regeneration potential of beta-tricalcium phosphate with fibronectin (ß-TCP-Fn) in critical-sized calvarial defects (CSDs) in rats to assess whether fibronectin (Fn) improved new bone formation. MATERIAL AND METHODS: Critical-sized calvarial defects were created in 30 adult male Sprague Dawley rats, which were divided into four groups according to the time of euthanasia (6 or 8 weeks of healing) and type of filling (ß-TCP-Fn/6 weeks, ß-TCP/6 weeks, ß-TCP-Fn/8 weeks and ß-TCP/8 weeks). The primary variables related to new bone formation were augmented area (AA) and gained tissue (GT; sum of mineralized bone matrix [MBM] and bone substitute [BS]). Secondary variables were the diameter of the defect, MBM, non-mineralized tissue (NMT) and BS. RESULTS: A total of 29 rats and 58 histological samples were evaluated, 28 (48.3%) samples obtained at 6 weeks and 30 (51.7%) at 8 weeks, homogeneously distributed between right and left sides. Thirteen (22.4%) were treated with ß-TCP-Fn, 16 (27.6%) with ß-TCP and 29 (50%) were controls. At 8 weeks, histomorphometric analysis showed significant differences in AA using ß-TCP and ß-TCP-Fn versus controls (p = 0.001 and p = 0.005, respectively). Bone turnover expressed as % within the target area was slightly higher but not statistically significant in the ß-TCP-Fn than in ß-TCP (MBM) at 6 weeks versus 8 weeks (p = 0.067 and p = 0.335, respectively). Finally, the total GT area in mm2 was higher using ß-TCP-Fn as compared to ß-TCP (p = 0.044). CONCLUSIONS: ß-TCP-Fn was slightly but non-significantly more effective than ß-TCP without Fn for improving the volume of regenerated bone in CSDs of rats, possibly allowing a more efficient bone remodelling process. This effect however should continue being investigated.

Periodontal Regenerative Therapy for Preventing Bone Defects Distal to Mandibular Second Molars After Surgical Removal of Impacted Third Molars: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

PURPOSE: The purpose of this study was to assess which regenerative techniques are most effective for preventing periodontal defects after extraction of the third molars, as well as to compare these procedures with spontaneous healing of the socket. MATERIALS AND METHODS: Five electronic databases were searched to identify randomized clinical trials that fulfilled the eligibility criteria. Two independent reviewers conducted literature screening, article selection, and data extraction. The outcome measures were mean clinical attachment level (CAL) gain, mean probing depth (PD) reduction, mean alveolar bone level (ABL) gain, and adverse events. The influence of several variables of interest on the outcomes of periodontal regenerative therapy was explored via subgroup analyses. RESULTS: Among 1,205 potentially eligible articles, 21 randomized clinical trials were included. Eighteen trials assessed periodontal regenerative therapy as an alternative to extraction alone. Statistically significant differences were found in CAL gain (1.98 mm; 95% confidence interval [CI], 1.44 to 2.52 mm; P < .001), PD reduction (1.76 mm; 95% CI, 1.20 to 2.31 mm; P < .001), and ABL gain (1.21 mm; 95% CI, 0.21 to 2.21 mm; P = .018). The risk of complications developing at treated sites did not increase with the regenerative procedures (odds ratio, 1.49; 95% CI, 0.71 to 3.14; P = .290). There was no evidence of any regenerative procedure being better than any other. However, osseous grafting techniques were associated with a significantly higher adverse event rate. CONCLUSIONS: Regenerative periodontal therapy, in comparison with spontaneous healing of the wound, is more effective regarding initial improvement in CAL gain, PD reduction, and ABL gain, without increasing the risk of postoperative complications.

Intratissue lymphovenous communications in the mechanism of action of vascularized lymph node transfer.

BACKGROUND AND OBJECTIVES: Vascularized lymph node transfer (VLNT) as a surgical treatment for cancer-related lymphedema has shown beneficial effects. The mechanism of action of this procedure involves lymphangiogenesis and lymphovenous communications (LVC) within the lymph nodes. We propose intratissue LVC as an additional element responsible for drainage of lymph to blood in the flap and examine this hypothesis in the current study. METHODS: This prospective study determined the passage of lymph to the venous system via intratissue LVC in 26 free flaps used for breast reconstruction. We evaluated whether fluorescence was positive in the pedicle vein after increasing time intervals following intradermal injection of indocyanine green (ICG) dye into the flaps using near infra-red fluorescence lymphography. RESULTS: We studied 26 free flaps, 22 deep inferior epigastric perforator (DIEP) flaps (84.6%), and 4 superior gluteal artery perforator (SGAP) flaps (15.4%). Fluorescence in the pedicle vein was positive in 22 of the 26 flaps (P = 0.000). The median time for fluorescence evaluation in the pedicle vein was 120 min. CONCLUSIONS: Fluorescence in the pedicle vein after ICG intradermal injection indicates functional intratissue LVC in free flaps. J. Surg. Oncol. 2017;115:27-31. © 2016 Wiley Periodicals, Inc.

A comprehensive review of the natural lymphaticovenous communications and their role in lymphedema surgery.

Cancer-related lymphedema is a progressive, chronic condition that impairs quality of life. Its pathophysiology and the mechanisms of action of current reconstructive surgical treatments are not fully understood but lymphaticovenous communications may play a key role. We review the available literature on lymphaticovenous communications and their implications in lymphedema surgery, and propose a subclassification of lymphaticovenous communications. J. Surg. Oncol. 2016;113:374-380. © 2016 Wiley Periodicals, Inc.

Longitudinal analysis of maternal serum Follistatin concentration in normal pregnancy and preeclampsia.

OBJECTIVE: Follistatin (FST) is a regulator of the biological activity of activin A (Act A), binding and blocking it, which could contribute to the modulation of its pro-inflammatory activity during pregnancy. We sought to investigate, in this nested case-control study, FST serum levels during normal pregnancy and correlate it with the FST profile in preeclamptic pregnant women, normal pregnant women followed 3 months postpartum and eumenorrheic nonpregnant women throughout the menstrual cycle. SUBJECTS AND METHODS: Follistatin serum levels determined by ELISA, biochemical and anthropometric variables were measured in normal pregnant (n = 28) and preeclamptic (n = 20) women during three periods of gestation. In addition, FST serum levels were measured in a subset of normal pregnant women (n = 13) followed 3 months postpartum and in eumenorrheic nonpregnant women (n = 20) during the follicular and luteal phases of the menstrual cycle. RESULTS: Follistatin serum levels in the eumenorrheic nonpregnant and postpartum group were significantly lower when compared to levels throughout gestation (P < 0·01). Serum FST levels increased in each period of pregnancy analysed, being significantly higher towards the end of gestation (P < 0·01). FST levels were lower in late pregnancy in preeclamptic women compared to normal pregnant women (P < 0·05). Finally, FST levels were higher in the luteal phase when compared with the follicular phase of the menstrual cycle (P < 0·05). CONCLUSIONS: These analyses would permit the consideration that changes in FST levels during pregnancy contribute to the control of the Act A system.

Maternal serum omentin-1 profile is similar in humans and in the rat animal model.

Omentin-1 is an adipocytokine with anti-inflammatory activity that has been associated with different metabolic disorders. The aim of this study is to investigate the serum profiles of omentin-1 throughout human and rat pregnancy. Serum omentin-1 levels were determined by ELISA in a prospective cohort study of healthy pregnant women (n=40) during the three trimesters of pregnancy and in twenty healthy non-pregnant women during the follicular and luteal phase of the menstrual cycle. In addition, serum omentin-1 levels were measured in rats during different periods of pregnancy (gestational days 8, 12, 16, 19, and 21) and in an age-matched control (virgin) group of rats (n=12rats/group). Finally, immunohistochemistry was used to demonstrate the presence of omentin-1 protein in human and rat placenta. Omentin-1 immunoreactivity was detected in cytotrophoblasts, syncytiotrophoblasts, sparse Hofbauer cells, and endothelial cells of the stem villi of human placenta. Additionally, it was detected in the labyrinthine trophoblast and yolk sac layer of the rat placenta. Human and rat serum omentin-1 levels were significantly lower in the late gestational period when compared with the non-pregnant women and virgin rats (p<0.05). Serum omentin-1 changes were not significant throughout the gestation in both species (p>0.05). Human serum omentin-1 levels have an inverse relationship with triglyceride levels during pregnancy. Our findings have not determined the exact role of omentin-1 during pregnancy, concerning the metabolic control of triglycerides and other energy sources. Whether omentin-1 decrease implies a regulatory function is still not clear. Further studies are needed to address this issue and determine the role of omentin-1 in metabolic adaptations during normal human and rat pregnancy.

Survival of immediately versus delayed loaded short implants: A prospective case series study.

BACKGROUND: To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. MATERIAL AND METHODS: 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delayed loading. Failures, bone loss, probing depth and bleeding on probing were evaluated. RESULTS: 54 Mk III Shorty TiU and 15 Brånemark System®MK III TiU implants with a length longer than 7mm were included in the study. Twenty-eight implants were inserted following the immediate loading protocol and 26 according a two-stage procedure, depending on the torque value. The cumulative survival rate of short implants was 87% (n=54) after a mean time of 47.72 months (range 33-62 months), showing statistically significant differences related to loading protocol (p=0.047). Short implants immediately loaded had a higher long-term survival rate (96.4%) compared to the other study group (76.9%). Besides, short implants splinted to longer immediately loaded implants presented the highest survival rate (100%). Twenty-five (53.19%) short implants showed a bone loss of less than one millimeter after the follow-up period. Statistically significant differences were found between bleeding on probing, presence of plaque or suppuration and a higher bone loss in both loading protocols (p=0.001). CONCLUSIONS: Immediate loading of short implants placed on free ends can be considered an option in the treatment protocol of patients with severe bone resorption especially if implants are splinted to others of greater length.

Clinical significance of interleukin-1 genotype in smoking patients as a predictor of peri-implantitis: A case-control study.

BACKGROUND: Interleukin-1 (IL-1) is a proinflammatory cytokine that plays an important role in the pathogenesis of periodontitis, and so it might be useful to detect high-risk cases of peri-implantitis. It has been reported that IL-1 polymorphisms and smoking habit have a synergic effect, increasing the incidence of peri-implantitis. The aim of the present study was to evaluate the relationship between IL-1 gene polymorphisms and peri-implantitis in smoking patients. MATERIAL AND METHODS: A case-control study was performed in 27 patients with peri-implantitis and 27 patients with healthy implants. All patients included were smokers. IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C were identified by polymerase chain reaction (PCR) amplification in order to establish a relation between these variables and the presence of peri-implantitis. A bivariate analysis was performed and odds-ratio (OR) were calculated. RESULTS: The incidence of peri-implantitis was significantly higher in patients with previous history of periodontitis (p=0.024; OR=10.9). Both groups were similar regarding IL-1A-C889T, IL-1B+C3953T and IL-1RN+T2018C genotypes. No increased risk in heavy smokers with IL-1 polymorphism was found. CONCLUSIONS: IL-1 genotypes do not seem to be good predictors of peri-implantitis in the great majority of smoking patients. Furthermore, no synergic effect was found between IL-1 genotypes and heavy smokers. Patients with a previous history of periodontitis were more prone to peri-implantitis.

A retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and cone beam computerized tomography.

OBJECTIVES: To compare the prevalence and the length of mental loop, measured with panoramic radiography (PR) and cone beam computerized tomography (CBCT). MATERIAL AND METHODS: PG and CBCT images where analyzed by a single calibrated examiner to determine the presence and the position of the mental foramen (MF), its distance to the lower mandible border, the anterior length of the mental loop (ML) and the bone quality in 82 PR and 82 CBCT. RESULTS: ML was identified in 36.6 % of PR and 48.8 % of CBCT. PR showed a magnification of 1.87 when compared to CBCT. The mean of anterior extension of the inferior alveolar nerve and the distance to the inferior border of the mandible was higher for PR (2.8 mm, sd 0.91 mm on the PR , range 1.5 to 4.7 mm and 1.59, sd 0.9 on the CBCT ,range 0.4 to 4.0 mm) CONCLUSIONS: There is a magnification in PR images with respect to those of CBCT. The differences between CBCT and PR with regards to the identification and length of the ML are not statistically significant. Identification and accuracy measurements of ML did not depend on the bone quality. Considering that two dimensional imaging provides less accurate and reliable information regarding the anterior loop, a CBCT scan could be recommended when planning implant placement in the anterior region.

Brain-derived neurotrophic factor is expressed in rat and human placenta and its serum levels are similarly regulated throughout pregnancy in both species.

OBJECTIVE: Pregnancy is characterized by several metabolic changes that promote fat gain and later onset of insulin resistance. As Brain-derived neurotrophic factor (BDNF) decreases hyperglycaemia and hyperphagia, we aimed to investigate the potential role of placental and circulating BDNF levels in these pregnancy-related metabolic changes in rats and humans. DESIGN AND METHODS: We identified the mRNA and protein expression of placental BDNF and its receptor TrkB using real-time PCR, Western blot and immunohistochemical approaches in both rat and humans. Serum BDNF was measured by ELISA. We also did a longitudinal prospective cohort study in 42 pregnant women to assess BDNF levels and correlations with other metabolic parameters. RESULTS: We found that BDNF and TrkB are expressed in both rat and human placenta. In rat, both placental mRNA and serum levels are increased throughout pregnancy, whereas their protein levels are significantly decreased at the end of gestation. Serum BDNF levels in pregnant women are significantly lower in the first trimester when compared to the second and third trimester (P < 0·0148, P < 0·0012, respectively). Serum BDNF levels were negatively correlated with gestational age at birth and fasting glucose levels. CONCLUSION: Our findings suggest that both BDNF and its receptor TrkB are expressed in rodent and human placenta being regulated during pregnancy. Taken together, these findings support a role of BDNF in the regulation of several metabolic functions during pregnancy.

People in Ecuador and the United States conceptualize compassion differently: The role of avoided negative affect.

Even people from frequently studied cultural contexts differ in how they conceptualize compassion, partly because of differences in how much they want to avoid feeling negative. To broaden this past work, we include participants from an understudied cultural context and start to examine the process through which culture shapes compassion. Based on ethnographic and empirical studies that include Ecuadorians, we predicted that Ecuadorians would want to avoid feeling negative less compared to U.S. Americans. Furthermore, we hypothesized that because of these differences in avoided negative affect, compared to U.S. Americans, for Ecuadorians, a compassionate response would contain more emotion sharing, which in turn would be associated with conceptualizing a compassionate face as one that mirrors sadness more and expresses happiness (e.g., a kind smile) less. Using a reverse correlation task, participants in the United States and Ecuador selected the stimuli that most resembled a compassionate face. They also reported how much they wanted to avoid feeling negative and described what a compassionate response would entail. As predicted, compared to U.S. Americans, Ecuadorians wanted to avoid feeling negative less, they conceptualized a compassionate response as one that focused more on emotion sharing, and visualized a compassionate face as one that contained more sadness and less happiness. Furthermore, exploratory analyses suggest that wanting to avoid feeling negative and conceptualizations of a compassionate response as emotion sharing partly sequentially explained the cultural differences in conceptualizations of a compassionate face. What people regard as compassionate differs across cultures, which has important implications for cross-cultural counseling. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relationship between Medication-Related Osteonecrosis of the Jaw and CDK4/6 Inhibitors in Breast Cancer.

OBJECTIVE: We aimed to evaluate the use of CDK4/6 inhibitors as a risk factor for medication-related osteonecrosis of the jaw (MRONJ) in a cohort of patients with metastatic breast cancer treated with denosumab. METHODS: This was a multicentre, retrospective, observational study. All patients with breast cancer treated with denosumab (January 2011-December 2022) were included. The relationship between CDK4/6 inhibitors and MRONJ was analysed. RESULTS: A total of 243 patients were included, ninety-five (44.2%) of whom used a CDK4/6 inhibitor. There were 21 patients with MRONJ. In patients treated with denosumab without CDK4/6 inhibitors, the incidence of MRONJ and mean time to the occurrence of MRONJ were 6.6% (8/120) and 16.8 months (SD 7.8), respectively; in patients treated with denosumab and CDK4/6 inhibitor, these values were 13.7% (13/95) and 15.4 months (SD 8.7), respectively. The difference in the incidence was not significant (p = 0.085). Among the 19 patients who used abemaciclib, the probability of MRONJ occurrence was significantly higher compared to patients not using CDK4/6 inhibitors (p = 0.0178). CONCLUSIONS: These results suggest that the incidence of MRONJ in patients with metastatic breast cancer treated with denosumab is higher, and the onset of MRONJ occurs earlier in the presence of CDK4/6 inhibitors. The differences were statistically significant in the patients who used abemaciclib. Given that the use of this combination is very common in routine clinical practice, it would be advisable to carry out larger prospective studies to clarify the risk of this association.

Comparison of Efficacy of Micropulse and Continuous Wave Cyclophotocoagulation in Patients With Pediatric Glaucoma.

PRCIS: Both micropulse (MP-CPC) and continuous wave (CW-CPC) cyclophotocoagulation exhibited short-term effectiveness in lowering IOP, followed by reversion to near baseline levels 12 months after laser treatment. OBJECTIVE: To determine and compare the effectiveness and safety of MP-CPC and CW-CPC in patients diagnosed with pediatric glaucoma. METHODS: A retrospective cohort study was conducted on a total of 28 patients (81 eyes) diagnosed with pediatric glaucoma either undergoing MP-CPC or CW-CPC. Intraocular pressure (IOP) measurements, number of glaucoma medications, and the onset of complications were collected at baseline, 1-month, 3-month, 6-month, and 12-month intervals. Success rate (SR) was defined as eyes achieving IOP ≤21 mm Hg and ≥5 mm Hg and a 20% reduction in IOP at the last follow-up visit. RESULTS: All patients either undergoing MP-CPC or CW-CPC were matched for age (mean ± SD; 1.76 ± 1.69 vs 1.56 ± 2.49 y). Patients undergoing MP-CPC had significant decreases in IOP from baseline IOP at 1, 3, and 6 months with a 22% SR at 12 months. CW-CPC had a significant decrease in IOP from baseline IOP at all follow-ups, with a 27% SR at 12 months. At the 12-month follow-up, the CW-CPC cohort exhibited a significantly larger overall drop in IOP when compared with the MP-CPC cohort, (7.99 ± 7.95 vs 1.78 ± 6.89, P < 0.05); however, the difference in SR between treatment groups (27% vs 22%) at 12 months was not significant ( P > 0.05). Complications were minimal for both groups. CONCLUSION: Both MP-CPC and CW-CPC exhibited short-term effectiveness in lowering IOP, followed by reversion to near baseline levels 12 months after laser treatment. Both MP-CPC and CW-CPC exhibited similar SR at 12 months, 22% and 27% respectively.

VEXAS syndrome: A 2-case series report.

VEXAS syndrome is a rare entity secondary to UBA1 gene mutations, located on the X chromosome. This mutation generates, as a consequence, a characteristic vacuolation on haematopoietic stem-cells. It is characterized by multiple autoinflammatory and haematologic manifestations, which respond and end up being dependent on corticosteroid treatment. In this publication we present a 2-case series diagnosed at our hospital and make a brief literature review of the published evidence so far.