Observational cross-sectional study of Trichomonas tenax in patients with periodontal disease attending a Chilean university dental clinic.

BACKGROUND: The oral flagellated protozoan Trichomonas tenax has been associated with patients with periodontal disease. However, no recent studies have been conducted on the prevalence of T. tenax in Chile. The aim of this study was to determine the presence of T. tenax in patients with periodontal disease, admitted to the Dental Clinic of the University of Antofagasta, Chile, through Polymerase Chain Reaction (PCR) amplification of the beta-tubulin gene. METHODS: An observational, cross-sectional study was conducted on 50 patients diagnosed with periodontal disease, 20 of them with gingivitis and 30 with periodontitis. T. tenax was identified by PCR amplification of the beta-tubulin gene. Associations between the protozoan and periodontal disease or the presence of risk factors to establish T. tenax infection were determined using the chi-square test and binary logistic regression analysis. RESULTS: T. tenax was present in 28 out of 50 (56%) of patients with periodontal disease, and was more prevalent when associated with periodontitis (21 out of 30; 70%) than dental plaque-induced gingivitis (7 out of 20; 35%). Non-statistically-significant associations were observed between the presence of T. tenax and age, gender, smoking habit or diabetes. Statistically significant associations were observed between the presence of T. tenax and periodontal disease, and between T. tenax and the Periodontal Screening and Recording (PSR) index. CONCLUSION: T. tenax showed a high presence in patients with progressive states of periodontal diseases. Consequently, T. tenax detection is strongly recommended in patients with periodontal disease diagnosis and with a PSR index greater than 3.

Patient-Related Benefits for Adults with Cochlear Implantation: A Multicultural Longitudinal Observational Study.

OBJECTIVES: To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. DESIGN: This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. SUBJECTS: Two hundred ninety-one routinely treated, unilateral CI recipients, aged 13-81 years, from 9 clinics across 4 countries. RESULTS: Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). CONCLUSIONS: Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers.

Age of Onset, Current Use of Alcohol, Tobacco or Marijuana and Current Polysubstance Use Among Male and Female Mexican Students.

AIMS: This study aimed to examine alcohol, tobacco or marijuana use onset and associations between age of onset and current use, and between age of onset and current polysubstance use among a sample of Mexican young people aged 17-20 years. METHODS: Alcohol, tobacco, marijuana and other substance use were identified in a 2012 cross-sectional survey of male and female students entering first year university in Mexico City. Chi-square tests and logistic regression models examined associations between gender, age of onset, order of onset, family substance use and current polysubstance use among 22,224 students. RESULTS: The largest proportions of males and females initiated alcohol at age 15, tobacco at ages 15-16 and marijuana at ages 16-17. Earlier alcohol and tobacco initiation was associated with past 30-day use of the same substance. Gender differences in alcohol and tobacco use were small but males were significantly more likely than females to use marijuana and be polysubstance users. Family substance use was associated with earlier onset. There was a significant association between the earliest age of any of the three substances and current polysubstance use. CONCLUSIONS: A number of contextual and cultural factors in Mexico may be contributing to early onset, continued use and polysubstance use and deserve attention in research and by prevention programs.

Drinking patterns and victimization among male and female students in Mexico.

AIMS: The purpose of this study is to estimate the prevalence of alcohol use and alcohol-related consequences, identify drinking profiles using latent profile analysis (LPA), and investigate associations between profiles and violent victimization among young people in Mexico. METHODS: LPA identified profiles of drinking behavior in a survey of entering first year university students. Multinomial and logistic regression examined associations between drinking patterns, socio-demographic variables and violent victimization. RESULTS: The LPA identified five profiles of behaviors and consequences among the 22,224 current, former and never drinkers: Non/Infrequent-No Consequences, Occasional-Few Consequences, Regular-Some Consequences, Heavy-Many Consequences and Excessive-Many Consequences drinkers. The Occasional-Few Consequences profile comprised the largest, and the Excessive-Many Consequences profile the smallest, group of drinkers. Multinomial regression showed males and older students more likely to be Heavy or Excessive-Many Consequences drinkers. Living alone was associated with higher odds, and higher maternal education with lower odds, of being a Non/Infrequent-No Consequences drinker. Heavier drinking profiles were more likely to experience violent victimization adverse consequences. Logistic regression showed male and female Heavy and Excessive-Many Consequences drinkers had the highest odds, and Non/Infrequent drinkers the lowest odds, of experiencing any victimization. CONCLUSION: Findings suggest changes in male and female drinking behavior and a continuation of the established pattern of infrequent but high consumption among Mexican youths. Both male and female Heavy and Excessive-Many Consequences drinkers were at elevated risk for experiencing victimization. Identifying cultural gender norms about drinking including drinker expectations and drinking context that contribute to these patterns can inform prevention efforts.

Natural mentors and youth drinking: a qualitative study of Mexican youths.

Parental influences on youth drinking are well documented but not the influence of extended family members. This article explores extended family influences on alcohol use among Mexican youths and whether extended family members can be considered natural mentors. We conducted a qualitative study using ethnographic open ended interviews with 117 first year university students in Mexico City. The ethnographic interviews revealed six drinking groups: excessive, heavy, regular, occasional, abstainers and non drinkers. Youths reported close relationships with extended family members who provided counsel and acted as representatives of familial norms and values. The alcohol beliefs and behaviors of these family members, including their alcohol misuse, had a positive influence on youths' alcohol attitudes. The naturally occurring mentoring relationships of Mexican extended family members can positively influence moderate youth drinking. Natural mentoring relationships should be encouraged and facilitated in prevention efforts for Mexican youths, Mexican-American youths and potentially other Hispanic/Latino youths.

Changes in alcohol use among first year university students in Mexico.

BACKGROUND: Alcohol use and misuse is widespread among university students in many countries. Specific cultural factors may impact alcohol use after entering university. OBJECTIVE: This paper considers changes in alcohol use among first year university students in Mexico. METHODS: A qualitative study using ethnographic interviews with 57 female and 60 male student drinkers in Mexico City from March to June 2011. Each interview was evaluated by a set of thematic codes developed inductively from the interviews. Findings from excessive, heavy, regular, occasional drinkers, abstainers, and non-drinkers were analyzed to explore whether or not linkages existed between and/or among particular themes. RESULTS: Students reported factors associated with changes in role and status, friendships, and increased autonomy as reasons for increasing or decreasing their alcohol use after entering university. CONCLUSIONS/IMPORTANCE: Understanding the influence of Mexican cultural norms on alcohol use among Mexican and Mexican Americans can be helpful in informing studies and preventive efforts among both Mexican and Mexican American young people.

[Rates of frailty among older people ascribed to Chilean primary care clinics]. / Indicadores de fragilidad en adultos mayores del sistema público de salud de la ciudad de Antofagasta.

BACKGROUND: Frailty is not universal among older people but increases the risk of dependence. AIM: To assess frailty among older people and its relationship with biological, psychological and social factors. MATERIAL AND METHODS: Seven hundred fifty four older people aged 73 ± 6 years (61% females), attending a public primary care were assessed. Frailty was defined according to Fried criteria that considers inexplicable weight loss, tiredness, muscle weakness and lack of physical activity. RESULTS: Absence of frailty, pre-frailty and frailty was found in 26, 69 and 5% of participants, respectively. Significant differences between frailty groups were observed for age, gender, years of studies, minimental and self-efficacy scores. Among participants defined as being in a pre-frail condition, 59% were non-disabled without risk and 41% non-disabled in risk, according to the functional assessment for older people used in Chilean primary care clinics. CONCLUSIONS: Frailty among older people is associated with increasing age, education, cognitive status and self-efficacy.

Coastal, valley, and oasis interaction: impact on the evolution of ancient populations in the South Central Andes.

The existing biocultural links are analyzed among ancient inhabitants of the Cochabamba valleys (Bolivia) from the Formative and Tiwanaku periods, coastal and inland Azapa region (Chile) from the Late Archaic to the Late periods, and the Atacama Desert oases (Chile) from the Formative period to the time of European contact. Craniometric information obtained from a sample of 565 individuals from different sites of the studied regions was evaluated using methods derived from quantitative genetics and multivariate statistical analysis techniques. It is shown that during the Formative and Tiwanaku periods inhabitants of the Cochabamba valleys maintained contact with the population of northern Chile. This contact was more fluid with the people from the interior valley of Azapa than it was with the settlers of San Pedro Atacama (SPA). An important biological affinity in the Late Period between the inhabitants of the Azapa valley and the late SPA groups is also examined. The Late-Inca Catarpe SPA sample shows a broad genetic variability shared with the majority of the groups studied. The results reaffirm the differences between the coastal and interior Azapa valley groups and strengthen the hypothesis of two pathways to populating the south central Andean area. The divergence observed among subpopulations can be explained by the spatiotemporal dispersion between them, genetic drift dispersion compensated by the action of gene flow, and cultural norms that regulate within group mating.

Impact Of PET/CT On Treatment In Patients With Head And Neck Squamous Cell Carcinoma.

<b><br>Introduction:</b> Although PET/CT is effective for staging HNSCC, its impact on patient management is somewhat controversial. For this reason, we considered it necessary to carry out a study in order to verify whether PET/CT helps to improve the prognosis and treatment in patients. This study was designed to address the impact of PET-FDG imaging when used alongside CT in the staging and therapeutic management of patients with HNSCC.</br> <b><br>Material and methods:</b> Data was collected from 169 patients diagnosed with HNSCC with both CT and PET/CT (performed within a maximum of 30 days of each other). It was evaluated whether discrepancies in the diagnosis of the two imaging tests had impacted the treatment.</br> <b><br>Results:</b> The combined use of CT and PET/CT led to a change in the treatment of 67 patients, who represented 39.7% of the sample. In 27.2% of cases, it entailed a change in the type of treatment which the patient received. In 3.0% of the cases, using both diagnostic tests led to modifications of the therapeutic intention of our patients.</br> <b><br>Conclusions:</b> Using PET/CT in addition to the conventional imaging method in staging resulted in more successful staging and more appropriate therapeutic decision-making.</br>.

Kinship and post-marital residence in native populations of the South American Chaco.

The genetic structure, kinship and type of post-marital residence are studied in four native groups of the Gran Chaco, through the analysis of somatometric traits. The sample used was published by Lehmann-Nitsche (1907) and is represented by 158 individuals of both sexes. To meet the objectives, methods and techniques of multivariate statistics and population genetics of quantitative traits were applied. The results show a genetic divergence (FST) of 0.047, a greater kinship between chorote and mataco, a significant isolation of the chiriguano, an important interaction of the chorote with the rest of the groups, a greater regional mobility of males than of the women, and a matrilocal or bilocal post-marital residence system.

Survival study in early stages of glottis cancer, stratified by treatment.

INTRODUCTION: Squamous cell carcinoma (SCC) of the vocal cord in stages I or II can be treated with radiotherapy (RT) or transoral CO2 laser microsurgery (TLM), with good oncological results. OBJECTIVES: To study the survival of patients with SCC of the vocal cord in early stages, treated with RT or TLM, in a tertiary hospital. MATERIAL AND METHODS: Disease-free survival (DFS), specific survival (SS), and overall survival (OS) were studied in patients diagnosed with stage I and II SCC of the vocal cord, for a span of 10 years of follow-up, based on sociodemographic characteristics of the patient and the primary treatment (TLM or RT). RESULTS: Both treatments achieved good survival rates. However, long-term SS was greater in patients treated with TLM compared to those treated with RT (91.7% vs. 50%, respectively, p = .001). In addition, patients treated with TLM presented a higher OS in the short term than those treated with RT (99.0% vs. 89.1%, respectively. p = .004). CONCLUSIONS AND SIGNIFICANCE: Primary treatment with TLM obtained better results than RT in the survival of patients with SCC of the vocal cord in the early stages.

Correlation between PET-CT and ct in the staging after the treatment of head and neck squamous cell carcinoma.

OBJECTIVE: The aim of this study is to find out if a single imaging test is enough to follow-up on an oncological post-treatment patient. In such a case, we would know which was more valuable after comparing the two, by CT or PET-CT. METHODS: Between January 2012 and July 2018, we collected data from all patients with previous medical history who were treated with a head and neck squamous cell carcinoma in our hospital, through surgery or by using an organ preservation protocol which we had done. Patients were required to have a CT and a PET-CT performed in a maximum period of 30 days between techniques. We compared the post post-treatment stage given to each case by using only the physical examination (only the CT and the PET-CT), with the ones given by the Tumor Board. After treatment, we analysed the similarity through Cramer's V statistic test. RESULTS: We performed a comparative analysis, obtaining a correlation of 0.426 between the stages given by the Tumor Board and the one assigned based on physical examination, without imaging techniques. By only using the computed tomography as an imaging method the correlation was 0.565, whereas with only the use of positron emission computed technology, it was estimated at 0.858. When we compared the statistical association between stages using exclusively one of the two imaging techniques, the correlation was 0.451. CONCLUSION: Independent of the modality, we have demonstrated that in patients who have received previous treatment, there was a higher correlation in the stages with respect to the diagnostic method conducted by the Tumor Board using PET-CT as the sole image. LEVEL OF EVIDENCE: Level 1.

Economic valuation of a created wetland fed with treated wastewater located in a peri-urban park in Catalonia, Spain.

The main objective of this study was to calculate the economic value (including externalities) of a created wetland located in a peri-urban park in Catalonia, Spain. The wetland, which covers an area of 1 ha, was constructed in 2003 and receives a secondary treated wastewater flow of between 100 and 250 m(3)/day. The externalities of the wetland were evaluated using the travel cost method. The value of the wetland is expressed in terms of the price of the water that flows through the system, which is estimated to range from 0.71 to 0.75 €/m(3). The value of positive externalities (1.25 €/m(3)) was greater than private costs (from 0.50 to 0.54 €/m(3)). These results constitute empirical evidence that created wetlands in peri-urban parks can be considered to be a source of positive externalities when used in environmental restoration projects focusing on the reuse of treated wastewater. This study also illustrates 1) the small influence of the hydraulic infrastructure depreciation costs on the private costs of constructed wetlands (less than 10%), and 2) the low investment costs of constructed wetlands in comparison with operation and maintenance costs (less than 10% of total private costs).

Correlation between PET/CT and CT in the staging prior to the treatment of head and neck squamous cell carcinoma.

INTRODUCTION: Head and neck squamous cell carcinoma is the seventh most common malignant tumor. The advances in treatment have improved the global survival rates in the past years, although the prognosis is still grave. OBJECTIVE: The aim of the present study is to evaluate the correlation between positron emission computed tomography and computed tomography at the time of staging a previously untreated head and neck squamous cell carcinoma, and to determine which of the two imaging techniques gives us more information at the time of initial diagnosis. METHODS: Data from all patients diagnosed in our hospital of head and neck squamous cell carcinoma by a biopsy of any location or unknown primary tumor was collected, between January 2012 and July 2017. In all cases, computed tomography and positron emission computed tomography were performed with a maximum of 30 days difference between them and patients had not received any prior treatment to staging. The stage given to each case was compared based solely on the physical examination, only on the computed tomography/positron emission computed tomography, with respect to the stage given by the tumor board, observing the concordance obtained through Cramer's V statistical test. RESULTS: We performed a comparative analysis obtaining a correlation of 0.729 between the stage given by the tumor board and the one assigned based on the physical examination without imaging techniques. When only using computed tomography as an imaging method, the correlation was 0.848, whereas with only the use of positron emission computed tomography it was estimated at 0.957. When comparing the statistical association between staging using exclusively one of the two imaging techniques, correlation was 0.855. CONCLUSION: Positron emission computed tomography is useful for the diagnosis of head and neck squamous cell carcinoma, improving the patient's staging especially when detecting cervical and distant metastases. Therefore, we consider that the use of positron emission computed tomography for the staging of patients with head and neck squamous cell carcinoma is a diagnostic test to be considered.

Use of lipid emulsions for treatment of local anesthetic toxicity: a case report.

Local anesthetic toxicity remains a clinical concern when performing regional anesthesia. Because signs and symptoms of toxicity may not appear for 20 to 30 minutes after administration of local anesthetic, vigilance is crucial. When signs and symptoms of local anesthetic toxicity appear, traditional standards mandate resuscitative measures, including maintenance of oxygenation, elimination of seizures, and treatment of cardiac arrhythmias. However, intravenous administration of lipid emulsions may offer a viable adjunctive treatment of local anesthetic toxicity. The number of case reports demonstrating successful use of lipid emulsions is growing. Continued research remains pivotal to improve understanding of the theory of lipid emulsion pharmacology and application to clinical practice.

Radiotherapy versus laser microsurgery in the treatment of early glottic cancer.

BACKGROUND: Glottic squamous cell carcinoma (SCC) in stages I or II can be treated by transoral CO2 laser microsurgery (TLM) or exclusive radiotherapy (RT). OBJECTIVES: To compare the oncological results of patients treated with TLM, to those treated with RT, in a tertiary hospital. MATERIAL AND METHODS: Data from patients diagnosed with glottic SCC in stages I and II between 2004 and 2018 were analyzed. Response to treatment was studied in terms of recurrence, local control and laryngeal preservation. RESULTS: Of 164 patients, 63.41% received treatment with TLM and 36.58% with RT. 26.21% presented a recurrence or progression of the tumor. Both treatments obtained good local control rates (84.15% in the case of TLM and 89.6% in the case of RT) and no significant association was found between tumor recurrence and type of treatment, nor with the involvement of the anterior commissure. However, treatment with RT obtained worse laryngeal preservation rate compared to TLM (81.6% and 100% respectively) (p < .001LR). Conclusions and significance: Both treatments obtained good oncological results. There were no significant differences regarding local control. However, TLM obtained a better laryngeal preservation rate. The involvement of the anterior commissure was not a poor prognosis factor for tumor recurrence.

[IgG4 related disease with exclusive sinonasal involvement: A case report and literature review]. / Enfermedad relacionada con IgG4 con afectación exclusiva nasosinusal: presentación de un caso clínico y revisión de la literatura.

IgG4 related disease (igG4-RD) is a pathological process which integrates a large number of diseases of unknown pathogenesis, considered as being exclusive to many different organs. Diagnosis is established through histological, radiological and serological criteria. Treatment is based on long term corticosteroids; rituximab being used only in refractory cases. It is unusual for this entity to be found exclusively in the head and neck, without systemic involvement; there are only a few reported cases to date. We present a case of a nasosinusal IgG4-RD orbital tumor with paranasal sinus involvement. The accurate diagnosis made early onset corticosteroid treatment possible and the patient is currently asymptomatic.

Reliability of the Scapula Reposition Test in Subjects with Rotator Cuff Tendinopathy and Scapular Dyskinesis.

The Scapula Reposition Test (SRT) is proposed to determine if a relationship exists between scapular dyskinesis and shoulder pathology. The purpose of this study was to evaluate intra-rater and inter-rater reliability of the SRT in subjects with rotator cuff tendinopathy and scapular dyskinesis. In addition, we compared subjective strength findings from the test to an objective measure made by dynamometry. The SRT was independently and randomly performed by two physical therapists in 42 subjects. The percent agreement, Cohen's kappa (κ), maximum attainable κ, prevalence and bias indexes, and prevalence-adjusted-bias-adjusted kappa were used as intra- and inter-rater reliability estimates. Finally, the point-biserial correlation coefficient (rpb) was used for correlation analysis of objective and subjective strength findings. A moderate intra-rater (κ = 0.43; CI 95%, 0.14 to 0.73; p = 0.004) and poor inter-rater (κ = 0.08; CI 95%, -0.22 to 0.38; p = 0.61) agreement was found. Subjective strength changes during SRT and dynamometry were poorly correlated (rpb = 0.137; CI 95%, -0.175 to 0.423; p = 0.389). The SRT cannot be recommended for clinical practice. More studies evaluating its reliability are needed as well as further research on the capability of a rater to manually detect strength changes.

The genetic divergence of prehistoric populations of the south-central Andes as established by means of craniometric traits.

The peopling of the south-central Andean region can be determined by exploring a combination of cultural, economic, and biological factors that influence the structure of populations and determine particular dispersals of gene frequencies. Quantitative characters from 1,586 adult crania of both sexes from northern Chile, northwestern Argentina, and the Cochabamba valleys in Bolivia were analyzed employing multivariate statistical analyses. Biological distances, representing phenotypic variation between these regions and their subregions, were studied within a population genetics framework. An analysis of Mahalanobis D(2) distances establishes two principle directions of interaction: the first between the Cochabamba valleys and northern Chile, and the second between the Cochabamba region and northwestern Argentina. The Chile and Argentina regions are shown to be less related to each other than each is to the Bolivian region. A higher mean genetic divergence is found for the entire region (F(ST) = 0.195); with northwestern Argentina having the highest spatial isolation (F(ST) = 0.143) and northern Chile the lowest (F(ST) = 0.061). These results allow us to propose a populating model based on the dispersion of several lines from a common ancestral population similar to those who inhabited the Cochabamba valleys. These lines differentiated themselves in time and space according to the effective size and the rate of gene flow, eventually producing the human groups which inhabited the valleys of northern Chile and northwestern Argentina.

[Study of olfactory function for pyridine in healthy population: influence of variations in humidity]. / Estudio de la sensibilidad olfativa a la piridina en población sana: influencia de las variaciones de humedad.

OBJECTIVES: We study the influence of humidity and its variations on human olfactory threshold for pyridine. MATERIAL AND METHOD: Olfactory function was tested on 154 healthy volunteers without rhino-sinusal pathology. Pyridine was used as odorant in four different concentrations investigating the ability to detect the stimulus and the acuity to estimate its intensity. All subjects were exposed to four pre-set concentrations of pyridine and their ability to detect the stimulus and its intensity was assessed. We measured the variations in ambient humidity and evaluated its effects on the results. RESULTS: A total of 154 healthy volunteers between 20 and 60 years old (69 men and 85 women) were tested for different concentrations of pyridine with an ambient humidity variation of 50 % +/- 20 %. The average humidity was 50.74 % with a standard deviation of 4.95 %. We did not find significant differences (P>.05) for mean humidity measures between volunteers who detected the odorant and those who did not. Nor did we find significant differences when estimating intensity. CONCLUSIONS: We did not find any effect of ambient humidity variation between 42 % and 67 % on human olfactory sensitivity for pyridine.