RESUMEN

El propósito de esta declaración es obtener apoyo mundial para una definición basada en evidencia de la Caries de Primera Infancia (ECC), además de lograr un consenso en la comprensión de la etiología, factores de riesgo e intervenciones para reducir ECC, todas también basadas en evidencia. También presentará políticas y enfoques colaborativos para disminuir esta enfermedad crónica. Con estos antecedentes, 11 expertos de todo el mundo se reunieron bajo el auspicio de la Asociación Internacional de Odontopediatría (IAPD) para formular esta declaración.

RESUMEN

Frailty is an age-associated condition, characterized by an inappropriate response to stress that results in a higher frequency of adverse outcomes (e.g., mortality, institutionalization and disability). Some light has been shed over its genetic background, but this is still a matter of debate. In the present study, we used network biology to analyze the interactome of frailty-related genes at different levels to relate them with pathways, clinical deficits and drugs with potential therapeutic implications. Significant pathways involved in frailty: apoptosis, proteolysis, muscle proliferation, and inflammation; genes as FN1, APP, CREBBP, EGFR playing a role as hubs and bottlenecks in the interactome network and epigenetic factors as HIST1H3 cluster and miR200 family were also involved. When connecting clinical deficits and genes, we identified five clusters that give insights into the biology of frailty: cancer, glucocorticoid receptor, TNF-α, myostatin, angiotensin converter enzyme, ApoE, interleukine-12 and -18. Finally, when performing network pharmacology analysis of the target nodes, some compounds were identified as potentially therapeutic (e.g., epigallocatechin gallate and antirheumatic agents); while some other substances appeared to be toxicants that may be involved in the development of this condition.

Asunto(s)

RESUMEN

The decrease in mortality in critical patient units led to an increase in intensive care unit acquired weakness (ICUAW), which significantly affects the functional performance and quality of life of patients. There are several scales that measure functionality in critical patients. The aim of this systematic review is to determine the criterion validity and reliability of the scales that evaluate functionality in critically ill adult patients. We considered studies in critically ill adult subjects of both genders that determined the psychometric properties of the scales that evaluate functionality. Six minutes' walk test (6MWT), timed up and go (TUG), the Medical Research Council sum score (MRC-SS), grip strength, discharge destination and need for rehabilitation at discharge were considered as gold standards. Three scales were identified: PFIT-s, Perme MS, and DEMMI. PFIT-s has a positive correlation with 6MWT, MRC-SS and grip strength, and a negative correlation with TUG. It also predicts the need for rehabilitation at discharge and discharge to the home. DEMMI has a positive correlation with MRC-SS. the interobserver reliability was evaluated in three articles, demonstrating an almost perfect association. The intraobserver agreement was considered good in one report. With this information, it is not possible to determine which is the instrument with better measurement properties.

Asunto(s)

RESUMEN

The decrease in mortality in critical patient units led to an increase in intensive care unit acquired weakness (ICUAW), which significantly affects the functional performance and quality of life of patients. There are several scales that measure functionality in critical patients. The aim of this systematic review is to determine the criterion validity and reliability of the scales that evaluate functionality in critically ill adult patients. We considered studies in critically ill adult subjects of both genders that determined the psychometric properties of the scales that evaluate functionality. Six minutes' walk test (6MWT), timed up and go (TUG), the Medical Research Council sum score (MRC-SS), grip strength, discharge destination and need for rehabilitation at discharge were considered as gold standards. Three scales were identified: PFIT-s, Perme MS, and DEMMI. PFIT-s has a positive correlation with 6MWT, MRC-SS and grip strength, and a negative correlation with TUG. It also predicts the need for rehabilitation at discharge and discharge to the home. DEMMI has a positive correlation with MRC-SS. the interobserver reliability was evaluated in three articles, demonstrating an almost perfect association. The intraobserver agreement was considered good in one report. With this information, it is not possible to determine which is the instrument with better measurement properties.

Asunto(s)

RESUMEN

Adoptive immunotherapy requires the isolation of CD8+ T cells specific for tumor-associated antigens, their expansion in vitro and their transfusion to the patient to mediate a therapeutic effect. MUC1 is an important adenocarcinoma antigen immunogenic for T cells. The MUC1-derived SAPDTRPA (MUC1-8-mer) peptide is a potent epitope recognized by CD8+ T cells in murine models. Likewise, the T2 cell line has been used as an antigen-presenting cell to activate CD8+ T cells, but so far MUC1 has not been assessed in this context. We evaluated whether the MUC1-8-mer peptide can be presented by T2 cells to expand CD25+CD8+ T cells isolated from HLA-A2+ lung adenocarcinoma patients with stage III or IV tumors. The results showed that MUC1-8-mer peptide-loaded T2 cells activated CD8+ T cells from cancer HLA-A2+ patients when anti-CD2, anti-CD28 antibodies and IL-2 were added. The percentage of CD25+CD8+ T cells was 3-fold higher than those in the non-stimulated cells (P=0.018). HLA-A2+ patient cells showed a significant difference (2.3-fold higher) in activation status than HLA-A2+ healthy control cells (P=0.04). Moreover, 77.6% of MUC1-8-mer peptide-specific CD8+ T cells proliferated following a second stimulation with MUC1-8-mer peptide-loaded T2 cells after 10 days of cell culture. There were significant differences in the percentage of basal CD25+CD8+ T cells in relation to the cancer stage; this difference disappeared after MUC1-8-mer peptide stimulation. In conclusion, expansion of CD25+CD8+ T cells by MUC1-8 peptide-loaded T2 cells plus costimulatory signals via CD2, CD28 and IL-2 can be useful in adoptive immunotherapy.

Asunto(s)

RESUMEN

La endometriosis es una importante causa de dolor abdomino–pélvico en mujeres pre-menopáusicas y adolescentes en edad fértil, afectando en forma importante su calidad de vida. Se desconoce el mecanismo que produce la implantación de tejido endometrial fuera de la cavidad uterina. Sin embargo, la menstruación retrógrada es la hipótesis más aceptada. Dentro de la amplia gama de síntomas asociados a esta patología, el dolor pélvico recurrente, la dismenorrea, la dispareunia e infertilidad están entre las formas más frecuentes de presentación. Sin embargo, esta patología puede comprometer tanto a intestino delgado como recto sigmoides, debiendo ser considerado en el diagnóstico diferencial etiológico de obstrucción intestinal aguda. Se describe el caso de una paciente de 38 años, nulípara, usuaria de anticonceptivos orales; con antecedente de quistectomía anexial izquierda realizada el año 2007, quien presenta cuadro de dolor abdominal recurrente, asociado a vómitos profusos y ausencia de tránsito intestinal, coincidente con su menstruación y de resolución espontánea con el fin de ésta. Durante estudio complementario, bajo sospecha de endometriosis a nivel intestinal, se le realiza prueba terapéutica con agonistas de GnRh, logrando el cese de estos cuadros durante el tiempo de amenorrea, con reagudización de sintomatología obstructiva ante el cese del efecto. Tras identificarse mediante tomografía computada el sitio de obstrucción intestinal en íleon distal, se decide realizar resección del segmento intestinal comprometido por vía laparoscópica. El estudio histopatológico confirma el diagnóstico de endometriosis intestinal...

Endometriosis is a major cause of abdominal / pelvic pain in pre-menopausal and adolescent childbearing age women. The pathophysiological processes of implanted endometrial tissue outside the uterine cavity is unknown. Retrograde menstruation is the more accepted theory. Dysmenorrhea, chronic pelvic pain, dyspareunia and infertility are the most frequent symptoms of endometriosis. However, this disease can affect the small intestine and rectum sigmoid. Therefore, we must consider the endometriosis as a differential diagnosis of acute intestinal obstruction. We describe the case of a nulliparous 38- year-old user of oral contraceptives. She had a history of laparoscopy (left ovarian cystectomy) on 2007. This patient has a history of recurrent abdominal pain, vomiting and absence of intestinal transit, which occurred and ended simultaneously with menstruation. We suspect intestinal infiltration by endometriosis. The patient was administered GnRh agonists, achieving a state of hypoestrogenism and cessation of intestinal symptoms during the time of amenorrhea. Once completed the effect of GnRh agonist, obstructive symptoms reappeared. ACT scan identified the site of intestinal obstruction in the distal ileum, so we decided to perform a laparoscopy to resect the affected bowel segment. Histopathological analysis confirms the diagnosis of intestinal endometriosis...

Asunto(s)

RESUMEN

The respiratory muscle training has been used to improve muscle strength and optimize the mechanism of cough. The aim of this study is to evaluate the effect of abdominal muscle training on respiratory muscle strength (MIP, MEP), peak expiratory flow (PEF) and peak cough flow (PCF) in healthy adolescents. The study design was quasi-experimental, variables of respiratory function were assessed before and after the muscle training protocol in a sample of sedentary healthy adolescents without gender restriction. The sample size calculated was 15 subjects. The training protocol consisted in 8 weeks of training divided into two stages (basic and advanced training plan) twice a week. Descriptive statistics were performed, tests for normality (Shapiro Wilk), U Mann Whitney test, Pearson coefficient and t-student test were used. Results are expressed as mean and its standard deviation. It was considered significant a p value < 0,05. Seventeen subjects (8 males and 9 females) entered to the study, all subjects performed the protocol and completed it without incidents. After completing the training protocol the sit-up test performance increased 21.7% (p = 0.0001), the MIP increase 16,5 cm H2O (17.1%) (p = 0.006), MEP increased 34.9 cm H2O (50,2 %) (p = 0.0001). Moreover, PEF increased 35.3 L/min (8.3%) (p = 0.003) and PCF increased 36.6 L/min (9,1%). There was no correlation between sit-up test performance and lung function variables. PEF showed only a moderate correlation with PCF (r = 0.6; p = 0.007) and MEP (r = 0.59; p = 0.01). We conclude that, in this sample, increases in respiratory muscle strength, PEF and PCF were observed after abdominal muscle training. No association between abdominal muscle strength and respiratory function variables was found before initiating the training protocol.

El entrenamiento muscular respiratorio ha sido utilizado para mejorar la fuerza de los músculos y optimizar el mecanismo de la tos. El objetivo de este estudio es evaluar el efecto del entrenamiento de músculos abdominales sobre la fuerza de los músculos respiratorios (Pimax, Pemax), flujo espiratorio máximo (FEM) y flujo máximo de tos (FMT) en adolescentes sanos. Este estudio es cuasi experimental, donde se evaluaron las variables de función respiratoria antes y después del protocolo de entrenamiento. La muestra estuvo integrada por adolescentes sanos sedentarios sin restricción de sexo. La muestra mínima estimada fue de 15 sujetos. El protocolo de entrenamiento consistió en 8 semanas de entrenamiento dividido en 2 etapas (plan básico y avanzado de ejercicios) dos veces por semana. Se realizó estadística descriptiva, pruebas de normalidad (Shapiro Wilk); se utilizó test U de Mann Whitney, coeficiente de correlación de Pearson y test t-student para muestras pareadas. Los resultados se expresan en promedios y desviación estándar. Se consideró significativo un valor de p < 0,05. Ingresaron al estudio 17 sujetos (8 hombres y 9 mujeres), todos los sujetos realizaron el protocolo completo. Posterior al protocolo los sujetos incrementaron en 21,7% el rendimiento del sit-up test (p=0,0001); la Pimax aumentó 16,5 cm H2O (+17,1%) (p=0.006), la Pemax aumentó 34,9 cm H2O (+50,2%) (p=0,0001). Por otra parte, el FEM aumentó 35,3 L/min (+8,3%) (p=0,003) y el FMT aumentó 36,6 L/min (+9,1%). La fuerza de músculos abdominales no muestra correlación con las variables de función respiratoria. Sólo FEM muestra correlación moderada con el FMT (r = 0,6; p = 0,007) y Pemax (r = 0,59; p = 0,01). Se concluye que, en la muestra estudiada, se observan incrementos en la fuerza muscular respiratoria, FEM y FMT luego de un protocolo de entrenamiento de músculos abdominales. No se observó asociación entre la fuerza muscular abdominal y las variables de función respiratoria antes de iniciado el protocolo.

Asunto(s)

RESUMEN

Con la finalidad de contrastar la hipótesis nula "no hay asociación entre maloclusiones y alteraciones posturales de cabeza y cuello" se realizó un estudio descriptivo transversal en pacientes que consultaron por tratamiento de ortodoncia. La muestra consistió en 116 pacientes con maloclusión atendidos en el Programa de Especialización en Ortodoncia y Ortopedia Dento Máxilo Facial 2007-2009 de la Facultad de Odontología de la Universidad de Chile. Se analizaron las fichas de cada uno de ellos y se buscó asociación entre los valores del Análisis Cráneo Cervical de Rocabado, el cefalograma, estudio de modelos y la evaluación funcional de la lengua. Se encontró asociaciones estadísticas débiles entre la rotación anti horaria del cráneo (ángulo cráneo vertebral y distancia intervertebral C0-C1 disminuidas), con clase III esqueletal que además tenían rotación posterior mandibular y que eran dólico faciales. Altos valores del triángulo hioideo, se asociaron débilmente, con Clase II esqueletal, junto con alteraciones de la posición de la lengua en reposo y retrusión dentaria. Se concluye que en pacientes con maloclusión existe una asociación estadísticamente débil con alteraciones de la postura craneocervical.

In order to test the null hypothesis "there is no association between malocclusion and postural alterations in head and neck" a non-experimental analytical study was carried out in patients with clinical orthodontic treatment. The sample consisted of 116 patients with malocclusion treated at the Specialization Program in Orthodontics and Dento Maxillo Facial Orthopedics from 2007 to 2009, Faculty of Dentistry, Universidad de Chile. We analyzed the records of each patient, for search partnership between the values of Cervical Skull Rocabado Analysis, the cephalogram and study models. We found weak statistical associations between anti-rotation time of the cranium (skull, vertebral angle and distance diminished intervertebral C0-C1), with skeletal class III also had mandibular posterior rotation and were dolicho facial. High values of the hyoid triangle, were weakly associated with skeletal Class II, along with changes in tongue position at rest and dental retrusion. We conclude that in patients with malocclusion there is a statistically weak association with altered craniocervical posture.

Asunto(s)

RESUMEN

Heat transfer plays a key role in cryopreservation of liquid semen in plastic straws. The effect of several parameters on the cooling rate of a liquid-filled polypropylene straw when plunged into liquid nitrogen was investigated using a theoretical model. The geometry of the straw containing the liquid was assimilated as two concentric finite cylinders of different materials: the fluid and the straw; the unsteady-state heat conduction equation for concentric cylinders was numerically solved. Parameters studied include external (convection) heat transfer coefficient (h), the thermal properties of straw manufacturing material and wall thickness. It was concluded that the single most important parameter affecting the cooling rate of a liquid column contained in a straw is the external heat transfer coefficient in LN2. Consequently, in order to attain maximum cooling rates, conditions have to be designed to obtain the highest possible heat transfer coefficient when the plastic straw is plunged in liquid nitrogen.

Asunto(s)

Asunto(s)

RESUMEN

OBJECTIVE: To assess the methods used and results found in two surveys, one conducted in 1984 and the other in 1995, that indicated a large reduction in the prevalence and severity of dental caries among children in Jamaica, with special attention focused on methodological differences between the two surveys and the biological factors that may explain the large reduction in caries. METHODS: In 1984 a modified "pathfinder" methodology was used to measure the prevalence and severity of dental caries in 6-, 12-, and 15-year-old children in Jamaica. A similar survey was conducted in 1995. A comparison of the two surveys showed an 84% reduction in the severity of dental caries at age 12. Both surveys used the same diagnostic criteria and clinical procedures, but the 1984 survey included a higher proportion of rural residents than did the 1995 one. RESULTS: The data show an epidemiological transition between 1984, when dental caries was highly prevalent and severe, and 1995, when the disease was less prevalent and was concentrated in a smaller proportion of the population. CONCLUSIONS: Most of the reduction in dental caries between 1984 and 1995 is attributable to the introduction, in 1987, of salt fluoridation. While the 1995 survey included fewer rural areas than the 1984 survey did, that does not invalidate the observed reduction in dental caries. The use of fluoride toothpaste and dietary fluoride supplements as well as access to dental health promotion and preventive and curative services do not seem to be major contributors to the reductions observed.

Asunto(s)

RESUMEN

PURPOSE: In 1987, Jamaica initiated a comprehensive island-wide salt fluoridation program. A survey was conducted in 1995 to monitor the impact of salt fluoridation among children in Jamaica. METHODS: Dental examinations of 1,120 children aged 6-8, 12, and 15 years were conducted according to World Health Organization criteria to assess dental caries, fluorosis, the presence of and need for dental sealants, and Community Periodontal Treatment Needs (CPI). RESULTS: Age specific DMFT means observed in 1995 were 0.2 at age 7, 0.4 at age 8, 1.1 at age 12 and 3.0 at age 15. The mean DMFT scores in children 6, 12 and 15 years of age were dramatically lower than the corresponding scores of 1.7, 6.7 and 9.6 obtained at the baseline examination in 1984 for children of the same age groups, respectively (baseline data for 7- and 8-year-olds were not collected). The mean percentage of sound permanent teeth for all age groups was 90% in 1995. The percentage of children caries-free at baseline was 27.6% for 6 years, 2.8% for 12 years and 0.3% for 15 years of age. In 1995, the percentage of caries-free children (permanent teeth) was 61%. In 1984, 23 children were scored as having very mild or mild fluorosis. In 1995, five children were scored in the same categories of fluorosis, using Dean's criteria; thus, fluorosis remained at negligible levels in 1995. CONCLUSIONS: The oral health survey conducted in Jamaica in 1995 indicated a significant decline in dental caries compared with findings in 1984. The major change in Jamaica during the interval was the introduction of salt fluoridation in 1987. Dental fluorosis was low in the 1995 survey.

Asunto(s)

RESUMEN

Exposure of mango (Mangifera indica cv. Tommy Atkins) fruit to methyl jasmonate (MJ) vapors (10(-)(4) M) for 24 h at 25 degrees C reduced chilling injury during subsequent storage for 21 days at 7 degrees C and after 5 days of shelf life at 20 degrees C. The chilling tolerance induced by MJ was positively correlated with the reduction in the percent ion leakage of mango tissue. The overall quality of MJ-treated fruit was also better than that of control fruit. MJ treatment increased the total soluble solids but did not affect titratable acidity or pH. MJ also did not change the normal climacteric rise in respiration, water loss, and softening rates. The efficacy of MJ to reduce chilling injury and decay of mango could be related to the tolerance induced at low temperature. It was concluded that MJ treatment may prevent chilling injury symptoms of mango without altering the ripening process.

Asunto(s)

RESUMEN

The lectin from Amaranthus leucocarpus (ALL) is specific for N-acetyl-D-galactosamine and inhibits phagocytosis of Leishmania mexicana promastigotes in Balb/c mice peritoneal macrophages by 38%. The lipophosphoglycan (LPG) purified from L. mexicana inhibits penetration of promastigotes into peritoneal macrophages by 31%; interestingly, treatment of macrophages with both, ALL and LPG, inhibits phagocytosis of promastigotes by 72%, confirming that ALL induces modification of the macrophage's phagocytic activity by a different route than mannose or C3b receptors. The Inhibitory effect of ALL was time-dependent. N-acetyl-D-galactosamine (GalNAc) or O-glycosidically linked glycoproteins modified macrophage phagocytosis of Leishmania. These results suggest that macrophage membrane glycoproteins, possessing constitutive GalNAc, can influence the signaling pathways used by this intracellular parasite to infect.

Asunto(s)

RESUMEN

La hendidura palatina es una malformación de mucha importancia para el niño, por lo cual, hay que presentarle atención rápida para propiciar al paciente una alimentación más fácil, fonación correcta y en forma sostenida el desarrollo de la oclusión. Se presenta un caso donde se evidencia que la intervención a temprana edad del paladar duro deja como secuela el hipodesarrollo del maxilar superior. Esto complica el tratamiento para devolverle al paciente una anatomía correcta y funciones normales

Asunto(s)

RESUMEN

Data on the prevalence and severity of dental caries collected by country members of the Pan American Health Organisation (PAHO) were summarised to analyse current status and trends since the 1970s. The mean number of decayed, missing, and filled teeth (DMF-T) among 12-year-old children and the relative contribution of each DMF-T component were collected from official reports and publications in the scientific literature. Overall, a secular trend toward lower caries prevalence was observed in most countries, more notably among those with large prevention programmes using fluorides. Many countries have reached the World Health Organization (WHO) year 2000 goal of a mean DMF-T of < or = 3 but others are still far from reaching that goal. Few countries have reached the status of having large proportions of disease prevalence localised in a small percentage of the population, a pattern observed as prevalence decreases. Since 1994, PAHO's Regional Oral Health Program has developed two strategies to address these issues: the introduction and reinforcement of national preventive programmes using fluorides and the introduction of the atraumatic restorative treatment (ART).

Asunto(s)

RESUMEN

This study was carried out to evaluate the marginal discrepancy of collarless metal ceramic restorations, using a combination of three different techniques to manufacture the porcelain butt margin with two brands of body porcelain. Statistical analysis showed no significant difference between the techniques or brands of body porcelain used in this study.

Asunto(s)

RESUMEN

Since 1958 the World Health Organization (WHO) has recommended the use of RT-23 (2 tuberculin unit [TU] purified protein derivative [PPD]) instead of the standard 5 TU PPD to establish the prevalence of tuberculosis (TB) around the world. Before starting a hospital program to control the transmission of TB among health care workers at the National Institute of Nutrition (Mexico City), we compared the tuberculin product commonly used in Mexico (RT-23) with that used in the United States (5 TU PPD). In this trial the Mantoux test was performed on 80 health care workers from various areas of the hospital: 5 TU PPD and RT-23 were simultaneously inoculated in the left forearm and in the right forearm, respectively. The test results for both tuberculin products were read 72 hours later. When a 10-mm induration was used as the cutoff for reactivity, the specificity with use of RT-23 was 100%, but the sensitivity was only 57%. However, when a 5-mm induration was used as the cutoff, the sensitivity with use of RT-23 was 90%. Because of these findings, we advise that every country using RT-23 either consider changing the cutoff for reactivity or consider using 5 TU PPD for reassessment of the data on the incidence and prevalence of TB that were obtained with use of RT-23 (the product recommended by WHO).

Asunto(s)

RESUMEN

Means of vascular access are fundamental in the management of cancer. However, since current intravenous devices for long-term treatment are expensive and necessitate a high degree of education among medical personnel, in developing countries they are impractical for use in most of the population. We describe the use of a nontunneled, low-cost, long-lasting Silastic catheter (LLSC), cared for by an intravenous therapy team (IVTT), in 462 patients with cancer. The rate of infectious complications was 0.66 infections per 1,000 catheter-days, which is as low as that reported in association with other catheters in developed countries. Neutropenia and skin and/or soft-tissue infections were significant risk factors associated with LLSC-related infections. We believe that use of this catheter may be an alternative for patients with cancer who need chemotherapy, as long as an IVTT is established for its care. Our experience could be useful for practitioners in countries with similar socioeconomic characteristics.

Asunto(s)

RESUMEN

We analyzed the type and dosage of opiates used for pain in a large general hospital from April to September 1985. Information was obtained from the computerized data base in 234 patients with a mean age of 49 years. Most patients came from the surgical service. The route of administration was intramuscular in 64% and not specified in 10% of patients. The most common drug was meperidine, the dose being 65 ñ 26 mg intramuscular and 39 ñ 26 intravenously. Methadone and morphine were used with less frequency. Good analgesic effect was recorded in 42 of 71 (59%) of patients, but the effect was not written down in the majority of subjects (70%). Other analgesics were associated in 73% of cases, most commonly a pyrazolone derivative. Nausea or vomiting was observed in only 12 patients; there were no instances of respiratory depression. We conclude that the dose of opiate used was frequently low and the associated drugs were not the best to obtain increased analgesic effect. Better recording of clinical effect of analgesics is needed in medical practice

Asunto(s)