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In this study, we evaluated the impact of incorporating diblock and triblock amphiphilic copolymers, as well as cholesterol into DPPC liposomes on the release of a model molecule, calcein, mediated by exogenous phospholipase A2 activity. Our findings show that calcein release slows down in the presence of copolymers at low concentration, while at high concentration, the calcein release profile resembles that of the DPPC control. Additionally, calcein release mediated by exogenous PLA2 decreases as the amount of solubilized cholesterol increases, with a maximum between 18 mol% and 20 mol%. At concentrations higher than 24 mol%, no calcein release was observed. Studies conducted on HEK-293 and HeLa cells revealed that DPPC liposomes reduced viability by only 5% and 12%, respectively, after 3 hours of incubation, while DPPC liposome in presence of 33 mol% of Cholesterol reduced viability by approximately 11% and 23%, respectively, during the same incubation period. For formulations containing copolymers at low and high concentrations, cell viability decreased by approximately 20% and 40%, respectively, after 3 hours of incubation. Based on these preliminary results, we can conclude that the presence of amphiphilic copolymers at low concentration can be used in the design of new DPPC liposomes, and together with cholesterol, they can modulate liposome stabilization. The new formulations showed low cytotoxicity in HEK-293 cells, and it was observed that calcein release depended entirely on PLA2 activity and the presence of calcium ions.
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Obesity in women of reproductive age has a number of adverse metabolic effects, including Type II Diabetes (T2D), dyslipidemia, and cardiovascular disease. It is associated with increased menstrual irregularity, ovulatory dysfunction, development of insulin resistance and infertility. In women, estradiol is not only critical for reproductive function, but they also control food intake and energy expenditure. Food intake is known to change during the menstrual cycle in humans. This change in food intake is largely mediated by estradiol, which acts directly upon anorexigenic and orexigenic neurons, largely in the hypothalamus. Estradiol also acts indirectly with peripheral mediators such as glucagon like peptide-1 (GLP-1). Like estradiol, GLP-1 acts on receptors at the hypothalamus. This review describes the physiological and pathophysiological mechanisms governing the actions of estradiol during the menstrual cycle on food intake and energy expenditure and how estradiol acts with other weight-controlling molecules such as GLP-1. GLP-1 analogs have proven to be effective both to manage obesity and T2D in women. This review also highlights the relationship between steroid hormones and women's mental health. It explains how a decline or imbalance in estradiol levels affects insulin sensitivity in the brain. This can cause cerebral insulin resistance, which contributes to the development of conditions such as Parkinson's or Alzheimer's disease. The proper use of both estradiol and GLP-1 analogs can help to manage obesity and preserve an optimal mental health in women by reducing the mechanisms that trigger neurodegenerative disorders.
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Diabetes Mellitus Tipo 2 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Resistência à Insulina , Humanos , Feminino , Estradiol , Peptídeo 1 Semelhante ao Glucagon , ObesidadeRESUMO
RESUMEN: El maltrato infantil es una grave vulneración a los derechos humanos de los niños, que afecta su salud física, mental y emocional, y que puede provocar además graves consecuencias en su vida adulta. El odontólogo tiene la responsabilidad de detectar los posibles casos de maltrato infantil y tomar acciones para detenerlo en una etapa temprana. Sin embargo, muchas veces la decisión de intervenir y/o denunciar un caso se hace difícil, pues no se posee las herramientas para objetivar la sospecha. Aplicando el método Delphi, con el apoyo de destacados expertos nacionales, se desarrolló un breve formulario de auto-aplicación para el odontólogo, en el que se definieron siete puntos clave que se deben examinar al enfrentarse a un niño lesionado que llega a la clínica odontológica. Este formulario guía al cirujano dentista en el reconocimiento de las señales y signos clínicos de abuso, y le permite determinar cuándo un caso presenta suficientes elementos que apuntan a posible maltrato infantil y se hace recomendable su denuncia, tal como indica la ley. La aplicación del formulario mejorará la pesquisa de los casos, que es el primer paso para asegurar el bienestar de las niñas y los niños maltratados.
ABSTRACT: Child abuse is a serious violation of children's human rights, that affects their physical, mental and emotional health, and can, furthermore, have serious consequences in their adult life. Dentists have the responsibility to detect possible cases of child abuse and take actions to put a stop to it at an early stage. However, often the decision to report a case is made difficult due to a lack of tools to express an objective suspicion. Applying the Delphi method with the support of prominent national experts, a short self-application questionnaire was developed to be applied by odontologists in the dental clinic, defining seven key points that should be examined when handling the case of an injured child. The questionnaire guides dentists in recognizing the signs of abuse and deciding when a case has enough elements suggesting possible child abuse that it is advisable to report it, as required by law. Applying this questionnaire will improve the detections of cases, which is the first step to ensure the wellbeing of abused children.
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Stress is known to be associated with adverse health outcomes. The COVID-19 pandemic and its associated lockdowns are examples of chronic stressors. Lockdown measures inadvertently caused significant psychological distress and became a powerful source of anxiety/stress, sleep disturbances, nutritional changes and weight gain. Stress is known to impact women's health specifically, through hypothalamic-pituitary-gonadal (HPG) axis dysfunction and resultant ovulatory dysfunction. Such dysfunction may manifest in menstrual irregularities and/or infertility due to hypothalamic hypogonadism. Here, we review the key physiological mediators of stress and associated ovulatory dysfunction. The kisspeptinergic system is comprised of sets of neurons located in the hypothalamus, the rostral periventricular region of the third ventricle (RP3V) and the arcuate nucleus (ARC). This system links nutrition, reproductive signals and stress. It plays a key role in the function of the HPG axis. During chronic stress, the kisspeptinergic system affects the HPG axis, GnRH pulsatility, and, therefore, ovulation. Leptin, insulin and corticotrophin-releasing hormone (CRH) are thought to be additional key modulators in the behavioral responses to chronic stress and may contribute to stress-related ovulatory dysfunction. This mini-review also summarizes and appraises the available evidence on the negative impact of chronic stress as a result of the COVID-19 pandemic lockdowns. It proposes physiological mechanisms to explain the observed effects on women's reproductive health and well-being. The review suggests areas for future research.
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The Smoothened (SMO) receptor is the most druggable target in the Hedgehog (HH) pathway for anticancer compounds. However, SMO antagonists such as vismodegib rapidly develop drug resistance. In this study, new SMO antagonists having the versatile purine ring as a scaffold were designed, synthesised, and biologically tested to provide an insight to their mechanism of action. Compound 4s was the most active and the best inhibitor of cell growth and selectively cytotoxic to cancer cells. 4s induced cell cycle arrest, apoptosis, a reduction in colony formation and downregulation of PTCH and GLI1 expression. BODIPY-cyclopamine displacement assays confirmed 4s is a SMO antagonist. In vivo, 4s strongly inhibited tumour relapse and metastasis of melanoma cells in mice. In vitro, 4s was more efficient than vismodegib to induce apoptosis in human cancer cells and that might be attributed to its dual ability to function as a SMO antagonist and apoptosis inducer.
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Antineoplásicos/farmacologia , Neoplasias/tratamento farmacológico , Purinas/farmacologia , Receptor Smoothened/antagonistas & inibidores , Animais , Antineoplásicos/química , Antineoplásicos/uso terapêutico , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Células HT29 , Proteínas Hedgehog/metabolismo , Humanos , Camundongos Endogâmicos C57BL , Neoplasias/metabolismo , Purinas/química , Purinas/uso terapêutico , Transdução de Sinais/efeitos dos fármacos , Receptor Smoothened/metabolismoRESUMO
RESUMEN En el presente trabajo se caracterizó la flora briofítica en troncos en descomposición en la estación meteorológica El Zafire, Amazonas-Colombia. Para ello se realizó un muestreo de 100 unidades muestrales en 20 troncos en diferente estado de descomposición y en dos tipos de bosque (tierra firme y varillal inundable). Se reportan 120 especies, 81 hepáticas y 39 musgos, pertenecientes a 55 géneros (33 hepáticas y 22 musgos) y 21 familias (nueve hepáticas y 12 musgos). Se registran cuatro especies nuevas para el país, 25 para la amazonia colombiana y 41 para el departamento del Amazonas. En términos de riqueza total, el bosque de varillal presentó un valor mayor al de tierra firme. Sin embargo, esta diferencia no es significativa (Kruskal Wallis X 2=0,199; p = 0,05); así mismo la diversidad fue mayor en el bosque de varillal inundable (Shanon = 3,93) en comparación con la del bosque de tierra firme (Shanon = 3,67). La composición de las comunidades de briófitos fue diferente entre los dos tipos de bosques (similitud igual a 40 %). En el estudio florístico de los dos tipos de bosques de la estación biológica, se evidenció una marcada dominancia de la familia Lejeunaceae, que representó el 55,5 % de las hepáticas y el 37,5 % del total de las especies de briófitos.
ABSTRACT The present study aims to characterize the bryophyte community on rotten logs in El Zafire biological station, Amazonas-Colombia. We sampled 100 plots on 20 trunks with different states of decomposition in two types of forest (terra firme and floodplain). 120 species are reported, 81 liverworts and 39 mosses, belonging to 55 genera (33 liverworts and 22 mosses) and 21 families (nine liverworts and 12 mosses). Four new species are registered for Colombia, 25 for the Colombia Amazon, and 41 for the department of Amazonas. In terms of richness, the floodplain presented a higher value than the terra firme forest. However, no significant difference was found between the two types of forests (Kruskal Wallis X 2c= 0.199, X 2t= 3.81). Diversity was higher in the floodplain (Shanon = 3.93) compared to the terra firme forest (Shanon = 3.67). The composition of the bryophyte communities shows differences between the two types of forests (similarity equal to 40 %). In the floristic study of the two types of forests of the biological station, the most common family was Lejeuneaceae, it represented 55.5 % of the liverworts sampled and 37.5 % of the total of the bryophyte species.
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RESUMEN: Hipomineralización Molar-Incisal (MIH) es un trastorno del desarrollo dentario asociado a factores sistémicos, producido por una incompleta mineralización y maduración del esmalte. La prevalencia en niños, a nivel mundial, varía en la literatura entre el 2,4 % y el 40,2 %. Este trastorno que implica al menos un primer molar permanente, pudiendo también verse afectados los incisivos, dependiendo del momento, la duración, la susceptibilidad del individuo y la gravedad de la injuria prenatal, perinatal o postnatal. El esmalte presenta un grado variable de alteración en la translucidez, siendo éste de un espesor normal y de color blanco, o café-amarillo. Si bien se encuentra intacto en el momento de la erupción, puede sufrir fracturas post eruptivas debido a las fuerzas de la masticación, dejando límites definidos. Por lo general, los molares gravemente afectados son extremadamente hipersensibles, propensos a lesiones de caries de rápida progresión, y pueden ser difíciles de tratar en pacientes jóvenes. La atención debe abordar el comportamiento y la ansiedad del niño, con el objetivo de proporcionar restauraciones duraderas en condiciones libres de dolor. La ejecución de medidas preventivas individuales puede posponer el inicio del tratamiento restaurador y reducir la incomodidad del paciente a largo plazo. El diagnóstico precoz permitirá el seguimiento y la instauración de dichas medidas preventivas tan pronto las superficies afectadas sean accesibles. Pese a que los enfoques de tratamiento para MIH han comenzado a ser más claros y los avances en los materiales dentales han proporcionado soluciones clínicas en los casos que se consideraban sin posibilidad de restauración en el pasado, deben llevarse a cabo ensayos clínicos a largo plazo para facilitar aún más el manejo clínico de este cuadro.
ABSTRACT: Molar Incisor Hypomineralization (MIH) is a tooth development disorder, which is associated with systemic factors, produced by incomplete enamel mineralization and maturation below the enamel surface that is intact at the time of eruption. In literature, the prevalence in children worldwide varies between 2.4 % and 40.2 %. This disorder which involves at least one first permanent molar, and depending on duration, the child's susceptibility as well as the severity of prenatal, perinatal or postnatal insult may also compromise incisors. The defect reveals a variable degree of alteration in the translucency of the enamel, that has initially normal thickness and can be white, yellow or brown. Enamel surface may breakdown after eruption, due to masticatory forces, leaving sharp borders. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The complex care involved must address the child's behavior and anxiety, aiming to provide pain free treatment and durable restorations. Intensive individually prescribed preventive programs may postpone the onset of restorative treatment and reduce patient discomfort in the long term. Early identification of such children will allow monitoring and implementation of preventive measures as soon as affected surfaces are accessible. Although treatment approaches for MIH have become more clear, and advances in dental materials have provided clinical solutions in cases that in the past were regarded as unrestorable, long-term clinical trials should be realized to further facilitate clinical management of this dental defect.
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Humanos , Desmineralização do Dente/patologia , Desmineralização do Dente/prevenção & controle , Desmineralização do Dente/terapia , Esmalte Dentário/anormalidadesRESUMO
High incidence of Rho Cdc42-GTPase overexpression has been found in Colorectal Cancer (CRC) samples, suggesting its potential role in tumor development. However, no conclusive studies have shown the lack of mutations and/or copy number of Cdc42 gene in this type of samples. To understand mutation/deletion and copy number status of Cdc42 gene, CRC patients were evaluated for both parameters. More than Cdc42 mutants, single-nucleotide variants were found. Analysis of regions flanking the Cdc42 gene showed allelic imbalance; 58.7% were loss of heterozygosity (LOH) positive and 14.8% presented microsatellite instability. The highest LOH percentage was located between microsatellite markers D1S199 and D1S2674, where the Cdc42 gene is located. No association between gender, age, and tumor stage was found. LOH validation through gene dosage analysis showed most CRC patients with allelic imbalance also presented a low gene dosage of Cdc42, although equal amounts of Cdc42 mRNA were detected in all samples. Although changes in Cdc42 expression were not found in any condition, Cdc42 activation was different between high and normal gene dosage samples, but not between samples with normal and low copy number. Low dosage of Cdc42 was also not related to changes in methylation status at the Cdc42 promoter region. Results suggest that low copy of Cdc42 gene is not associated with Cdc42 protein dysfunction in CRC patients.
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Neoplasias Colorretais/genética , Dosagem de Genes , Regulação Neoplásica da Expressão Gênica , Perda de Heterozigosidade , Proteína cdc42 de Ligação ao GTP/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Colo/metabolismo , Colo/patologia , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Repetições de Microssatélites , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Deleção de Sequência , Proteína cdc42 de Ligação ao GTP/deficiênciaRESUMO
Introducción: La pérdida prematura de incisivos primarios puede producir alteraciones estéticas, funcionales y psicológicas. La rehabilitación protésica permite reemplazar los dientes faltantes y evitar las secuelas que ello puede acarrear. Objetivo Describir la técnica y evolución clínica de una prótesis fija anterior tipo Denari durante 12 meses de seguimiento. Descripción del caso Paciente de sexo femenino de 3 años de edad que acude en busca de atención profesional posterior a la avulsión de los incisivos centrales superiores. Con la finalidad de devolver la estética del sector anterosuperior, recuperar la función oral e interferir con el hábito de interposición lingual se decidió realizar una terapia basada en prótesis parcial fija tipo Denari. Durante el año de seguimiento la prótesis fue muy bien tolerada por la paciente y sin alteración de los tejidos blandos adyacentes, destacando un aumento en el espacio interincisal, lo que demuestra el crecimiento transversal. Conclusión La prótesis dental en niños es una tarea exigente, marcada por la necesidad de adaptación a los cambios continuos que conllevan los procesos de crecimiento y maduración de complejo maxilofacial. En este contexto es que la prótesis tipo Denari con sistema tubo-barra es una excelente y estética alternativa en pacientes de corta edad en donde la prótesis va a permanecer en la boca por un largo período de tiempo, sin interferir en el crecimiento, desarrollo y función del sistema estomatognático.
Introduction: Premature loss of primary incisors may result in aesthetic, functional and psychologic problems. Prosthetic restoration allows replacing missing teeth, avoiding the unwanted consequences that their absence may carry. Objective The aim of this clinical case is to describe the technique and clinical evolution of a Denari fixed anterior prosthesis over 12 months of follow-up. Case description 3 year-old female patient sought professional attention after the avulsion of the upper central incisors. In order to restore the natural appearance of the anterior superior area, recover oral function and intervene in the habit of tongue interposition, the treatment decided upon was a partially fixed Denari prosthesis. During the follow-up year the prosthesis was very well tolerated by the patient and without altering any adjacent soft tissues. We highlight an increase in the interincisal space, which demonstrates transversal growth. Conclusion A dental prosthesis in a child is a demanding task marked by the need to adapt to the continuous changes brought about by maxillofacial growth and maturation. It is in this context that the Denari prosthesis with its tube-bar system is an excellent and esthetic alternative in young patients where the prosthesis is going to remain in place for a prolonged period without interfering in the growth, development and function of the stomatognatic system.
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Humanos , Feminino , Pré-Escolar , Avulsão Dentária/terapia , Prótese Parcial Fixa , Mantenedor de Espaço em Ortodontia/instrumentação , Dente Decíduo , Evolução Clínica , Odontopediatria , Resultado do TratamentoRESUMO
Los avances en medicina y en particular en pediatría han permitido sobrevivir a más niños que nacen prematuros. Aunque la mayoría de los sobrevivientes no tienen inconvenientes en su desarrollo, un significativo número de niños demuestran discapacidad en su neurodesarrollo. En los prematuros, las complicaciones y las secuelas neurológicas, aumentan con la disminución de la edad gestacional y el peso al nacer. La parálisis cerebral es la discapacidad neuromuscular más frecuente que afecta a los niños, y constituyen un grupo de alto riesgo de patologías orales. El reporte del presente caso clínico, muestra el tratamiento odontológico de un pre-escolar con parálisis cerebral, realizado en forma ambulatoria, sin premedicación ni anestesia general, sustentado en un conocimiento profundo de la patología basal médica y características individuales. La compresión de las enfermedades orales, la aplicación de técnicas de manejo conductual y la sensibilización del clínico, permitieron controlar y mejorar el deplorable estado de salud oral del pre-escolar, contribuyendo por lo tanto a una mejor calidad de vida. La promoción, la prevención y recuperación de la salud oral en los pacientes con necesidades de cuidados especiales de salud debe ser una parte integral de la odontología, para lo cual el odontopediatra debe estar integrado al equipo multidisciplinario, que busca brindar atenciones adecuadas a las necesidades de este grupo en particular.
Advances in medicine, particularly in pediatric medicine, have enabled more premature babies to survive. While the majority of the survivors present trouble-free development, a significant number of all children present disabilities in their neural development. In premature babies, the neurological complications and consequences increase inversely with the gestational age and weight at birth. Cerebral palsy is the most common neuromuscular disability affecting these children, and as a group they also present a high risk of oral pathologies. The report of the present clinical case describes the dental treatment of a pre-school child with cerebral palsy, in outpatient conditions and without either pre-medication or general anaesthesia, based on a profound knowledge of the basic medical pathology and individual characteristics. The understanding of oral disease, the use of behavioral management techniques and raising awareness in the clinic, enabled the child's deplorable state of oral health to be controlled and improved, thus contributing to a better quality of life. Preventative measures and the promotion and recovery of oral health in patients requiring special health care must be an integral part of dentistry. This requires the dental-pediatrician to form part of a multidisciplinary team specializing in providing proper treatment for the needs of this particular group.
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Humanos , Feminino , Pré-Escolar , Paralisia Cerebral/patologia , Assistência Odontológica , Saúde Bucal , Crianças com Deficiência , Placa Dentária , Gengivite , Consentimento Livre e EsclarecidoRESUMO
El pediatra sostiene una estrecha relación con el niño y sus padres durante sus primeros años de vida, teniendo periódicamente la oportunidadde detectar problemas orales y educar en su prevención. El objetivo de este estudio fue evaluar los conocimientos, actitudes y experiencia profesional de pediatras chilenos en relación a la salud oral infantil. Se aplicó una encuesta a 164 pediatras asistentes al 50 Congreso Chileno de Pediatría. El instrumento fue traducido y adaptado de la encuesta nacional para pediatras de la Universidad de Washington. La validez de fachada y contenido fue evaluada mediante un grupo focal compuesto por pediatras. La encuesta incluyó datos demográficos, aspectos relacionados con su conocimiento sobre terapias preventivas en salud oral, su opinión sobre su rol en promoción de salud oral, su experiencia para detectar problemas orales y barreras existentes al referir pacientes al odontólogo. Los resultados mostraron que el 64% de los encuestados reportaron diagnosticar caries en preescolares al menos una vez al mes. El 51,53% estaba de acuerdo con derivar al odontólogo al niño al año de edad, sin embargo, 55,82% reportó dificultad al referir pacientes menores de 2 años. Sólo 3% respondió correctamente todas las preguntas sobre conocimiento. 66,87% nunca recibió instrucción en salud oral durante su formación como especialista. A pesar que los pediatras asumen que la salud oral es un aspecto importante de la salud general y que se enfrentan frecuentemente a patologías orales, reconocen que no cuentan con los conocimientos y estrategias de derivación oportuna, para participar de la prevención de ellas.
The pediatrician holds a close relationship with children and their parents during the first years of life. As such, this professional has regular opportunities to perform screening dental examination in young children and to educate families on preventive oral health. The aim of this study was to assess Chilean pediatricians' knowledge, attitudes and professional experience regarding children's oral health. A survey was responded by 164 pediatricians attending the 50th Chilean Pediatrics Convention. The survey questionnaire was translated and adapted from a national survey for pediatricians designed by the Department of Pediatrics, University of Washington. The face and content validity of the instrument was evaluated through a focus group with Chilean pediatricians. The survey included demographic data, elements related to knowledge about oral preventive therapies, their own role in oral health promotion, their experience to screen oral problems and the barriers to refer patients to the dentist. The results showed that 64% of the respondent pediatricians reported to diagnose dental cavities in preschool children at least once a month. 51.53% agreed with referring children to the dentist from the age of 1, however 55.82% found difficulties to successfully refer children under 2 years old. Only 3% of the respondents answered all knowledge questions correctly. 66.87% never received training in oral health during their pediatrics specialization studies. In spite of the general consensus about the relevance of oral health and the frequent encounter with oral pathologies, pediatricians acknowledge that they do not possess enough knowledge nor referral strategies to participate in their prevention.
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BACKGROUND & AIMS: Cdc42 is a Rho GTPase that regulates diverse cellular functions, including proliferation, differentiation, migration, and polarity. In the intestinal epithelium, a balance among these events maintains homeostasis. We used genetic techniques to investigate the role of Cdc42 in intestinal homeostasis and its mechanisms. METHODS: We disrupted Cdc42 specifically in intestinal epithelial cells by creating Cdc42flox/flox-villin-Cre+ and Cdc42flox/flox-Rosa26-CreER+ mice. We collected intestinal and other tissues, and analyzed their cellular, molecular, morphologic, and physiologic features, compared with the respective heterozygous mice. RESULTS: In all mutant mice studied, the intestinal epithelium had gross hyperplasia, crypt enlargement, microvilli inclusion, and abnormal epithelial permeability. Cdc42 deficiency resulted in defective Paneth cell differentiation and localization without affecting the differentiation of other cell lineages. In mutant intestinal crypts, proliferating stem and progenitor cells increased, compared with control mice, resulting in increased crypt depth. Cdc42 deficiency increased migration of stem and progenitor cells along the villi, caused a mild defect in the apical junction orientation, and impaired intestinal epithelium polarity, which can contribute to the observed defective intestinal permeability. The intestinal epithelium of the Cdc42flox/flox-villin-Cre+ and Cdc42flox/flox-Rosa26-CreER+ mice appeared similar to that of patients with microvillus inclusion disease. In the digestive track, loss of Cdc42 also resulted in crypt hyperplasia in the colon, but not the stomach. CONCLUSIONS: Cdc42 regulates proliferation, polarity, migration, and differentiation of intestinal epithelial cells in mice and maintains intestine epithelial barrier and homeostasis. Defects in Cdc42 signaling could be associated with microvillus inclusion disease.
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Mucosa Intestinal/citologia , Intestino Delgado/citologia , Proteína cdc42 de Ligação ao GTP/fisiologia , Animais , Diferenciação Celular , Movimento Celular , Polaridade Celular , Proliferação de Células , CamundongosRESUMO
La Hipomineralización Molar Incisal (MIH) es una alteración del desarrollo dentario, que estaría asociada a causas de origen sistémico, e involucra al menos uno o más primeros molares permanentes, pudiendo estar comprometidos los incisivos. La prevalencia de este síndrome varía en la literatura entre 2,5 a 40 por ciento en la población infantil mundial. El objetivo de este estudio fue determinar la frecuencia y grado de severidad de MIH entre los pacientes atendidos en la Clínica de Odontopediatría de pregrado y postgrado de la Universidad de La Frontera y los posibles factores asociados. Se realizó un estudio descriptivo en 334 niños entre 6 y 13 años de edad. El examen fue realizado por 2 examinadores en las clínicas de la Universidad de la Frontera. Se estableció el diagnóstico, de acuerdo a los criterios establecidos por Weerheijm et al. (2003) y la severidad según a los criterios propuestos por Mathu-Muju & Wright (2006). La prevalencia encontrada correspondió a 16,8 por ciento. De estos, el 57 por ciento mostró signos severos de MIH, el 20 por ciento signos moderados y 23 por ciento signos leves. No hubo diferencias significativas por sexo y edad respecto a la presencia de MIH o su severidad. El 87 por ciento de los afectados reportó antecedentes mórbidos en el período comprendido desde el preparto hasta la primera infancia. Esta patología presenta alta prevalencia en los pacientes muestreados, comparable a la establecida en estudios realizados a nivel mundial.
Molar incisor hypomineralization (MIH) is a tooth development disorder, which would be associated with systemic causes, and involves at least one or more first permanent molars, incisors may be compromised. The prevalence of this syndrome varies in literature between 2.5 to 40 percent of the world's children. The aim of this study was to determine the frequency and severity of MIH between patients attended at the Graduate Pediatric Dentistry Clinic of the Universidad de La Frontera and the possible associated factors. We conducted a descriptive study of 334 children between 6 and 13 years of age. The review was conducted by 2 examiners at the Universidad de La Frontera. The diagnosis, according to the criteria established by Weerheijm et al (2003) and severity according to the criteria proposed by Mathu-Muju & Wright (2006). The prevalence found corresponded to 16.8 percent. Of these, 57 percent showed severe signs of MIH, 20 percent and 23 percent moderate and mild signs respectively. No significant differences by sex and age for the presence of MIH or its severity. 87 percent of those affected reported morbid history in the period from pre-early childhood. This disorder has high prevalence in patients sampled, comparable to that established in studies worldwide.
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Humanos , Masculino , Adolescente , Feminino , Criança , Desmineralização do Dente/epidemiologia , Desmineralização do Dente/patologia , Distribuição por Idade e Sexo , Chile/epidemiologia , Epidemiologia Descritiva , Incisivo , Dente Molar , Prevalência , Índice de Gravidade de DoençaRESUMO
En 11 pacientes se realizaron 7 pulpotomías con agregado trióxido mineral (MTA) y 6 con Sulfato Férrico (SF). Se incluyeron pacientes que presentaron dientes primarios con exposición accidental de la pulpa durante la remoción de caries en ausencia de signos y síntomas clínicos y/o radiográficos de patología pulpar. Las piezas tratadas fueron restauradas con coronas preformadas de acero inoxidable y controladas clínica y radiográficamente cada 6 meses. El seguimiento promedio fue de 15,6 meses para ambos grupos, con éxito clínico de un 100 por ciento para ambos medicamentos. El éxito radiográfico fue de 85,71 por ciento para el MTA y de 83,33 por ciento para el SF. Si bien ambos medicamentos presentaron un buen desempeño clínico y radiográfico durante el periodo de seguimiento, el SF fue más económico y necesitó un menor tiempo de trabajo, característica deseable en odontopediatría.
In eleven patients 7 pulpotomies were performed with Mineral Trioxide Aggregate (MTA) and 6 with ferric sulphate (FS). We included patients who had primary teeth with accidental exposure of the pulp during caries removal in the absence of clinical signs and symptoms and / or radiographic evidence of pulpal pathology. The treated pieces were restored with preformed stainless steel crowns and controlled clinically and radiographically every 6 months. The average follow-up was 15.6 months for both groups, with clinical success of 100 percent for both treatments. Radiographic success was 85.71 percent for the MTA and 83.33 percent for SF.ÊAlthough both procedures showed good performance during the clinical and radiographic follow-up period, the SF was cheaper and required less working time, a desirable characteristic in pediatric dentistry.
Assuntos
Humanos , Pré-Escolar , Criança , Alumínio/uso terapêutico , Compostos Férricos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Dente Decíduo , Exposição da Polpa Dentária/terapia , Pulpotomia/métodos , Silicatos/uso terapêutico , Combinação de Medicamentos , Exposição da Polpa Dentária , Seguimentos , Óxidos/uso terapêutico , Pulpotomia/efeitos adversos , Análise de Sobrevida , Resultado do TratamentoRESUMO
Comparado con la población adolescente y adulta, las fracturas del esqueleto facial y región maxilomandibular, son poco comunes en el paciente pediátrico, especialmente en pre-escolares menores de 5 años. Las fracturas de los huesos de la región facial en el niño son una entidad patológica muy especial, ya que los pacientes de esta edad están en procesos de crecimiento y desarrollo, los maxilares presentan corticales muy delgadas, y en su espesor se encuentran los gérmenes dentarios permanentes en desarrollo y dientes en proceso de erupción. Existen y se han descrito diferentes estrategias de abordaje clínico, pero el enfoque y acercamiento con una terapia conservadora es lo más importante, antes de utilizar técnicas más agresivas como la utilización de fijación rígida con placas de titanio y tornillos. El conocimiento adecuado de los principios biológicos que regulan el crecimiento y desarrollo del esqueleto facial en los niños es esencial para minimizar riesgos y alteraciones en los gérmenes permanentes, anquilosis de las articulaciones temporomandibulares y el crecimiento del esqueleto facial propiamente tal. Este reporte clínico muestra y describe el tratamiento de un niño pre-escolar de 5 años, con fractura parasinfisiaria mandibular expuesta, la cual fue tratada con técnica de reducción no invasiva y estabilización con férula de alambre/composite, y férula interproximal. El alto potencial osteogénico del tejido óseo en niños, permite y favorece un manejo no quirúrgico de estas lesiones. Además, se destaca la importancia de la intervención con un manejo interdisciplinario con diferentes especialidades.
Compared with adult and adolescent population, fractures to facial skeleton and maxillomandibular region are uncommon in paediatric patient, especially in pre-school children under 4-5 years-old. Paediatric bone facial fractures are a particular pathology because it occurs in bone that is at growing process, presence of thin cortical bone, teeth buds development and partially erupted permanent teeth. Require different clinical treatments strategies, so conservative approach is advocated before the use of internal rigid fixation with plates and screws. The knowledge of growing and developmental biologic principles of the facial skull in children is essential to minimize the risks and disturbances at the permanent tooth buds, TMJ ankylosis and facial skeletal growth. This case report showed and described a 5-year-old boy that sustained open fracture of the mandible, whom was successfully treated by close reduction technique with wire composite and proximal splints. The high osteogenic potential of paediatric bone tissue allows non surgical management of these injuries. Moreover, the importance of interdisciplinary management with different specialists is presented.
Assuntos
Humanos , Masculino , Pré-Escolar , Fraturas Maxilomandibulares/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Resultado do TratamentoRESUMO
RATIONALE: It is widely accepted that sleep facilitates memory consolidation. Hypnotics (e.g., benzodiazepines), which reportedly increase sleep efficiency but also modify sleep architecture, could affect memory improvement that occurs during sleep. OBJECTIVES: The present study examined the effects of single doses of two short half-life hypnotics, zolpidem and triazolam, on sleep-induced improvement of memory. METHODS: Twenty-two healthy volunteers participated in this randomized, double-blind, crossover study. All subjects received a single oral dose of zolpidem (10 mg), triazolam (0.25 mg) or placebo at 9 P.M.: and slept for 7.5+/-0.2 h. The effect of sleep on memory was investigated by comparing the performance of this group of volunteers with a group of 21 subjects in wakefulness condition. Declarative memory was evaluated by using a free-recall test of ten standard word and seven nonword lists. Subjects memorized the word and nonword lists 1 h before dosing and they were asked to recall the memorized lists 10 h after dosing. Digit symbol substitution test (DSST) and forward and backward digit tests were also given 1 h before and 10 h after dosing. RESULTS: Subjects who slept remembered more nonwords than those in wakefulness condition, but they did not recall significantly more standard words. Neither zolpidem nor triazolam affected the enhanced nonword recall observed after sleep. Finally, none of the hypnotics affected the improvement in the DSST performance of subjects who slept. CONCLUSIONS: The hypnotics tested did not interfere with the nocturnal sleep-induced improvement of memory.
Assuntos
Rememoração Mental/efeitos dos fármacos , Piridinas/farmacologia , Sono/efeitos dos fármacos , Triazolam/farmacologia , Administração Oral , Adulto , Ritmo Circadiano/fisiologia , Estudos Cross-Over , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/farmacologia , Masculino , Rememoração Mental/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Piridinas/administração & dosagem , Sono/fisiologia , Estatística como Assunto/métodos , Triazolam/administração & dosagem , Vocabulário , ZolpidemRESUMO
We compared the effect of a single bedtime dose of two short half-time hypnotics, brotizolam (0.25 mg) and zopiclone (7.5 mg), on memory storage during sleep in a double blind, placebo-controlled, three-way crossover design trial in eight healthy volunteers. Memory was evaluated using a standard word list free-recall test learned before the bedtime dose by the subjects, who were asked to remember the list the following morning. Digit Symbol Substitution Test revealed no residual sedation by brotizolam or zopiclone. Brotizolam did not affect the morning recall compared to placebo, but subjects remembered less words under zopiclone treatment, suggesting that this drug could affect memory storage during sleep.
Assuntos
Azepinas/farmacologia , Memória/efeitos dos fármacos , Piperazinas/farmacologia , Sono/efeitos dos fármacos , Adolescente , Adulto , Análise de Variância , Compostos Azabicíclicos , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Memória/fisiologia , Sono/fisiologiaRESUMO
Recientes estudios han establecido que las fuerzas mecánicas producen efectos importantes en la estructura y función de los distintos tipos celulares del sistema cardiovascular. El estrés mecánico no sólo afecta las propiedades mecánicas de los cardiomiocitos sino que también a la homeostasis de otras células cardíacas y a la composición y estructura de la matriz extracelular. La estimulación mecánica crónica, clínicamente representada por la hípertensión arterial, produce el desarrollo de hipertrofia y fibrosis, procesos celulares centrales de la remodelación cardíaca patológica, ya sea en forma directa o a través de la liberación y/o producción de diversas substancias neuroendocrinas y factores de crecimiento locales. Aunque no se han identificado y caracterizado del todo aquellos elementos que sensan y transducen molecularmente dichos cambios mecánicos, en esta revisión se recopilan los últimos avances en la mecanotransducción cardíaca y su relación con el proceso de remodelación cardíaca patológica, los cuales abren nuevas expectivas farmacoterapéuticas
Assuntos
Miocárdio/citologia , Estresse Mecânico , Angiotensina II , Matriz Extracelular , Hipertrofia Ventricular Esquerda , Integrinas , Canais Iônicos , Somatomedinas , Fator de Crescimento Transformador betaRESUMO
La hipertrofia ventricular es una respuesta celular a la sobrecarga de presión. Se ha sugerido que el factor de crecimiento análogo a la insulina, tipo I (IGF-I), un polipéptido con mecánismo de acción paracrino y/o endocrino, puede participar como estímulo para el crecimiento celular cardiaco. Usando RIA determinamos los niveles séricos de IGF-I en ratas hipertensas por el mecánismo de Goldblatt de 2 riñones-1 clamp, 9 semanas después de la operación. La hipertrofia ventricular fue evaluada por peso ventricular en relación a peso corporal y por la relación de peso del ventrículo izquierdo al ventrículo derecho. El número de receptores cardiacos de IGF-I de alta afinidad fue determinado por la unión de 125-I IGF-I a las membranas ventriculares a las 3, 6 y 9 semanas siguientes a la cirugía. En relación a los controles, se observó una significativa (p< 0,05) hipertensión sistólica en cada punto: 184 vs 136, 196 vs 131 y 197 vs 136 mmHg, respectivamente. Se documentó hipertrofia ventricular izquierda (relación de peso con VD): 4,8 vs 3,7, 4,6 vs 3,6 y 4,4 vs 3,7. El número de receptores de IGF-I (fmol/mg protein) en los mismos periodos fue 1,6 vs 4,1, 2,3 vs 7,5 y no detectable vs 3,0. Los niveles séricos de IGF-I fueron determinados sólo a las 9 semanas y fueron similares en los animales tratados que en los controles (452 vs 469). Los errores estándar de todos los valores dados fueron menores de 5 por ciento del promedio. La progresiva disminución de los receptores cardiacos de IGF-I puede reflejar un aumento de los niveles tisulares de IGF-I, más aún cuando el nivel sérico de IGF-I no difirió entre los animales tratados y los controles
Assuntos
Animais , Ratos , Hipertrofia Ventricular Esquerda/sangue , Receptor IGF Tipo 1/deficiência , Estudos de Casos e Controles , Hipertensão/etiologia , Hipertensão/sangue , Proteínas Sanguíneas/análise , Radioimunoensaio , Receptor IGF Tipo 1RESUMO
El objetivo del presente trabajo fue el de determinar los requerimientos de propofol versus propofol/midazolam en pacientes oncológicos, durante anestesia total intravenosa. 60 pacientes fueron estudiados en dos grupos; 31 pacientes (grupo control) recibieron propofol y fentanyl para la inducción y mantenimiento de la anestesia, 29 pacientes (grupo experimental), recibieron propofol y midazolam para la inducción anestésica y propofol más fentanyl para el mantenimiento. La combinación de propofol y midazolam redujo los requisitos de propofol y fentanyl para anestesia total intravenosa en este grupo de pacientes